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Doustmohammadi F, Tavoli A, Tanhaye Reshvanloo F, Abaszad A. The Relationship Between Childhood Traumatic Experiences and Bodily Distress Syndrome: The Mediating Role of Somatoform Dissociation. J Genet Psychol 2024; 185:355-365. [PMID: 38456805 DOI: 10.1080/00221325.2024.2315932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/16/2024] [Indexed: 03/09/2024]
Abstract
This research aimed to investigate the relationship between childhood traumatic experiences and bodily distress syndrome, and the mediating role of somatoform dissociation. A total of 241 individuals living in Iran aged 20-40 years (M = 26.41 years, SD = 6.30; 74.7% females) were selected by convenience sampling to participate online in the research in March 2023. They answered the Childhood Trauma Questionnaire (CTQ-SF), the Bodily Distress Syndrome Checklist (BDS-25), and the Somatoform Dissociation Questionnaire (SDQ-20). The results of the structural equation modeling showed that the model had a good fit, and significant relationships were observed between childhood traumatic experiences and bodily distress syndrome, between childhood traumatic experiences and somatoform dissociation, and also between somatoform dissociation and bodily distress syndrome. The results indicated that somatoform dissociation partially mediates the relationship between childhood traumatic experiences and bodily distress syndrome. Furthermore, the prevalence of bodily distress syndrome was higher in the female than the male participants. The results thus highlight the role of childhood traumatic experiences and somatoform dissociation in creating bodily distress syndrome.
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Affiliation(s)
- Fatemeh Doustmohammadi
- Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
| | - Azadeh Tavoli
- Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
| | | | - Asal Abaszad
- Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
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Cheung CTY, Cheng CMH, Lee VWP, Lam SKK, He KL, Ling HWH, Lee K, Ross CA, Fung HW. COULD FAMILY WELL-BEING MODERATE THE RELATIONSHIP BETWEEN ADVERSE CHILDHOOD EXPERIENCES AND SOMATOFORM DISSOCIATION? A PRELIMINARY INVESTIGATION. J Trauma Dissociation 2024; 25:153-167. [PMID: 37424207 DOI: 10.1080/15299732.2023.2233095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 06/05/2023] [Indexed: 07/11/2023]
Abstract
The impacts of adverse childhood experiences (ACEs) have been well documented. One possible consequence of ACEs is dissociation, which is a major feature of post-traumatic psychopathology and is also associated with considerable impairment and health care costs. Although ACEs are known to be associated with both psychoform and somatoform dissociation, much less is known about the mechanisms behind this relationship. Little is known about whether social and interpersonal factors such as family environments would moderate the relationship between ACEs and somatoform dissociation. This paper discusses the importance of having a positive and healthy family environment in trauma recovery. We then report the findings of a preliminary study in which we examined whether the association between ACEs and somatoform dissociation would be moderated by family well-being in a convenience sample of Hong Kong adults (N = 359). The number of ACEs was positively associated with somatoform dissociative symptoms, but this association was moderated by the level of family well-being. The number of ACEs was associated with somatoform dissociation only when the family well-being scores were low. These moderating effects were medium. The findings point to the potential importance of using family education and intervention programs to prevent and treat trauma-related dissociative symptoms, but further investigation is needed.
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Affiliation(s)
- Cherry T Y Cheung
- School of Professional Education and Executive Development, The Hong Kong Polytechnic University, Hong Kong
| | | | - Vincent Wan Ping Lee
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kyle Langjie He
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Henry Wai-Hang Ling
- The Department of Social Work and Social Administration, The University of Hong Kong, Po Fok Lam, Hong Kong
| | - Kunhua Lee
- Department of Educational Psychology and Counseling, National Tsing Hua University, Hsinchu, Taiwan
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, Texas, USA
| | - Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
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Xu J, Wang H, Morrow KE, Xu Y, Gao MM, Hu Y, Suveg C, Han ZR. Respiratory sinus arrhythmia (RSA) dynamics matter for children's emotion regulation: RSA inertia and instability within a stress task. Child Dev 2024; 95:70-81. [PMID: 37467355 DOI: 10.1111/cdev.13976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 05/15/2023] [Accepted: 05/28/2023] [Indexed: 07/21/2023]
Abstract
The present study employed two key dynamic indicators (i.e., inertia and instability) to the psychophysiological research of child emotion regulation (ER) and examined whether respiratory sinus arrhythmia (RSA) dynamics were associated with child ER during a stress task. Eighty-nine Chinese school-age children (Mage = 8.77 years, SD = 1.80 years; 46.1% girls) and their primary caregivers participated in the study. After controlling for RSA static reactivity, multiple regression analyses indicated that lower RSA inertia was related to fewer in-task negative emotions rated by children and their caregivers, and higher RSA instability was associated with better child trait ER. This study introduces physiological indicators of the dynamic aspects of parasympathetic activity to the study of child ER.
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Affiliation(s)
- Jianjie Xu
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, National Demonstration Center for Experimental Psychology Education, National Virtual Simulation Center for Experimental Psychology Education, Beijing Normal University, Beijing, China
| | - Hui Wang
- Department of Psychology, Faculty of Arts and Sciences, Beijing Normal University at Zhuhai, Zhuhai, China
| | | | - Yang Xu
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, National Demonstration Center for Experimental Psychology Education, National Virtual Simulation Center for Experimental Psychology Education, Beijing Normal University, Beijing, China
| | - Mengyu Miranda Gao
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, National Demonstration Center for Experimental Psychology Education, National Virtual Simulation Center for Experimental Psychology Education, Beijing Normal University, Beijing, China
| | - Yueqin Hu
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, National Demonstration Center for Experimental Psychology Education, National Virtual Simulation Center for Experimental Psychology Education, Beijing Normal University, Beijing, China
| | - Cynthia Suveg
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Zhuo Rachel Han
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, National Demonstration Center for Experimental Psychology Education, National Virtual Simulation Center for Experimental Psychology Education, Beijing Normal University, Beijing, China
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Cossette-Côté F, Daigneault I, Lecomte T, Francoeur A, Brassard A. Explaining the Association Between Childhood Maltreatment and Psychological Adjustment in Youth in a Romantic Relationship. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:1119-1132. [PMID: 38045837 PMCID: PMC10689713 DOI: 10.1007/s40653-023-00562-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Flavie Cossette-Côté
- Psychology Department, Université de Montréal, 90 Vincent D’Indy Ave, Outremont, Montréal, QC H2V 2S9 Canada
| | - Isabelle Daigneault
- Psychology Department, Université de Montréal, 90 Vincent D’Indy Ave, Outremont, Montréal, QC H2V 2S9 Canada
| | - Tania Lecomte
- Psychology Department, Université de Montréal, 90 Vincent D’Indy Ave, Outremont, Montréal, QC H2V 2S9 Canada
| | - Audrey Francoeur
- Psychology Department, Université de Montréal, 90 Vincent D’Indy Ave, Outremont, Montréal, QC H2V 2S9 Canada
| | - Audrey Brassard
- Psychology Department, Université de Sherbrooke, 2500, boulevard de l’Université Sherbrooke, Sherbrooke, Québec J1K 2R1 Canada
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Fereidooni F, Daniels JK, D Krause-Utz A, Hagenaars MA, Smeets T, Heins J, Dorahy MJ, Emmerik AAPV, de Jong PJ, Hoekstra S, Warrens MJ, Lommen MJJ. Childhood maltreatment and adulthood victimization: An evidence-based model. J Psychiatr Res 2023; 167:46-62. [PMID: 37832203 DOI: 10.1016/j.jpsychires.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 09/12/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023]
Abstract
There is ample evidence showing that childhood maltreatment increases two to three fold the risk of victimization in adulthood. Various risk factors, including posttraumatic stress disorder (PTSD) symptoms, dissociation, self-blame, and alcohol abuse are related to revictimization. Although previous research examined associations between risk factors for revictimization, the evidence is limited and the proposed models mostly include a handful of risk factors. Therefore, it is critical to investigate a more comprehensive model explaining the link between childhood maltreatment and adulthood (re)victimization. Accordingly, this study tested a data-driven theoretical path model consisting of 33 variables (and their associations) that could potentially enhance understanding of factors explaining revictimization. Cross-sectional data derived from a multi-wave study were used for this investigation. Participants (N = 2156, age mean = 19.94, SD = 2.89) were first-year female psychology students in the Netherlands and New Zealand, who responded to a battery of questionnaires and performed two computer tasks. The path model created by structural equation modelling using modification indices showed that peritraumatic dissociation, PTSD symptoms, trauma load, loneliness, and drug use were important mediators. Attachment styles, maladaptive schemas, meaning in life, and sex motives connected childhood maltreatment to adulthood victimization via other factors (i.e., PTSD symptoms, risky sex behavior, loneliness, emotion dysregulation, and sex motives). The model indicated that childhood maltreatment was associated with cognitive patterns (e.g., anxious attachment style), which in turn were associated with emotional factors (e.g., emotion dysregulation), and then with behavioral factors (e.g., risky sex behavior) resulting in revictimization. The findings of the study should be interpreted in the light of the limitations. In particular, the cross-sectional design of the study hinders us from ascertaining that the mediators preceded the outcome variable.
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Affiliation(s)
- Fatemeh Fereidooni
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands
| | - Judith K Daniels
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands.
| | - Anne D Krause-Utz
- Department of Clinical Psychology, Leiden University, the Netherlands
| | | | - Tom Smeets
- Department of Medical and Clinical Psychology, Tilburg University, the Netherlands
| | - Jenna Heins
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Martin J Dorahy
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | | | - Peter J de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands
| | - Steven Hoekstra
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands
| | - Matthijs J Warrens
- Department of Educational Sciences, University of Groningen, the Netherlands
| | - Miriam J J Lommen
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands
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Schmitz M, Back SN, Seitz KI, Harbrecht NK, Streckert L, Schulz A, Herpertz SC, Bertsch K. The impact of traumatic childhood experiences on interoception: disregarding one's own body. Borderline Personal Disord Emot Dysregul 2023; 10:5. [PMID: 36788573 PMCID: PMC9930318 DOI: 10.1186/s40479-023-00212-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/01/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Deficient interoception, the processing and perception of internal bodily signals, has been discussed as a mechanism underlying various mental disorders. First results indicate a mediating role of interoception in the interplay of traumatic childhood experiences and adult mental disorders. Traumatic childhood experiences may hinder the adequate processing, integration, and trust in bodily signals that are important in order to understand and regulate own needs and emotions, thereby increasing the vulnerability for mental disorders. However, an overarching study investigating alterations in different interoceptive measures and trauma-related disorders as well as their mediating role between early trauma and emotion dysregulation is still missing. METHODS One hundred thirty-six individuals with varying levels of traumatic childhood experiences who either had a current diagnosis of major depression, posttraumatic stress disorder, or somatic symptom disorder, or no mental disorder, took part in a multidimensional assessment of interoceptive processes, including interoceptive accuracy, sensibility, and awareness. Kruskal-Wallis tests were used to compare groups regarding interoceptive processes and associations with traumatic childhood experiences and emotion dysregulation were analyzed with Spearman correlations. Furthermore, mediation analyses were computed to examine and compare interoceptive processes as potential mediators between traumatic childhood experiences and emotion dysregulation. RESULTS Only body dissociation, a measure for interoceptive sensibility, was significantly reduced in individuals with a current mental disorder. Body dissociation was also the only interoceptive measure significantly associated with traumatic childhood experiences and emotion dysregulation and the only significant mediator in the relationship between traumatic childhood experiences and emotion dysregulation across groups. CONCLUSION Results suggest body dissociation, but not other interoceptive measures, as an important feature linking traumatic childhood experiences to current emotion dysregulation, an important transdiagnostic feature. As body dissociation refers to a habitual non-attendance or disregard of interoceptive signals, integrative therapeutic interventions could help affected individuals to overcome difficulties in emotion perception and regulation. TRIAL REGISTRATION The general study design was preregistered; see the German Clinical Trials Register (DRKS-ID: DRKS00015182). This study's analysis plan was not preregistered.
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Affiliation(s)
- Marius Schmitz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany. .,Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany. .,Institute of Psychology, University of Heidelberg, Heidelberg, Germany.
| | - Sarah N Back
- Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Katja I Seitz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.,Institute of Psychology, University of Heidelberg, Heidelberg, Germany
| | - Nele K Harbrecht
- Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Lena Streckert
- Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - André Schulz
- Department of Behavioural and Cognitive Sciences, Clinical Psychophysiology Laboratory, University of Luxembourg, Esch-Sur-Alzette, Luxembourg
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.,Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
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Cristofanelli S, Baccini G, Centonze E, Colombesi A, Cariello M, Ferro L. Can Dissociation Mediate the Relationship between Emotional Dysregulation and Intelligence? An Empirical Study Involving Adolescents with and without Complex Trauma Histories. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1729. [PMID: 36767096 PMCID: PMC9913985 DOI: 10.3390/ijerph20031729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/10/2023] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
The main aim of the study was to map the psychological functioning of individuals with adverse childhood experiences, with the objective to characterize developmental trajectories. Specifically, we investigated the relations among three of the seven domains of impairment in children and adolescents who had been exposed to complex trauma. To this end, we tested a mediation model with emotional dysregulation as the independent variable, intelligence as the dependent variable, and dissociation as the mediator. The research sample was composed of 64 participants (10-19 years old); 31 adolescents formed the clinical group and 33 the non-clinical group; for the clinical group, we recruited adolescents who were residents of therapeutic communities and had a history of complex trauma. Both groups completed the Difficulties in emotion regulation scale (DERS), Adolescent dissociative experience scale (A-DES), Trauma symptom checklist for children (TSCC), and Wechsler scales. The data analysis yielded significant results for the control group only. We suggest that healthy adolescents adopt a non-pathological dissociative cognitive style in response to increased emotional dysregulation, thus explaining their enhanced cognitive performance.
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Affiliation(s)
- Stefania Cristofanelli
- Department of Psychology, Faculty of Psychology, University of Valle d’Aosta, 11100 Aosta, Italy
| | | | | | | | | | - Laura Ferro
- Department of Psychology, Faculty of Psychology, University of Valle d’Aosta, 11100 Aosta, Italy
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Doba K, Saloppé X, Choukri F, Nandrino JL. Childhood trauma and posttraumatic stress symptoms in adolescents and young adults: The mediating role of mentalizing and emotion regulation strategies. CHILD ABUSE & NEGLECT 2022; 132:105815. [PMID: 35914329 DOI: 10.1016/j.chiabu.2022.105815] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/13/2022] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Childhood trauma (physical, emotional, sexual abuse and/or physical and emotional neglect) represents a specific risk for developmental perturbations and long-term negative outcomes. Adolescents and young adults with childhood trauma have rarely experienced a single type of traumatic event but rather multiple traumatic experiences. However, studies on adolescent PTSD are sparse. This study examines the possible mediating role of mentalizing, cognitive and interpersonal emotion regulation strategies between multiple types of childhood trauma exposure and PTSD in adolescents and young adults. METHODS The sample consisted of 456 adolescents and young adults aged 15 and 25, recruited from four high schools and one university. Participants completed self-report questionnaires assessing childhood trauma, mentalizing, cognitive and interpersonal strategies of emotion regulation and PTSD. RESULTS Structural Equation Modeling revealed that multiple types of childhood trauma exposure have a significant indirect effect on PTSD symptoms through its association with hypomentalizing and maladaptive cognitive strategies of emotion regulation (i.e. self-blame, rumination, catastrophizing). Results also showed a significant indirect effect between multiple types of childhood trauma exposure and PTSD symptoms through its association with hypomentalizing and maladaptive interpersonal strategies of emotion regulation (i.e. emotional reactivity and tendency to avoid emotional connection). Indirect paths were also run in reverse to control for the direction of the effect. CONCLUSION Our findings show that exposure to multiple types of childhood trauma contributes to severe PTSD through several complex pathways including both hypomentalizing and maladaptive emotion regulation strategies in adolescence and young adulthood.
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Affiliation(s)
- Karyn Doba
- University of Lille, CNRS, UMR 9193-SCALab, Sciences Cognitives et Sciences Affectives, F-59000 Lille, France; Fondation Santé des Etudiants de France, Clinique FSEF Villeneuve d'Ascq, 59653 Villeneuve d'Ascq, France.
| | - Xavier Saloppé
- University of Lille, CNRS, UMR 9193-SCALab, Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| | - Fatima Choukri
- University of Lille, CNRS, UMR 9193-SCALab, Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| | - Jean-Louis Nandrino
- University of Lille, CNRS, UMR 9193-SCALab, Sciences Cognitives et Sciences Affectives, F-59000 Lille, France; Fondation Santé des Etudiants de France, Clinique FSEF Villeneuve d'Ascq, 59653 Villeneuve d'Ascq, France
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Pfluger V, Rohner SL, Eising CM, Maercker A, Thoma MV. Internalizing Mental Health Disorders and Emotion Regulation: A Comparative and Mediational Study of Older Adults With and Without a History of Complex Trauma Exposure. Front Psychol 2022; 13:820345. [PMID: 35814079 PMCID: PMC9260226 DOI: 10.3389/fpsyg.2022.820345] [Citation(s) in RCA: 2] [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: 11/22/2021] [Accepted: 05/17/2022] [Indexed: 12/04/2022] Open
Abstract
Individuals with complex trauma exposure (CTE) in early life (i.e., childhood/adolescence) are at heightened risk for developing problems in various domains of functioning. As such, CTE has repeatedly been linked to internalizing mental health disorders, such as depression and anxiety, as well as emotion dysregulation across the lifespan. While these correlates of CTE are comparatively well studied up to middle adulthood, they are insufficiently studied in older adulthood. Therefore, this study aimed to (a) compare Swiss older adults with and without a CTE history regarding current and lifetime internalizing mental health disorders and emotion regulation strategies; and (b) to examine the potential mediating role of emotion regulation in the mental health disparities between these groups. A total of N = 257 participants (age = 49-95 years; 46.3% female) were assessed in a retrospective, cross-sectional study, using two face-to-face interviews. The CTE group (n = 161; M age = 69.66 years, 48.4% female) presented with significantly more current and lifetime internalizing mental health disorders than the non-affected (nCTE) group (n = 96; M age = 72.49 years, 42.7% female). The CTE group showed significantly higher emotion suppression and lower emotion reappraisal compared to the nCTE group. Mediation analysis revealed that the two emotion regulation strategies were significant mediators between CTE history and internalizing mental health disorders. Findings emphasize the relevance of emotion (dys-)regulation in understanding mental health disparities in older age and deciding about treatment strategies. Research and practice should pay more attention to the needs of this high-risk group of older individuals.
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Affiliation(s)
- Viviane Pfluger
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Shauna L. Rohner
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Carla M. Eising
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Myriam V. Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
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Ford JD, Charak R, Karatzias T, Shevlin M, Spinazzola J. Can developmental trauma disorder be distinguished from posttraumatic stress disorder? A symptom-level person-centred empirical approach. Eur J Psychotraumatol 2022; 13:2133488. [PMID: 36340008 PMCID: PMC9635476 DOI: 10.1080/20008066.2022.2133488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Developmental Trauma Disorder (DTD) is a proposed childhood psychiatric diagnosis for psychopathological and developmental sequela of victimization and attachment trauma extending beyond posttraumatic stress disorder (PTSD). OBJECTIVE To determine whether a sub-group of trauma-impacted children is characterized by symptoms of DTD that extend beyond, or co-occur with, the symptoms of PTSD. METHOD Person-centred Latent Class Analyses (LCA) were done with data from 507 children (ages 7-18 years, (M = 12.11, SD = 2/92); 49% female) referred to the study by mental health or paediatric clinicians. RESULTS A four class solution was optimal (LMR = 398.264, p < .001; Entropy = .93): (1) combined DTD + PTSD (n = 150); (2) predominant DTD (n = 156); (3) predominant PTSD (n = 54); (4) minimal symptoms (n = 147). Consistent with prior research, the DTD + PTSD class was most likely to have experienced traumatic emotional abuse and neglect (X2 (3) = 16.916 and 28.016, respectively, p < .001), and had the most psychiatric comorbidity (F(3, 502) = 3.204, p < .05). Predominant DTD class members were most likely to meet criteria for Oppositional Defiant Disorder (ODD) (X2(3) = 84.66, p < .001). CONCLUSION Symptoms of DTD may occur with, or separately from, PTSD symptoms. Children with high DTD|+PTSD symptoms had extensive psychiatric comorbidity, while those with high DTD symptoms and minimal PTSD symptoms were highly likely to meet criteria for ODD. In clinical and research assessment and treatment of children with complex psychiatric comorbidity or disruptive behaviour problems, symptoms of DTD should be considered, both along with, and in the absence of, PTSD symptoms.
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Affiliation(s)
- Julian D Ford
- Department of Psychiatry, University of Connecticut Health Center MC1410, Farmington, CT, USA
| | - Ruby Charak
- University of Texas Rio Grande Valley, Edinburg, TX, USA
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Glaus J, Moser DA, Rusconi Serpa S, Jouabli S, Turri F, Plessen KJ, Schechter DS. Families With Violence Exposure and the Intergenerational Transmission of Somatization. Front Psychiatry 2022; 13:820652. [PMID: 35280182 PMCID: PMC8904725 DOI: 10.3389/fpsyt.2022.820652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Adults who have histories of childhood trauma have been noted to display greater somatization, dissociative symptoms and affect dysregulation. What happens in the parent-child relationship when those traumatized children become parents? A potential link to somatization in the child has been suggested by several prior studies. Children who have early attachment disturbances had more physical complaints if their mothers displayed less maternal sensitivity during observed parent-child interactions. Yet, the intergenerational link between maternal and child somatization has not been sufficiently explored in a longitudinal study in order to understand the potential impact of maternal trauma history and related psychopathology on subsequent child somatization and psychopathology. METHODS This paper examined prospective, longitudinal data of 64 mother-toddler dyads (mean age = 2.4 years, SD = 0.7) who were later studied when children had a mean age of 7 years. Mothers with and without histories of interpersonal violence (IPV; physical/sexual abuse and/or family violence exposure) were included. Mothers with IPV histories were oversampled. Linear and Poisson regression models were used to test the associations between maternal IPV-related post-traumatic stress disorder (PTSD) with maternal somatization severity when children were toddlers, and between maternal somatization and maternal interactive behaviors with child somatization by maternal report and clinician-rated assessment at school-age. RESULTS Maternal PTSD severity was significantly associated with increased maternal somatization severity (p = 0.031). Maternal somatization severity during the child's early childhood predicted both maternal report of child somatization (p = 0.011) as well as child thought problems (p = 0.007) when children were school-aged. No association was found between maternal somatization and child-reported psychopathology. The study did not find that maternal alexithymia, caregiving behaviors or child exposure to violence contributed significantly to the model examining the association between maternal and child somatization. CONCLUSION The results are in line with the hypothesis of intergenerational transmission of somatization in the context of IPV and related maternal PTSD during formative early development. We interpret this as an expression of psychological distress from mother to child, as maternal trauma and pathology affect the caregiving environment and, thus, the parent-child relationship. The authors conclude with a discussion of implications for parent-infant and early childhood intervention.
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Affiliation(s)
- Jennifer Glaus
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Dominik A Moser
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | | | - Sondes Jouabli
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Fiorella Turri
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Kerstin J Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Daniel S Schechter
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.,Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, United States
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12
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Stroink L, Mens E, Ooms MHP, Visser S. Maladaptive schemas of patients with functional neurological symptom disorder. Clin Psychol Psychother 2021; 29:933-940. [PMID: 34585455 DOI: 10.1002/cpp.2671] [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: 02/08/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND The psychological underpinnings of functional neurological symptom disorders (FNSD) remain poorly understood. A disintegration of explicit and implicit information processing in patients with FNSD has previously been suggested; however, this suggestion has so far received little empirical support. Trauma and maladaptive schemas probably reinforce disintegration in FNSD. The present study explored the occurrence of maladaptive schemas and investigated the impact of trauma-related maladaptive schemas in patients with FNSD. METHODS Forty-eight FNSD patients were assessed at the start of treatment using the Young Schema Questionnaire (YSQ-2) to explore maladaptive schemas. The Life Event Checklist (LEC-5) and the PTSD Checklist for DSM-5 (PCL-5) were used to explore trauma states, and the Sickness Impact Profile (SIP-68) was used to measure health dysfunction. RESULTS The self-sacrifice schema scored within a clinically relevant range where no increased scores were found in other maladaptive schemas. Linear regression models showed a positive association between mistrust/abuse and severity of health dysfunction. DISCUSSION Results suggest that maladaptive schemas play a modest role in FNSD at the start of treatment. It is suggested to examine the occurrence of maladaptive schemas in FNS-disordered patients with a longitudinal design.
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Affiliation(s)
- Luuk Stroink
- Pro Persona Integrated Mental Health Care, Pro Persona Behavioral Science Institute, Nijmegen, The Netherlands
| | - Ellen Mens
- Department of Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
| | - Martijn H P Ooms
- Department of Rehabilitation Medicine, Klimmendaal Rehabilitation Medical Center, Arnhem, The Netherlands
| | - Sako Visser
- Pro Persona Integrated Mental Health Care, Pro Persona Behavioral Science Institute, Nijmegen, The Netherlands
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13
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Pitluk M, Elboim-Gabyzon M, Shuper Engelhard E. Validation of the grounding assessment tool for identifying emotional awareness and emotion regulation. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2021.101821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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14
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Schmitz M, Bertsch K, Löffler A, Steinmann S, Herpertz SC, Bekrater-Bodmann R. Body connection mediates the relationship between traumatic childhood experiences and impaired emotion regulation in borderline personality disorder. Borderline Personal Disord Emot Dysregul 2021; 8:17. [PMID: 34001243 PMCID: PMC8127297 DOI: 10.1186/s40479-021-00157-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/12/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Previous studies revealed an association between traumatic childhood experiences and emotional dysregulation in patients with borderline personality disorder (BPD). However, possible mediating pathways are still not fully understood. The aim of the present study was to investigate the potential mediating role of body connection, describing the awareness of the relationship of bodily and mental states, for the association between a history of traumatic childhood experiences and BPD core symptomatology. METHODS One-hundred-twelve adult female individuals with BPD and 96 healthy female controls (HC) were included. Impaired emotion regulation, traumatic childhood experiences, and BPD symptomatology were assessed with self-report questionnaires. The Scale of Body Connection was used to assess two dimensions of body connection, that is body awareness, describing attendance to bodily information in daily life and noticing bodily responses to emotions and/or environment and body dissociation, describing a sense of separation from one's own body, due to avoidance or emotional disconnection. Mann-Whitney U tests were employed to test for group differences (BPD vs. HC) on the two SBC subscales and associations with clinical symptoms were analyzed with Spearman correlations. We performed mediation analyses in the BPD group to test the assumption that body connection could act as a mediator between a history of traumatic childhood experiences and emotion dysregulation. RESULTS Individuals with BPD reported significantly lower levels of body awareness and significantly higher levels of body dissociation compared to HC. Body dissociation, traumatic childhood experiences, and emotion dysregulation were significantly positively associated. Further analyses revealed that body dissociation, but not body awareness, significantly and fully mediated the positive relationship between traumatic childhood experiences and impaired emotion regulation in the BPD sample. This mediation survived when trait dissociation, i.e., general dissociative experiences not necessarily related to the body, was statistically controlled for. CONCLUSION Certain dimensions of body connection seem to be disturbed in BPD patients, with body dissociation being an important feature linking a history of traumatic childhood experiences to current deficits in emotion regulation.
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Affiliation(s)
- Marius Schmitz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
- Department of Psychology, LMU Munich, Munich, Germany
| | - Annette Löffler
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sylvia Steinmann
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Robin Bekrater-Bodmann
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
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15
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Ford JD, Courtois CA. Complex PTSD and borderline personality disorder. Borderline Personal Disord Emot Dysregul 2021; 8:16. [PMID: 33958001 PMCID: PMC8103648 DOI: 10.1186/s40479-021-00155-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/09/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND This article builds on a previous review (Ford and Courtois, Borderline Personal Disord Emot Dysregul 1:9, 2014) which concluded that complex posttraumatic stress disorder (cPTSD) could not be conceptualized as a sub-type of either PTSD or BPD. Recent research is reviewed that extends and clarifies the still nascent understanding of the relationship between cPTSD and BPD. MAIN BODY The circumscribed formulation of adult cPTSD that has been developed, validated, and included in the 11th Edition of the International Classification of Diseases has spurred research aimed at differentiating cPTSD and BPD both descriptively and empirically. A newly validated Developmental Trauma Disorder (DTD) syndrome for children and adolescents provides a basis for systematic research on the developmental course and origins of adult cPTSD and BPD. This review summarizes recent empirical findings regarding BPD, PTSD, and cPTSD in terms of: (1) prevalence and comorbidity; (2) clinical phenomenology; (3) traumatic antecedents; (4) psychobiology; (5) emotion dysregulation; (6) dissociation; and (7) empirically supported approaches to clinical assessment and psychotherapeutic treatment. CONCLUSION The evidence suggests that PTSD, cPTSD, and BPD are potentially comorbid but distinct syndromes. A hypothesis is advanced to stimulate scientific research and clinical innovation defining and differentiating the disorders, positing that they may represent a continuum paralleling the classic conceptualization of the stress response, with dissociation potentially involved in each disorder.
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Affiliation(s)
- Julian D Ford
- University of Connecticut Health Center MC1410, 263 Farmington Avenue, Farmington, CT, 06030-1410, USA.
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16
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Childhood maltreatment, personality vulnerability profiles, and borderline personality disorder symptoms in adolescents. Dev Psychopathol 2021; 34:1163-1176. [PMID: 33494855 DOI: 10.1017/s0954579420002151] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Adverse childhood experiences are significant risk factors in the development of adolescent borderline personality disorder symptoms (BPDs). Theorists have posited that two personality vulnerabilities factors, self-criticism and dependency, may inform our understanding of this relationship. However, no research has examined the associations between early negative experiences, personality vulnerabilities, and adolescent BPDs. The current study aimed to identify profiles of dependency and self-criticism to examine the associations of these profiles with cumulative forms of childhood maltreatment (CM) and BPDs as well as to explore the mediating and moderating role of vulnerable personality profiles in the relationship between cumulative CM and BPDs. Two hundred and forty-one nonclinical and clinical adolescents participated in the study (Mage = 16.37, SD = 1.84). The findings indicated three different profiles: average dependent profile, dependent and self-critical profile, and self-critical profile. Individuals in the average dependent profile presented lower levels of CM and BPDs. Mediation analyses showed that relative to the average dependent profile, a higher cumulative CM history predicted a higher probability of belonging in the dependent and self-critical profile or the self-critical profile and, in turn, this was associated with higher levels of BPDs. No moderating effects of profiles of dependency and self-criticism were found.
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17
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Janů A, Malinakova K, Kosarkova A, Tavel P. Associations of childhood trauma experiences with religious and spiritual struggles. J Health Psychol 2020; 27:292-304. [PMID: 32830557 DOI: 10.1177/1359105320950793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Childhood trauma is associated with many interpersonal and psychosocial problems in adulthood. The aim of this study was to explore the associations with a spiritual area of personality, namely religious and spiritual struggles (R/S struggles). A nationally representative sample of 1,000 Czech respondents aged 15 years and older participated in the survey. All types of CT were associated with an increased level of all six types of R/S struggles, with the highest values for demonic struggles. Thus, the findings of this study might be important for clinical practice and pastoral care as well as a further research.
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Affiliation(s)
- Anna Janů
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Klara Malinakova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Alice Kosarkova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Peter Tavel
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
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