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Hautle LL, Kurath J, Jellestad L, Lüönd AM, Wingenbach TSH, Jansson B, Pfaltz MC. Larger comfortable interpersonal distances in adults exposed to child maltreatment: The role of depressive symptoms and social anxiety. Br J Psychol 2024; 115:599-615. [PMID: 38651545 DOI: 10.1111/bjop.12705] [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: 10/17/2022] [Revised: 03/15/2024] [Accepted: 03/24/2024] [Indexed: 04/25/2024]
Abstract
Previous studies report a preference for larger comfortable interpersonal distance (CIPD) in individuals with child maltreatment (CM) when being approached by others. Yet, research on approaching others, as opposed to being approached, as well as on potential effects of social anxiety and depression is lacking. We investigated if CM and depressive symptoms influence CIPD and if social anxiety mediates the possible association of CM and CIPD when approaching a female stranger. One hundred ten participants with CM (CM) and 58 participants without CM (non-CM) experiences performed the stop-distance paradigm and stopped first when feeling uncomfortable (D1) and again when feeling very uncomfortable (D2). CM experiences were associated with a preference for larger CIPD, independent of depressive symptoms. All CM subtypes were associated with a larger D2. The relationship between CM and CIPD was partially mediated by social anxiety. These novel findings can help to develop interventions strengthening socially relevant skills and processes in those affected by CM, targeting alterations in social anxiety and depression.
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Affiliation(s)
- Lara-Lynn Hautle
- Medical Faculty, University of Zurich, Zürich, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
| | - Jennifer Kurath
- Medical Faculty, University of Zurich, Zürich, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
| | - Lena Jellestad
- Medical Faculty, University of Zurich, Zürich, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
| | - Antonia M Lüönd
- Medical Faculty, University of Zurich, Zürich, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
| | - Tanja S H Wingenbach
- Medical Faculty, University of Zurich, Zürich, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
- School of Human Sciences, Faculty of Education, Health, and Human Sciences, University of Greenwich, London, UK
| | - Billy Jansson
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Monique C Pfaltz
- Medical Faculty, University of Zurich, Zürich, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
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Colley D, Seidler J, Rasch L, Gahr B, Küppers L, Mayatepek E, De Bock F. Systematic review of variables that moderate and/or mediate the relationship between child maltreatment and adverse outcomes: a study protocol. BMJ Open 2024; 14:e079537. [PMID: 39448213 PMCID: PMC11499797 DOI: 10.1136/bmjopen-2023-079537] [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] [Received: 09/04/2023] [Accepted: 05/21/2024] [Indexed: 10/26/2024] Open
Abstract
INTRODUCTION Child maltreatment (CM) is associated with adverse cognitive, behavioural, physical and social outcomes that often continue until adulthood. Systematic reviews on mediators and moderators of this relationship mostly investigate childhood adversities in general or only with regard to an adult population, single outcomes or single forms of maltreatment. The purpose of this review is to synthesise the evidence of variables that mediate and/or moderate the relationship between CM and diverse outcomes. METHOD A systematic search will be performed in Scopus, PsychInfo, Medline and Web of Science until January 2022. Eligibility criteria include children under 18 years who have been maltreated and experienced adverse outcomes until the age of 21, moderators and/or mediators that influence the relationship between maltreatment and adverse outcomes must belong to the individual level and be amenable to change. After independent screening of studies by two reviewers, data extraction and study quality of included studies will be done using adapted checklists of similar reviews, the Strengthening the Reporting of Observational Studies in Epidemiology report, the COnsensus-based Standards for the selection of health Measurement INstruments checklist and Downs and Black Checklist. The results will be presented in narrative form and, if adequate, meta-analysis. ETHICS AND DISSEMINATION Ethics approval will not be required. The results of this systematic review will be submitted for publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42022297982.
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Affiliation(s)
- Denise Colley
- Klinik für allgemeine Pädiatrie, Neonatologie und Kinderkardiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
- Heinrich-Heine-Universität Düsseldorf, Dusseldorf, Germany
| | - Jenny Seidler
- Klinik für allgemeine Pädiatrie, Neonatologie und Kinderkardiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
- Heinrich-Heine-Universität Düsseldorf, Dusseldorf, Germany
| | - Lena Rasch
- Klinik für allgemeine Pädiatrie, Neonatologie und Kinderkardiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
- Heinrich-Heine-Universität Düsseldorf, Dusseldorf, Germany
| | - Britta Gahr
- Universitätsklinikum Düsseldorf Institut für Rechtsmedizin, Düsseldorf, Germany
| | - Lisa Küppers
- Universitätsklinikum Düsseldorf Institut für Rechtsmedizin, Düsseldorf, Germany
| | - Ertan Mayatepek
- Klinik für allgemeine Pädiatrie, Neonatologie und Kinderkardiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Freia De Bock
- Klinik für allgemeine Pädiatrie, Neonatologie und Kinderkardiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
- Heinrich-Heine-Universität Düsseldorf, Dusseldorf, Germany
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Nadaraia T, Whittaker E, Kenyon I, Boonpor J, Zhou Z, Nakada S, Rochmawati ID, Celis-Morales C, Ward J, Rod NH, Pell JP, Minnis H, Hehlmann T, Ho FK, Mackay D. Childhood maltreatment, adulthood obesity and incident type 2 diabetes: a retrospective cohort study using UK Biobank. Int J Obes (Lond) 2024:10.1038/s41366-024-01652-x. [PMID: 39407013 DOI: 10.1038/s41366-024-01652-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 10/03/2024] [Accepted: 10/07/2024] [Indexed: 10/18/2024]
Abstract
BACKGROUND This study aims to explore the association of childhood maltreatment with obesity and type 2 diabetes (T2D) in adulthood, and whether obesity is a mediator of the latter. METHODS In a retrospective cohort study using UK Biobank data, participants recalled childhood maltreatment. Linear regression, logistic regression, and Cox proportional hazard models were used to investigate the associations with body mass index (BMI), obesity, and T2D, adjusted for sociodemographic factors. Decomposition analysis was used to examine the extent to which T2D excess risk was attributed to BMI. RESULTS Of the 153,601 participants who completed the childhood maltreatment questions, one-third reported some form of maltreatment. Prevalence of adult obesity and incidence of T2D were higher with the number of reported childhood maltreatment types. People who reported ≥3 types of childhood maltreatment were at higher risk of obesity (OR 1.55, 95% CI 1.47-1.63) and incident T2D (HR 1.65, 95% CI 1.52-1.80). Excess T2D risk among those reporting maltreatment could be reduced by 39% if their BMI was comparable to participants who had not been maltreated, assuming causality. CONCLUSIONS People who recalled maltreatment in childhood are at higher risk of T2D in adulthood, partly due to obesity.
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Affiliation(s)
- Tamta Nadaraia
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Department of Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Ed Whittaker
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Jirapitcha Boonpor
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Faculty of Public Health, Kasetsart University, Sakon Nakhon, Thailand
| | - Ziyi Zhou
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Shinya Nakada
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Ike Dhiah Rochmawati
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Faculty of Pharmacy, University of Surabaya, Surabaya, Indonesia
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
- Centro de Investigación en Medicina de Altura (CEIMA), Universidad Arturo Prat, Iquique, Chile
| | - Joey Ward
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Naja Hulvej Rod
- Copenhagen Health Complexity Center, University of Copenhagen, Copenhagen, Denmark
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Helen Minnis
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Thomas Hehlmann
- Department of Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Daniel Mackay
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Eberhardt A, Sterz-Burdack V, König E, Fegert JM, Hoffmann U. [Knowledge and implementation of institutional safeguarding measures in German hospitals as part of medical child protection]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:1180-1189. [PMID: 39279015 PMCID: PMC11424674 DOI: 10.1007/s00103-024-03948-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 08/20/2024] [Indexed: 09/18/2024]
Abstract
BACKGROUND Recent studies show the high prevalence of child maltreatment in Germany and that assaults by hospital staff also pose a problem. Since 2020, the Joint Federal Committee has been calling for institutional safeguarding measures (ISM) to protect and support those affected in hospitals. The aim of this study is to analyze the level of knowledge and action competencies regarding child maltreatment among hospital staff and the extent to which ISM are implemented in hospitals. METHODS A survey was administered to 1011 participants before they took part in two online courses on child protection and protection measures in hospitals, with questions regarding self-assessed level of knowledge and competence on child protection and the occurrence of cases of maltreatment and protective measures in their own institution. Data were analyzed using descriptive methods. RESULTS It becomes apparent that the knowledge and competencies of hospital staff regarding child protection are in the middle range. In hospitals, cases of maltreatment that occur outside the institution are particularly common, but violence by staff or other patients of the same age also plays a significant role. Of the respondents, 93.6% stated that their institution had already developed at least one element of an ISM, but only 1.0% of respondents reported that all the elements surveyed had already been fully developed. DISCUSSION Hospitals in Germany seem to be largely on the path to better protect children and adolescents from maltreatment and to support those affected. However, there are still deficits in the competencies of employees and the implementation of the ISM elements. More resources need to be made available by hospital operators and the public sector for this purpose.
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Affiliation(s)
- Anna Eberhardt
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Uniklinikum Ulm, Steinhövelstr. 5, 89075, Ulm, Deutschland.
| | - Verena Sterz-Burdack
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Uniklinikum Ulm, Steinhövelstr. 5, 89075, Ulm, Deutschland
| | - Elisa König
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Uniklinikum Ulm, Steinhövelstr. 5, 89075, Ulm, Deutschland
| | - Jörg M Fegert
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Uniklinikum Ulm, Steinhövelstr. 5, 89075, Ulm, Deutschland
| | - Ulrike Hoffmann
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Uniklinikum Ulm, Steinhövelstr. 5, 89075, Ulm, Deutschland
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5
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Clemens V, Jarczok M, Fegert JM, Brähler E, Jud A. Timing and chronicity of child maltreatment in Germany: results from a representative sample. Public Health 2024; 235:173-179. [PMID: 39146658 DOI: 10.1016/j.puhe.2024.06.019] [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: 12/08/2023] [Revised: 05/12/2024] [Accepted: 06/16/2024] [Indexed: 08/17/2024]
Abstract
OBJECTIVES Child maltreatment (CM) is a major risk factor across the lifespan. While research on CM and its consequences has risen strongly during the last decades, research is mainly focused on the prevalence of types of CM incidents. As valid prevalence rates on timing and chronicity of CM are lacking to date, we aimed to assess the timing of experienced CM by describing the age of onset, duration, and prevalence at each year of age for each CM subtype in a population-based sample. STUDY DESIGN Cross-sectional, observational study in a representative sample. METHODS Using different sampling steps including a random route procedure, a probability sample of the German population above the age of 16, encompassing 2514 persons (50.6% female, mean age: 50.08 years) was generated. Participants were asked about sociodemographic information in a face-to-face interview, CM was assessed using the ICAST-R questionnaire. RESULTS The earliest mean age of onset was seen in neglect with 8.07 (±3.07) years for boys and 7.90 (±2.96) years for girls, while the mean age of onset for sexual abuse was in adolescence with 13.65 (±3.86) years for boys and 13.91(±3.17) years for girls. The overall duration of CM was lowest for sexual abuse with 2.12 (±2.01) years for boys and 2.35 (±1.73) years for girls, the highest duration was seen for emotional abuse with 4.00 (±3.54) years for boys and 4.21 (±3.77) years for girls. CONCLUSIONS Our novel results provide important epidemiological information for prevention efforts.
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Affiliation(s)
- V Clemens
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Germany.
| | - M Jarczok
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Germany
| | - J M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Germany; Competence Center Child Protection in Medicine Baden-Württemberg, Ulm, Germany
| | - E Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz of the Johannes Gutenberg University Mainz, Germany; Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Germany
| | - A Jud
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Germany; Competence Center Child Protection in Medicine Baden-Württemberg, Ulm, Germany
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6
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Amiri S, Mahmood N, Yusuf R, Ghenimi N, Javaid SF, Khan MAB. Adverse Childhood Experiences and Risk of Abnormal Body Mass Index: A Global Systematic Review and Meta-Analysis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1015. [PMID: 39201949 PMCID: PMC11352292 DOI: 10.3390/children11081015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 07/23/2024] [Accepted: 08/12/2024] [Indexed: 09/03/2024]
Abstract
(1) Objectives: The impact of abnormal body mass index (BMI) on health is extensive, and various risk factors contribute to its effects. This study aimed to examine the association between adverse childhood experiences (ACEs) and BMI categories, including underweight, overweight, obesity, severe obesity, and morbid obesity; (2) Methods: Three databases were searched: Web of Science, PubMed, and Scopus. Manual searches were conducted using Google Scholar and ResearchGate. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the association between ACEs and BMI. A random-effects model was used to combine the ORs and CIs across studies; (3) Results: This meta-analysis included 71 studies. The pooled ORs for the relationship between ACEs and obesity was 1.42 (95% CI: 1.24-1.63, Z = 4.96, p < 0.001), indicating a significant association. ACEs showed a positive association with overweight (OR = 1.16, 95% CI: 1.06-1.27, Z = 3.24, p = 0.001). Specifically, ACEs ≥ 4 were strongly associated with obesity (OR = 2.06, 95% CI: 1.27-3.36, Z = 2.90, p = 0.004). Sexual abuse was also found to be significantly associated with obesity (OR = 1.46, 95% CI: 1.29-1.65, Z = 5.98, p < 0.001); (4) Conclusion: This study finds that individuals who have experienced ACEs are more likely to have a higher BMI in adulthood. Therefore, ACEs should be considered a factor associated with abnormal BMI.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran 17166, Iran;
| | - Nailah Mahmood
- Division of Health Research, Lancaster University, Lancaster LA1 4YW, UK;
| | - Rahemeen Yusuf
- Emirates Center for Happiness Research, United Arab Emirates University, Al-Ain 15551, United Arab Emirates;
| | - Nadirah Ghenimi
- Health and Wellness Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain 15551, United Arab Emirates;
| | - Syed Fahad Javaid
- Health and Wellness Research Group, Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain 15551, United Arab Emirates
| | - Moien AB Khan
- Health and Wellness Research Group, Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain 15551, United Arab Emirates
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Pedersen E, Malmberg-Heimonen I, Finne J, Pontoppidan M, Dion J, Tømmerås T, Tøge AG. Family Partner: study protocol for a pilot randomised study of a home-visitation intervention in Norway. Scand J Public Health 2024; 52:761-768. [PMID: 37574994 PMCID: PMC11308327 DOI: 10.1177/14034948231189773] [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: 11/18/2022] [Revised: 05/11/2023] [Accepted: 07/06/2023] [Indexed: 08/15/2023]
Abstract
AIM Every year, about 5% of children in Norway experience severe child maltreatment and need support from the child welfare services. However, research-supported interventions for this group are lacking. The current study piloted an intensive home-visitation intervention, Family Partner, which aims to reduce child maltreatment among at-risk parents by improving parental skills, agency and trust in the welfare services, and children's well-being. The randomised controlled trial piloted in this study examines the acceptability of the Family Partner intervention for staff and families and evaluates its feasibility for a full-scale randomised controlled trial. METHODS This protocol outlines a prospective, parallel, pilot randomised trial of the Family Partner intervention in three Norwegian municipal child welfare services. The participants are families with children under 12 years of age, where the parents are identified as having challenges. Families in the treatment group receive the Family Partner intervention, while families in the control group receive ordinary child welfare services. Data are collected at baseline, and at 3, 6, 12 and 18 months after recruitment. The pilot study monitor retention and adherence to inform the feasibility of a future full-scale randomised study. To assess the acceptability of the trial and intervention, a subsample of the participating families, as well as the family partners and representatives of the child welfare services in each municipality, are invited to complete qualitative interviews. CONCLUSIONS The results will guide the design of a fully powered randomised controlled trial of the Family Partner intervention compared with ordinary child welfare services. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04957394; Pilot Trial of Family Partner: a Child Maltreatment Prevention Intervention (FAMPART); registered on 12 July 2021.
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Affiliation(s)
| | | | | | | | | | - Truls Tømmerås
- Oslo Metropolitan University, Norway
- The Norwegian Centre for Child Behavioural Development (NUBU), Norway
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Clemens V, Wernecke D, Fegert JM, Genuneit J, Rothenbacher D, Braig S. Maternal child maltreatment and trajectories of offspring behavioural and emotional difficulties from age 4 to 7 years - results from a prospective birth cohort study. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02534-3. [PMID: 39039222 DOI: 10.1007/s00787-024-02534-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/12/2024] [Indexed: 07/24/2024]
Abstract
Maternal experience of child maltreatment (CM) has been associated with maternal and child mental health. However, evidence about the course of child mental health and maternal CM is scarce. Therefore, this study aims to compare trajectories of mental health in children according to maternal CM exposure and maternal mental health. We included 327 mothers and their singleton child from the Ulm SPATZ Health Study, a prospective birth cohort study. Child mental health was determined by the Strength and Difficulties Questionnaire (SDQ) at the age of 4, 5, 6, and 7 years and maternal CM by the Childhood Trauma Questionnaire (CTQ). Results display that maternal CM is associated with more behavioural and emotional difficulties in children, a trend that tends to increase with older child age. The sum of maternal mental health problems across this time course mediates this association. Male child sex is associated with more mental health problems in the child and the mother. These results provide an important first insight into the relevance of maternal CM on the trajectories of mental health in the offspring and highlight the importance of chronicity and severity of maternal mental health. Further prospective research in cohorts with longer follow-ups up into adolescence and adulthood is needed.
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Affiliation(s)
- Vera Clemens
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany
- German Center for Mental Health (DZPG), Partner site Ulm, Ulm, Germany
| | - Deborah Wernecke
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstraße 22, 89081, Ulm, Germany
- German Center for Children and Youth Health, Partner site Ulm, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany
- German Center for Mental Health (DZPG), Partner site Ulm, Ulm, Germany
- German Center for Children and Youth Health, Partner site Ulm, Ulm, Germany
| | - Jon Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstraße 22, 89081, Ulm, Germany
- German Center for Children and Youth Health, Partner site Ulm, Ulm, Germany
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Dietrich Rothenbacher
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstraße 22, 89081, Ulm, Germany
- German Center for Children and Youth Health, Partner site Ulm, Ulm, Germany
| | - Stefanie Braig
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstraße 22, 89081, Ulm, Germany.
- German Center for Children and Youth Health, Partner site Ulm, Ulm, Germany.
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Deschênes SS, Nearchou F, McInerney A, Schmitz N, Pouwer F, Nouwen A. Childhood maltreatment and the risk of impaired glucose metabolism or type 2 diabetes in young adults: Findings from the Lifelines Cohort Study. J Health Psychol 2024:13591053241243285. [PMID: 38600690 DOI: 10.1177/13591053241243285] [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: 04/12/2024] Open
Abstract
We examined the associations between childhood maltreatment and the risk of impaired glucose metabolism (IGM) or type 2 diabetes (T2D) in young adults aged 18-35. Participants (N = 8506) from the Lifelines Cohort Study without IGM or diabetes at baseline (2007-2013) were included. Childhood maltreatment was assessed by the Childhood Trauma Questionnaire (CTQ) and incident IGM/T2D was assessed by haemoglobin A1c levels (≥5.7%) in 2014-2017. There were 223 (2.6%) cases of IGM/T2D during the follow-up period. After adjusting for sociodemographic and health/lifestyle covariates and follow-up time, only the CTQ Sexual Abuse subscale was significantly associated with IGM/T2D (RR = 1.05 [95% CI = 1.01, 1.10]). The association remained when additionally accounting for depressive and anxiety symptoms (RR = 1.05 [95% CI = 1.00, 1.09]). Childhood sexual abuse was associated with an increased risk of IGM/T2D in young adults, highlighting the long-term metabolic consequences of childhood maltreatment.
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Affiliation(s)
| | | | | | | | - Frans Pouwer
- University of Southern Denmark, Denmark
- Steno Diabetes Center Odense, Denmark
- Vrije Universiteit Amsterdam, The Netherlands
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Chauviré-Geib K, Fegert JM. Victims of Technology-Assisted Child Sexual Abuse: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1335-1348. [PMID: 37313793 PMCID: PMC10913305 DOI: 10.1177/15248380231178754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Over the past two decades, technology-assisted child sexual abuse (TA-CSA) has become the focus of attention in politics, legislation, society, as well as research. However, the majority of literature and studies focus primarily on the offenders. This scoping review therefore aims to illustrate how victims of TA-CSA are represented in studies as primary participants. The databases Embase, PsychInfo, PSYNDEX, Cochrane Library, and Web of Science as well as reference lists were searched. Studies needed to be published between 2007 and 2021 and obtain data directly from and about victims to be included in this review. A total of 570 articles were identified from which 20 studies met inclusion criteria. The analysis showed that data can be obtained via different samples like adult and minor victims or other data such as legal documents or sexualized images. The studies researched different types of TA-CSA including exposure to pornographic material, online grooming leading to both online and offline sexual abuse, sexting and sexualized images, and the visual depiction of sexually explicit content. Consequences due to the abuse were of an emotional and psychological nature, medical or physical or impacted relationships, and the social environment. Even though the impact of the abuse on the victims appeared to be similar between different types of TA-CSA, much remains unknown. In order to gain further and more detailed insight into victims of TA-CSA, a universally accepted definition of TA-CSA as well as its different types and their distinctions needs to be established.
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Buderer C, Kirsch T, Pérez T, Swenson CC, Fürstenau U, Rhiner B, Schmid M. Child and family characteristics in multisystemic therapy for child abuse and neglect (MST-CAN): Are there associations with treatment outcome? JOURNAL OF MARITAL AND FAMILY THERAPY 2024; 50:453-476. [PMID: 38409887 DOI: 10.1111/jmft.12695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 02/02/2024] [Accepted: 02/13/2024] [Indexed: 02/28/2024]
Abstract
Evidence-based indication for targeted interventions is a central approach in the field of child welfare and psychotherapy. This study explored the characteristics of children and families referred to Multisystemic Therapy for Child Abuse and Neglect (MST-CAN) in Switzerland and their associations with treatment outcomes. We sought to identify subgroups of children and families referred to MST-CAN and understand their specific needs and alignment with the program. We identified five distinct subgroups of children: (a) those characterized by clinically significant "social withdrawal" and "anxiety/depression," (b) with multiple clinically significant emotional and behavioral problems, (c) with predominantly externalizing problems, (d) with no pathological findings at all, with parents who were less stressed and had fewer mental health problems, and (e) with mainly internalizing problems and parents whose mental health problems deteriorated during treatment. Investigating the fit of children and families referred to treatment programs can enhance the understanding of their healthcare needs and enable more individualized interventions.
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Affiliation(s)
- Corinna Buderer
- Clinic of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Services Aargau AG, Windisch, Switzerland
| | - Tom Kirsch
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland
| | - Tania Pérez
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland
| | - Cynthia Cupit Swenson
- Division of Global and Community Health, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Ute Fürstenau
- Mental Health Service for Children and Adolescents, Psychiatric Services Hospital Thurgau AG, Weinfelden, Switzerland
| | - Bruno Rhiner
- Mental Health Service for Children and Adolescents, Psychiatric Services Hospital Thurgau AG, Weinfelden, Switzerland
| | - Marc Schmid
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland
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Klinger-König J, Erhardt A, Streit F, Völker MP, Schulze MB, Keil T, Fricke J, Castell S, Klett-Tammen CJ, Pischon T, Karch A, Teismann H, Michels KB, Greiser KH, Becher H, Karrasch S, Ahrens W, Meinke-Franze C, Schipf S, Mikolajczyk R, Führer A, Brandes B, Schmidt B, Emmel C, Leitzmann M, Konzok J, Peters A, Obi N, Brenner H, Holleczek B, Moreno Velásquez I, Deckert J, Baune BT, Rietschel M, Berger K, Grabe HJ. Childhood Trauma and Somatic and Mental Illness in Adulthood. DEUTSCHES ARZTEBLATT INTERNATIONAL 2024; 121:1-8. [PMID: 37876295 PMCID: PMC10916765 DOI: 10.3238/arztebl.m2023.0225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Childhood trauma is associated with somatic and mental illness in adulthood. The strength of the association varies as a function of age, sex, and type of trauma. Pertinent studies to date have mainly focused on individual diseases. In this study, we investigate the association between childhood trauma and a multiplicity of somatic and mental illnesses in adulthood. METHODS Data from 156 807 NAKO Health Study participants were analyzed by means of logistic regressions, with adjustment for age, sex, years of education, and study site. The Childhood Trauma Screener differentiated between no/minor (n = 115 891) and moderate/severe childhood trauma (n = 40 916). The outcome variables were medical diagnoses of five somatic and two mental health conditions as stated in the clinical history. RESULTS Persons with childhood trauma were more likely to bear a diagnosis of all of the studied conditions: cancer (odds ratio [OR] = 1.10; 95% confidence interval: [1.05; 1.15]), myocardial infarction (OR = 1.13 [1.03; 1.24]), diabetes (OR = 1.16, [1.10; 1.23]), stroke (OR = 1.35 [1.23; 1.48]), chronic obstructive pulmonary disease (OR = 1.45 [1.38; 1.52]), depression (OR = 2.36 [2.29; 2.43]), and anxiety disorders (OR = 2.08 [2.00; 2.17]). All of these associations were stronger in younger persons, regardless of the nature of childhood trauma. Differences between the sexes were observed only for some of these associations. CONCLUSION Childhood trauma was associated with a higher probability of developing mental as well as somatic illness in adulthood. As childhood trauma is an element of individual history that the victim has little to no control over, and because the illnesses that can arise in adulthood in association with it are a heavy burden on the affected persons and on society, there is a need for research on these associations and for the development of preventive measures.
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Affiliation(s)
- Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Angelika Erhardt
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Maja P. Völker
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE), Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- State Institute of Health I, Bavarian State Office for Health and Food Safety, Erlangen, Germany
| | - Julia Fricke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Stefanie Castell
- Department of Epidemiology, Helmholtz Center for Infection Research (HZI), Braunschweig, Germany
| | - Carolina J. Klett-Tammen
- Department of Epidemiology, Helmholtz Center for Infection Research (HZI), Braunschweig, Germany
| | - Tobias Pischon
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Henning Teismann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Karin B. Michels
- Institute for Prevention and Tumor Epidemiology, Medical Center—University of Freiburg, Medical Faculty, Albert Ludwigs University of Freiburg, Freiburg, Germany
| | - K. Halina Greiser
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Heiko Becher
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Karrasch
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Claudia Meinke-Franze
- Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Sabine Schipf
- Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Rafael Mikolajczyk
- IInstitute of Medical Epidemiology, Biometry and Informatics, Profile Center Health Sciences, Medical School, Martin Luther University Halle-Wittenberg, Halle, Germany
- German Center for Mental Health (DZPG), Jena-Magdeburg-Halle Site, Halle, Germany
- Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Halle, Germany
| | - Amand Führer
- IInstitute of Medical Epidemiology, Biometry and Informatics, Profile Center Health Sciences, Medical School, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Berit Brandes
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Börge Schmidt
- Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Medicine Essen, Essen, Germany
| | - Carina Emmel
- Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Medicine Essen, Essen, Germany
| | - Michael Leitzmann
- Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Julian Konzok
- Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Anette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Medical Faculty, LMU—Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Mental Health (DZPG), Munich site, Munich, Germany
| | - Nadia Obi
- Central Institute for Occupational Medicine and Maritime Medicine (ZfAM,) University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hermann Brenner
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), Saarbrücken, Germany
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Saarbrücken, Germany
| | | | - Ilais Moreno Velásquez
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Bernhard T. Baune
- Department of Psychiatry, University Hospital Münster, Münster, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
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13
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Maier A, König E, Hoffmann U, Fegert JM, Brähler E, Clemens V. Health-related quality of life after child maltreatment in institutions: Results from a representative population-based sample in Germany. CHILD ABUSE & NEGLECT 2023; 146:106515. [PMID: 39321040 DOI: 10.1016/j.chiabu.2023.106515] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 10/06/2023] [Accepted: 10/12/2023] [Indexed: 09/27/2024]
Abstract
BACKGROUND Child maltreatment (CM) is a major public health problem associated with enormous consequences, including impaired health-related quality of life (HRQOL). While the consequences of CM that occurs in the family context have been studied numerous times, studies on the consequences of institutional CM are lacking. This is of particular importance because cases of CM in churches, sport clubs and school, educational and medical settings have become increasingly apparent in Germany. OBJECTIVE Thus, the objective of this study was to assess the association of CM in various institutions with HRQOL in adulthood. PARTICIPANTS AND SETTING In a cross-sectional observational approach, a representative sample of the German population (N = 2516) was identified via a random-route. METHODS Socioeconomic information, HRQOL and CM experiences in school, medical and educational institutions were obtained and statistically evaluated. RESULTS Of the 2516 participants, 834 (33.14 %) reported CM in institutions and 1194 (47.46 %) reported impaired HRQOL. Participants who reported CM in institutions were more likely to have HRQOL impairments than participants who had been in the respective institution in childhood but had not reported having experienced CM there. In the case of CM in medical institutions, HRQOL impairments increased 2.2-3.9-fold. If CM in school was reported, HRQOL impairments increased 1.6-2.0-fold. If CM in educational institutions was reported, HRQOL impairments increased 2.1-2.7-fold. CONCLUSIONS CM in institutions is associated with an increased likelihood of HRQOL impairments in Germany. Institutions need to be aware of the risk of CM and safeguarding measures should be implemented.
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Affiliation(s)
- Anna Maier
- Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm University Hospital, Steinhövelstr. 5, 89075 Ulm, Germany.
| | - Elisa König
- Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm University Hospital, Steinhövelstr. 5, 89075 Ulm, Germany
| | - Ulrike Hoffmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm University Hospital, Steinhövelstr. 5, 89075 Ulm, Germany
| | - Joerg M Fegert
- Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm University Hospital, Steinhövelstr. 5, 89075 Ulm, Germany
| | - Elmar Brähler
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany; Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Vera Clemens
- Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm University Hospital, Steinhövelstr. 5, 89075 Ulm, Germany
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14
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Lunding SH, Ueland T, Aas M, Høegh MC, Werner MCF, Rødevand L, Johansen IT, Hjell G, Ormerod MBEG, Ringen PA, Ottesen A, Lagerberg TV, Melle I, Andreassen OA, Simonsen C, Steen NE. Tobacco smoking related to childhood trauma mediated by cognitive control and impulsiveness in severe mental disorders. Schizophr Res 2023; 261:236-244. [PMID: 37806047 DOI: 10.1016/j.schres.2023.09.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/26/2023] [Accepted: 09/24/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND People with severe mental disorders (SMDs) show an increased prevalence of tobacco smoking compared to the general population. Tobacco smoking and other adult adverse health behaviors have been associated with traumatic experiences in childhood. In the present study we investigated the relationship between childhood trauma and tobacco smoking in people with SMDs, including the possible mediating role of cognitive- and personality characteristics, i.e. cognitive control, impulsiveness, affective lability and self-esteem. METHODS Enrolled in the study were 871 participants with schizophrenia (SCZ, N = 484) and bipolar (BD, N = 387) spectrum disorders. We assessed tobacco smoking behavior (yes/no and amount), and history of childhood trauma with the Childhood Trauma Questionnaire. Data on cognitive control, impulsiveness, affective lability, and self-esteem were available in subsamples. We performed linear and logistic regressions, and conducted mediation analyses in PROCESS. All analyses were as standard adjusted for age, sex, and diagnostic group. RESULTS Experience of one or more subtypes of childhood trauma was significantly associated with smoking tobacco in SMDs (p = 0.002). There were no significant associations between childhood trauma and amount of tobacco smoking. Cognitive control and impulsiveness were significant mediators between childhood trauma and tobacco smoking. CONCLUSIONS These findings indicate the experience of childhood trauma as a predisposing factor for tobacco smoking in SMDs. Cognitive control and impulsiveness were suggested as mediating mechanisms, indicating the importance of considering inhibition related self-regulatory aspects in efforts to improve health behavior in individuals with SMDs and childhood trauma.
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Affiliation(s)
- Synve Hoffart Lunding
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Torill Ueland
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Monica Aas
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Margrethe Collier Høegh
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Maren Caroline Frogner Werner
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Linn Rødevand
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Torp Johansen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gabriela Hjell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatry, Ostfold Hospital, Graalum, Norway
| | | | - Petter Andreas Ringen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Akiah Ottesen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Trine Vik Lagerberg
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Carmen Simonsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Oslo University Hospital, Oslo, Norway
| | - Nils Eiel Steen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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15
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Bürgin D, Clemens V, Witt A, Sachser C, Jud A, Brähler E, Strauß B, Petrowski K, Schmid M, Fegert JM. Adverse childhood experiences increase the risk for low perceived social participation and health-related quality of life in a large-scale population-based study in Germany. CHILD ABUSE & NEGLECT 2023; 144:106382. [PMID: 37527561 DOI: 10.1016/j.chiabu.2023.106382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 05/17/2023] [Accepted: 07/25/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are highly prevalent and increase the risk for long-term adverse health outcomes. Next to well-known ACE-associated risks for morbidity, recent research is increasingly invested in exploring pathways towards health, overall functioning, and partaking in society following early adversity. OBJECTIVES Thus, this study aims to assess the association between latent classes of ACEs with perceived social participation and health-related Quality of Life (QoL) in a large population-based sample and to explore potential moderators of these associations. METHOD A representative sample of the German population (N = 2531; Mage = 48.7; 51 % women) was cross-sectionally investigated for ACEs, social participation (KsT-5), and health-related QoL (EuroQol-5D-5L). Latent Class Analysis (LCA) was performed to derive groups with similar ACE patterns. Multiple regression analyses were used to investigate the association of latent classes of ACEs with social participation and health-related QoL and to explore potential moderators. RESULTS Four distinct latent classes of ACEs were identified; "no/low ACEs" (N = 1968, 77.8 %); "household-dysfunction" (N = 259, 10.2 %), "child abuse and neglect" (N = 188, 7.4 %), and "polyadversity" (N = 116, 4.6 %). Compared to participants in the no/low ACE class, those in the ACE-exposed classes showed overall lower levels of perceived social participation and health-related QoL. The polyadversity class showed lower levels of social participation compared to the two other ACE-exposed classes. Chronic stress, living with a partner, education, current job/educational involvement, and gender were found to moderate these associations in exploratory analyses. CONCLUSIONS This study shows people exposed to ACEs to have a higher risk for lower perceived social participation and lower health-related QoL - an increased risk, however, is not a deterministic uninventable fortune. Reduction of chronic stress, fostering of social support, and educational and vocational paths as interventional targets are discussed to enable those with precarious starting conditions to partake in society.
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Affiliation(s)
- David Bürgin
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; University Psychiatric Hospitals, Child and Adolescent Psychiatric Research Department (UPKKJ), University of Basel, Basel, Switzerland.
| | - Vera Clemens
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany
| | - Andreas Witt
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany
| | - Andreas Jud
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; Competence Center Child Abuse and Neglect in Medicine Baden-Wurttemberg com.can, Ulm, Germany
| | - Elmar Brähler
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Mainz, Germany; Integrated Research and Treatment Center (IFB) Adiposity Diseases-Behavioral Medicine, Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Bernhard Strauß
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Jena, Germany
| | - Katja Petrowski
- Medical Psychology and Medical Sociology, Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Marc Schmid
- University Psychiatric Hospitals, Child and Adolescent Psychiatric Research Department (UPKKJ), University of Basel, Basel, Switzerland
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; Competence Center Child Abuse and Neglect in Medicine Baden-Wurttemberg com.can, Ulm, Germany
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16
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Scardera S, Langevin R, Collin-Vézina D, Cabana MC, Pinto Pereira SM, Côté S, Ouellet-Morin I, Geoffroy MC. Derivation of probable child maltreatment indicators using prospectively recorded information between 5 months and 17 years in a longitudinal cohort of Canadian children. CHILD ABUSE & NEGLECT 2023; 143:106247. [PMID: 37276658 DOI: 10.1016/j.chiabu.2023.106247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 05/05/2023] [Accepted: 05/14/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Both prospective and retrospective measures of child maltreatment predict mental and physical health problems, despite their weak concordance. Research remains largely based on retrospective reports spanning the entire childhood due to a scarcity of prospectively completed measures targeting maltreatment specifically. OBJECTIVE We developed a prospective index of child maltreatment in the Québec Longitudinal Study of Child Development (QLSCD) using prospective information collected from ages 5 months to 17 years and examined its concordance with retrospective maltreatment. PARTICIPANTS AND SETTING The QLSCD is an ongoing population-based cohort that includes 2,120 participants born from 1997-1998 in the Canadian Province of Quebec. METHODS As the QLSCD did not have maltreatment as a focal variable, we screened 29,600 items completed by multiple informants (mothers, children, teachers, home observations) across 14 measurement points (5 months-17 years). Items that could reflect maltreatment were first extracted. Indicators were derived across preschool, school-age and adolescence periods and by the end of childhood and adolescence, including presence (yes/no), chronicity (re-occurrence), extent of exposure and cumulative maltreatment. Two maltreatment experts reviewed these items for inclusion and determined cut-offs for possible child maltreatment (n=251 items). Retrospective maltreatment was self-reported at 23 years. RESULTS Across all developmental periods, the presence of maltreatment was as follows: physical abuse (16.3-21.8%), psychological abuse (3.3-21.9%), emotional neglect (20.4-21.6%), physical neglect (15.0-22.3%), supervisory neglect (25.8-44.9%), family violence (4.1-11.2%) and sexual abuse (9.5% in adolescence only). The degree of concordance between prospective and retrospective reports for each type of maltreatment was weak (.038-.110), yet significant (ps<.01), except for emotional neglect (p=.148). CONCLUSIONS In addition to the many future research opportunities offered by these prospective indicators of maltreatment, this study offers a roadmap to researchers wishing to undertake a similar task.
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Affiliation(s)
- Sara Scardera
- Department of Educational and Counselling Psychology, McGill University, Education Building, 3700 McTavish Street, H3A 1Y2 Montreal, Quebec, Canada
| | - Rachel Langevin
- Department of Educational and Counselling Psychology, McGill University, Education Building, 3700 McTavish Street, H3A 1Y2 Montreal, Quebec, Canada
| | | | - Maude Comtois Cabana
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada; Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada
| | | | - Sylvana Côté
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Isabelle Ouellet-Morin
- School of Criminology, University of Montreal & the Research Center of the Montreal Mental Health University Institute, Montreal, Quebec, Canada
| | - Marie-Claude Geoffroy
- Department of Educational and Counselling Psychology, McGill University, Education Building, 3700 McTavish Street, H3A 1Y2 Montreal, Quebec, Canada; McGill Group for Suicide Studies, Douglas Mental Health University Institute & Department of Psychiatry, McGill University, Montreal, Canada.
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17
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Fitzgerald M, Morgan AA. Marital quality and depression as mediators linking childhood maltreatment to adult physical health. CHILD ABUSE & NEGLECT 2023; 141:106189. [PMID: 37163970 DOI: 10.1016/j.chiabu.2023.106189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/08/2023] [Accepted: 04/02/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Childhood maltreatment is known to influence adult physical health among midlife adults. Evidence suggests that depressive symptoms mediate the association. However, research has discounted the role of marital quality in understanding health outcomes among adults maltreated in childhood. OBJECTIVE To advance this line of inquiry, we examined the relationship between marital quality and depressive symptoms in a sequential mediation model linking childhood maltreatment to adult physical health over ten years. PARTICIPANTS AND SETTING Our sample consisted of midlife adults (n = 550) from three waves of the Midlife Development in the United States (MIDUS) study. The majority (n = 91.4 %) were white. At MIDUS 2, the mean age was 54.84 (SD = 10.78) and the mean age at MIDUS 3 was 63.96 (SD = 10.81). METHODS Structural equation modeling was used to examine the degree to which marital quality and depressive symptoms mediated the relationship between childhood maltreatment and adult physical outcomes. Bootstrapping procedures were used to estimate the indirect effects. RESULTS The serial mediation effects from maltreatment to adult physical health through marital quality and depressive symptoms were significant. Likewise, the simple indirect effects from maltreatment to subjective evaluations and the number of chronic health conditions through depressive symptoms were also significant. CONCLUSIONS Childhood maltreatment is linked to adult physical health problems through marital quality and depressive symptoms, suggesting that the quality of adult marriages may play a critical role in health outcomes. Improving the quality of marriages may reduce risk factors, such as depression, that potentate future physical health problems.
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Affiliation(s)
- Michael Fitzgerald
- Department of Human Development and Family Science, Oklahoma State University, Stillwater, OK, United States of America
| | - Amy A Morgan
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, United States of America.
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Rubens M, Bruenig D, Adams JAM, Suresh SM, Sathyanarayanan A, Haslam D, Shenk CE, Mathews B, Mehta D. Childhood maltreatment and DNA methylation: A systematic review. Neurosci Biobehav Rev 2023; 147:105079. [PMID: 36764637 DOI: 10.1016/j.neubiorev.2023.105079] [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: 07/19/2022] [Revised: 01/15/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
Child maltreatment (CM) encompasses sexual abuse, physical abuse, emotional abuse, neglect, and exposure to domestic and family violence. Epigenetic research investigating CM has focused on differential DNA methylation (DNAm) in genes associated with the stress response, but there has been limited evaluation of the specific effects of subtypes of CM. This systematic review of literature investigating DNAm associated with CM in non-clinical populations aimed to summarise the approaches currently used in research, how the type of maltreatment and age of exposure were encoded via methylation, and which genes have consistently been associated with CM. A total of fifty-four papers were eligible for review, including forty-one candidate gene studies, eight epigenome-wide association studies, and five studies with a mixed design. The ways in which the various forms of CM were conceptualised and measured varied between papers. Future studies would benefit from assessments that employ conceptually robust definitions of CM, and that capture important contextual information such as age of exposure and subtype of CM.
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Affiliation(s)
- Mackenzie Rubens
- Centre for Genomics and Personalised Health, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia; School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia
| | - Dagmar Bruenig
- Centre for Genomics and Personalised Health, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia; School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia
| | - Jessica A M Adams
- Centre for Genomics and Personalised Health, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia; School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia
| | - Shruthi M Suresh
- Centre for Genomics and Personalised Health, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia; School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia
| | - Anita Sathyanarayanan
- Centre for Genomics and Personalised Health, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia; School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia
| | - Divna Haslam
- Australian Centre for Health Law Research, School of Law, Queensland University of Technology (QUT), Australia; Parenting and Family Support Centre, University of Queensland, Australia
| | - Chad E Shenk
- Department of Human Development and Family Studies, The Pennsylvania State University, USA; Department of Pediatrics, The Pennsylvania State University College of Medicine, USA
| | - Ben Mathews
- Australian Centre for Health Law Research, School of Law, Queensland University of Technology (QUT), Australia; Bloomberg School of Public Health, Johns Hopkins University, USA
| | - Divya Mehta
- Centre for Genomics and Personalised Health, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia; School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia.
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Havermans DC, van Alphen SP, Olff M, Van der Velden-Daamen M, Verhey F, Rutten BP, Stuijts P, Cook JM, Sobczak S. The Need for a Diagnostic Instrument to Assess Post-Traumatic Stress Disorder in People with Dementia: Findings from a Delphi Study. J Geriatr Psychiatry Neurol 2023; 36:129-142. [PMID: 35713096 PMCID: PMC9941654 DOI: 10.1177/08919887221103583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cognitive and behavioral aspects may mask posttraumatic stress disorder (PTSD) in people with dementia. PTSD severely lowers quality of life in people with dementia. Proper recognition of PTSD is essential to ensure adequate treatment. However, a valid diagnostic tool for PTSD in dementia is lacking. A Delphi study was conducted among 20 Dutch and 6 international experts in the field of PTSD and dementia care or research. The aim was to reach consensus in 3 rounds on the added value, form, content, and application for developing such an instrument. The first round confirmed the need for a new diagnostic tool for research and clinical practice. Consensus was reached on 23 statements regarding the support base and 19 related to content of the instrument. In the third round, opinions on several conceptual problems were gathered. Based on the experts' opinions, a draft version of an instrument, the TRAuma and DEmentia-interview (TRADE-interview), was developed. Clinical and research implications of this new measure are discussed.
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Affiliation(s)
- Demi C.D. Havermans
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Old Age Psychiatry, Mondriaan Mental Health Center, Heerlen, The Netherlands
- Demi C.D. Havermans, MSc, Department of Old Age Psychiatry, Mondriaan Mental Health Center, Heerlen, The Netherlands. Kloosterkensweg 10, 6419PJ Heerlen.
| | - Sebastiaan P.J. van Alphen
- Department of Old Age Psychiatry, Mondriaan Mental Health Center, Heerlen, The Netherlands
- Department of Clinical and Life Span Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Medical and Clinical Psychology, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Miranda Olff
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
- Department of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Centers Location AMC, Amsterdam, The Netherlands
| | - Mariëlle Van der Velden-Daamen
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
- Department of Psychogeriatrics, Cicero-Zorggroep, Brunssum, The Netherlands
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Bart P.F. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Joan M Cook
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sjacko Sobczak
- Department of Old Age Psychiatry, Mondriaan Mental Health Center, Heerlen, The Netherlands
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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20
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Geprägs A, Bürgin D, Fegert JM, Brähler E, Clemens V. Parental stress and physical violence against children during the second year of the COVID-19 pandemic: results of a population-based survey in Germany. Child Adolesc Psychiatry Ment Health 2023; 17:25. [PMID: 36804027 PMCID: PMC9940081 DOI: 10.1186/s13034-023-00571-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/01/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Parents and caregivers belonged to those with the highest burdens during the COVID-pandemic. Considering the close link between parental stress and child maltreatment, identifying families with high parental stress is of utmost importance to prevent violence against children. Within this study, we thus aimed to investigate the interplay of parental stress, changes in parental stress, and physical violence against children during the second year of the COVID-pandemic on an exploratory level. METHODS We conducted a cross-sectional, observational study in Germany from July to October 2021. By using different sampling steps, a representative probability sample of the German population was generated. A subsample of these participants with children under the age of 18 was included for analysis within this study (N = 453, 60.3% females, Mage = 40.08; SD = 8.53). RESULTS Higher parental stress levels were associated with more physical violence against children, higher levels of own experiences of child maltreatment, and mental health symptoms. An increase in parental stress during the pandemic was associated with female sex, the use of physical violence against children, and parental experience of child maltreatment. Parents who have ever used physical violence against their children have been characterized by higher parental stress levels, a stronger increase in parental stress during the pandemic, own experience of child maltreatment, mental health symptoms and sociodemographic characteristics. Higher parental stress levels, a stronger increase of parental stress during the pandemic, having pre-existing psychiatric disorders, and parental experience of child maltreatment predicted an increased use of physical violence against children during the pandemic. CONCLUSIONS Our results underscore the importance of parental stress for the risk of physical violence against children, more so in times of overall increased stress due to the pandemic and underline the need for low threshold support for families at risk in times of crises.
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Affiliation(s)
- Alina Geprägs
- grid.6582.90000 0004 1936 9748Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - David Bürgin
- grid.6582.90000 0004 1936 9748Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany ,grid.6612.30000 0004 1937 0642Child and Adolescent Psychiatric Research Department (UPKKJ), Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Jörg M. Fegert
- grid.6582.90000 0004 1936 9748Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Elmar Brähler
- grid.410607.4Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Mainz, Germany ,grid.9647.c0000 0004 7669 9786Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Unit, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
| | - Vera Clemens
- Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
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21
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Klinger-König J, Hannemann A, Friedrich N, Nauck M, Völzke H, Grabe HJ. Association between childhood maltreatment and adult cortisol concentrations mediated through subjective health complaints. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1098822. [PMID: 38455886 PMCID: PMC10911021 DOI: 10.3389/fepid.2023.1098822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/16/2023] [Indexed: 03/09/2024]
Abstract
Background Lower cortisol concentrations in adulthood were repeatedly associated with more severe childhood maltreatment. Additionally, childhood maltreatment was reported to promote health risk behavior, such as smoking or alcohol consumption, and to increase the risk of mental and somatic diseases during adulthood, such as major depressive disorders or obesity. The present study investigated if health risk behavior and disease symptoms in adults mediate the associations between past childhood maltreatment and present basal serum cortisol concentrations. Methods Data from two independent adult cohorts of the general population-based Study of Health in Pomerania (SHIP-TREND-0: N = 3,517; SHIP-START-2: N = 1,640) was used. Childhood maltreatment was assessed via the Childhood Trauma Questionnaire (CTQ). Cortisol concentrations were measured in single-point serum samples. Health risk behavior and mental and physical symptoms were used as mediators. Mediation analyses were calculated separately for both cohorts; results were integrated via meta-analyses. Results In mediator-separated analyses, associations between childhood maltreatment and basal serum cortisol concentrations were partly mediated by depressive symptoms (BDI-II: βindirect effect = -.011, pFDR = .017, 21.0% mediated) and subjective somatic health complaints (somatic complaints: βindirect effect = -.010, pFDR = .005, 19.4% mediated). In the second step, both mediators were simultaneously integrated into one mediation model. The model replicated the mediation effects of the subjective somatic health complaints (whole model: βindirect effect = -.014, p = .001, 27.6% mediated; BDI-II: βindirect effect = -.006, p = .163, 11.4% mediated, somatic complaints: βindirect effect = -.020, p = .020, 15.5% mediated). Conclusion The results support the hypothesis that the long-lasting effects of childhood maltreatment on the stress response system are partly mediated through self-perceived disease symptoms. However, no mediation was found for health risk behavior or physically measured mediators. Mediation models with multiple simultaneous mediators pointed to a relevant overlap between the potential mediators. This overlap should be focused on in future studies.
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Affiliation(s)
- Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
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22
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Kızıltepe R, Ebeoğlu-Duman M, Sağel-Çetiner E, Hecker T. The unique contribution of childhood maltreatment types to risk-taking behavior and self-esteem. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04300-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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23
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Wilson-Genderson M, Heid AR, Cartwright F, Pruchno R. Adverse childhood experiences, adult trauma, and depressive symptom trajectories. Aging Ment Health 2022; 26:2170-2178. [PMID: 34541986 DOI: 10.1080/13607863.2021.1978926] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Associations among adverse childhood experiences prior to age 18 (ACEs), subjective reports of trauma during Hurricane Sandy, and trajectories of depressive symptoms reported by community-dwelling older people were examined. METHODS We analyzed 6 waves of data from 5,688 people aged 50-74 recruited in 2006 and followed for 12-years using multilevel mixed effects models. RESULTS We found that: (1) people who experienced ACEs had trajectories of depressive symptoms in late life that were higher than people not having these experiences, (2) people experiencing two or more ACEs were more likely to report fear and distress when Hurricane Sandy hit than people experiencing either one or no adverse childhood experiences, and (3) while both ACE exposure and peri-traumatic stress were associated with trajectories having higher levels of depressive symptoms, the risk associated with ACEs (especially multiple ACEs) was greater. CONCLUSION Findings support life course stress theories including the cumulative inequality theory and stress proliferation theory, suggesting that inequalities are manifested over the life course and that people experiencing adversity during childhood are at increased risk of experiencing adversity in late life. By studying the relationship between adverse childhood experiences and response to Hurricane Sandy our findings demonstrate that adverse childhood experiences can alter the way traumatic events in adulthood are experienced. This finding in turn, has important implications for clinical practice, as it identifies a group of people likely to be at risk for adult trauma.
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Affiliation(s)
| | | | - Francine Cartwright
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
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24
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Ernst M, Brähler E, Kampling H, Kruse J, Fegert JM, Plener PL, Beutel ME. Is the end in the beginning? Child maltreatment increases the risk of non-suicidal self-injury and suicide attempts through impaired personality functioning. CHILD ABUSE & NEGLECT 2022; 133:105870. [PMID: 36084408 DOI: 10.1016/j.chiabu.2022.105870] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/18/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Child maltreatment is a risk factor for a range of mental disorders later in life, including dangerous self-harm and suicide attempts. A better understanding of the mechanisms underlying this association can inform prevention and intervention. OBJECTIVE To investigate personality functioning as a potential mediator of the association of childhood abuse and neglect and self-harm and suicide attempts in the general population. PARTICIPANTS AND SETTING Data were drawn from a representative German population sample (N = 2510). METHODS Participants filled out the Childhood Trauma Questionnaire (CTQ), OPD Structure Questionnaire (OPD-SQS), and items of the Self-Injurious Thoughts and Behaviors Interview (SITBI). In structural equation models, we operationalized impaired personality functioning as the mediator between childhood abuse and neglect and self-harm. RESULTS Individuals with a history of self-harm (combining suicide attempts, N = 47, and non-suicidal self-injury, N = 83) reported more childhood abuse and neglect (d = 1.39, p < .001) and greater impairments in personality functioning (d = 1.64, p < .001) than the rest of the population. The indirect effect via personality functioning accounted for 48.8 % of the total effect of childhood abuse and neglect on self-harm. In more differentiated analyses, emotional abuse showed the strongest association with self-harm. Only physical and sexual abuse had direct effects. CONCLUSIONS The results specify the relationship between child maltreatment and self-harm by demonstrating that it is partly mediated by basic functions of personality assessed using a dimensional measure. These abilities constitute modifiable risk factors that can be addressed by psychotherapy.
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Affiliation(s)
- Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Leipzig, Leipzig, Germany
| | - Hanna Kampling
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Giessen, Germany
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Giessen, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Paul L Plener
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany; Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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25
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Terock J, Hannemann A, Klinger-König J, Janowitz D, Grabe HJ, Murck H. The neurobiology of childhood trauma-aldosterone and blood pressure changes in a community sample. World J Biol Psychiatry 2022; 23:622-630. [PMID: 34906037 DOI: 10.1080/15622975.2021.2018724] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Childhood trauma is an important risk factor for the onset and course of psychiatric disorders and particularly major depression. Recently, the renin-angiotensin-aldosterone system, one of the core stress hormone systems, has been demonstrated to be modified by childhood trauma. METHODS Childhood trauma was obtained using the Childhood Trauma Questionnaire (CTQ) in a community-dwelling sample (N = 2038). Plasma concentrations of renin and aldosterone were measured in subjects with childhood trauma (CT; N = 385) vs. subjects without this experience (NoCT; N = 1653). Multivariable linear regression models were calculated to assess the associations between CTQ, systolic and diastolic blood pressure, renin and aldosterone concentrations, and the ratio of aldosterone and systolic blood pressure (A/SBP). RESULTS CT subjects demonstrated higher plasma aldosterone (A) concentrations, a lower systolic and diastolic blood pressure, and a higher A/SBP. In addition, both aldosterone concentrations, as well as A/SBP, correlated with the severity of childhood trauma. These findings could not be attributed to differences in concomitant medication. CONCLUSIONS In conclusion, childhood trauma was associated with neurobiological markers, which may impact the risk for psychiatric disorders, primarily major depression. The altered A/SBP ratio points to a desensitisation of peripheral mineralocorticoid receptor function, which may be a target for therapeutic interventions.
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Affiliation(s)
- Jan Terock
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.,Department of Psychiatry and Psychotherapy, HELIOS Hanseklinikum Stralsund, Stralsund, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Deborah Janowitz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.,Department of Psychiatry and Psychotherapy, HELIOS Hanseklinikum Stralsund, Stralsund, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.,German Center for Neurodegenerative Diseases DZNE, Site Rostock/Greifswald, Greifswald, Germany
| | - Harald Murck
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.,Murck-Neuroscience LLC, Westfield, NJ, USA
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26
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Kascakova N, Petrikova M, Furstova J, Hasto J, Geckova AM, Tavel P. Associations of childhood trauma with long-term diseases and alcohol and nicotine use disorders in Czech and Slovak representative samples. BMC Public Health 2022; 22:1769. [PMID: 36123641 PMCID: PMC9484250 DOI: 10.1186/s12889-022-14160-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 09/12/2022] [Indexed: 11/11/2022] Open
Abstract
Objective The abuse and neglect of a child is a major public health problem with serious psychosocial, health and economic consequences. The aim of this study was to assess the relationship between various types of childhood trauma, selected long-term diseases and alcohol and nicotine use disorder in Czech and Slovak representative samples. Methods Data on retrospective reporting about selected long-term diseases, alcohol and nicotine use disorder (CAGE Questionnaire) and childhood maltreatment (Childhood Trauma Questionnaire; CTQ) in two representative samples (Czech sample: n = 1800, 48.7% men, mean age 46.61 ± 17.4; Slovak sample: n = 1018, 48.7% men, mean age: 46.2 ± 16.6) was collected. Multinomial logistic regression models were used to assess the relationships between childhood maltreatment and long-term diseases. Results There is a higher occurrence of some long-term diseases (such as diabetes, obesity, allergy, asthma) and alcohol and nicotine use disorder in the Czech sample; however, in the Slovak sample the associations between child maltreatment and long-term diseases are stronger overall. Emotional abuse predicts the occurrence of all the studied long-term diseases, and the concurrent occurrence of emotional abuse and neglect significantly predicts the reporting of most diseases. All types of childhood trauma were strong predictors of reporting the occurrence of three or more long-term diseases. Conclusion The extent of reporting childhood trauma and associations with long-term diseases in the Czech and Slovak population is a challenge for the strengthening of preventive and therapeutic programmes in psychosocial and psychiatric care for children and adolescents to prevent later negative consequences on health.
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Affiliation(s)
- Natalia Kascakova
- Olomouc University Social Health Institute, Palacky University Olomouc, Univerzitní 22, 771 11, Olomouc, Czech Republic. .,Psychiatric-Psychotherapeutic Outpatient Clinic, Pro mente sana, Heydukova 27, 811 08, Bratislava, Slovakia.
| | - Martina Petrikova
- Olomouc University Social Health Institute, Palacky University Olomouc, Univerzitní 22, 771 11, Olomouc, Czech Republic
| | - Jana Furstova
- Olomouc University Social Health Institute, Palacky University Olomouc, Univerzitní 22, 771 11, Olomouc, Czech Republic
| | - Jozef Hasto
- Olomouc University Social Health Institute, Palacky University Olomouc, Univerzitní 22, 771 11, Olomouc, Czech Republic.,Psychiatric-Psychotherapeutic Outpatient Clinic, Pro mente sana, Heydukova 27, 811 08, Bratislava, Slovakia.,Department of Social Work, St. Elizabeth College of Health and Social Work, Palackého 1, 811 02, Bratislava, Slovakia
| | - Andrea Madarasova Geckova
- Olomouc University Social Health Institute, Palacky University Olomouc, Univerzitní 22, 771 11, Olomouc, Czech Republic.,Department of Health Psychology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia
| | - Peter Tavel
- Olomouc University Social Health Institute, Palacky University Olomouc, Univerzitní 22, 771 11, Olomouc, Czech Republic
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27
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Bürgin D, Clemens V, Varghese N, Eckert A, Huber M, Bruttin E, Boonmann C, Unternährer E, O'Donovan A, Schmid M. Adverse and traumatic exposures, posttraumatic stress disorder, telomere length, and hair cortisol – Exploring associations in a high-risk sample of young adult residential care leavers. Brain Behav Immun Health 2022; 26:100524. [PMID: 36213488 PMCID: PMC9535425 DOI: 10.1016/j.bbih.2022.100524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/17/2022] [Accepted: 09/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Childhood adversities (CAs), potentially traumatic exposures (PTEs), and posttraumatic stress disorder (PTSD) are known to increase the risk for poor health outcomes, including diseases of aging and early mortality. Telomere length (TL) and hair cortisol concentrations (HCC) are biomarkers known to be associated with CA and PTEs, and PTSD, but there is considerable heterogeneity in findings. Objectives This study aims to investigate the association of CAs, PTEs, and PTSD with TL and HCC in a high-risk sample of young adults who were previously placed in youth residential care institutions throughout Switzerland. Method Our sample includes 130 participants (30.8% women, M Age = 26.5 ± 3.7 years) with previous youth residential care placements (MPlacements= 3.9). CAs and PTEs, as well as PTSD, were assessed with self-reported questionnaires and semi-structured clinical interviews. Immune cell TL was measured with quantitative polymerase chain reaction (qPCR) in whole blood. Hair samples were collected for HCC measurement and assayed with high-sensitivity ELISA. Multivariate regression models were fitted to describe the associations between CAs, PTEs, and PTSD with TL and HCC, adjusting for covariates. Results In our high-risk sample, a higher burden of CAs, PTEs, Criterion A trauma, and PTSD was associated with longer TL. PTEs, Criterion A trauma, and PTSD were associated with lower HCC, however no significant associations between CAs and HCC were found. The magnitude of these effects varied depending on the dimensional or categorical nature of the stress-phenotype and the specific measure used. Conclusions Our findings are in contrast with many, but not all, previous studies of associations between adversity and both TL and HCC. For instance, our findings are in line with other studies that find a state of hypocortisolism in PTSD. Better measurement of adversities and trauma, multisystem biomarker approaches, and more research in larger high-risk samples at the upper end of the adversity-continuum is warranted. In this high-risk sample,childhood adversities, potential traumatic exposures, criterion A trauma, or posttraumatic stress disorder (PTSD) was associated with longer telomere length (TL). Potentially traumatic exposures, criterion A trauma, and PTSD were associated with lower hair cortisol concentrations. The magnitude of these effects varied depending on the dimensional or categorical nature of the stress-phenotype and the specific measure used. Hypocortisolism might explain findings of longer TL in participants with cumulated adverse and traumatic exposures. Research in high-risk populations is strongly needed as results across the entire spectrum of adversity exposures may not generalize to the top end of the spectrum.
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Affiliation(s)
- David Bürgin
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
- Corresponding author. University Psychiatric Hospitals Basel Research Department for Child and Adolescent Psychiatry Wilhelm-Klein Strasse 27, 4056, Basel, Switzerland.
| | - Vera Clemens
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Nimmy Varghese
- Neurobiological Laboratory for Brain Aging and Mental Health, Transfaculty Research Platform, University of Basel, Basel, Switzerland
| | - Anne Eckert
- Neurobiological Laboratory for Brain Aging and Mental Health, Transfaculty Research Platform, University of Basel, Basel, Switzerland
| | - Mara Huber
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
| | - Evelyne Bruttin
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
| | - Cyril Boonmann
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
| | - Eva Unternährer
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
| | - Aoife O'Donovan
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Marc Schmid
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
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Pfluger V, Rohner SL, Eising CM, Maercker A, Thoma MV. Associations Between Complex Trauma Exposure in Childhood/Adolescence and Psychopathology in Older Age: The Role of Stress Coping and Coping Self-Perception. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:539-551. [PMID: 35958721 PMCID: PMC9360395 DOI: 10.1007/s40653-021-00419-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/26/2021] [Indexed: 06/15/2023]
Abstract
Complex trauma exposure in childhood and/or adolescence is common and has repeatedly been linked to mental ill-health across the lifespan. While the correlates of complex trauma and mental health are well-studied in individuals up to middle adulthood, correlates in older adulthood, as well as potential mediators of this relationship, such as stress coping, are insufficiently studied. Therefore, this study aimed to (a) examine the mental health of Swiss older adults affected by complex trauma exposure in childhood and/or adolescence, in comparison to non-affected individuals; and (b) to examine the potential mediating role of coping strategies and coping self-perception. Data from N = 257 participants (complex trauma [CT] group: n = 161; M age = 69.66 years, 48.4% female; non-complex trauma [nCT] group: n = 96; M age = 72.49 years, 42.7% female) were assessed using self-report questionnaires and a clinical interview. The CT group presented with significantly more current and lifetime mental health disorders, more disadvantageous coping strategies, and significantly lower coping self-perception, compared to the nCT group. Mediation analyses revealed that maladaptive coping and coping self-perception were relevant mediators of the relationship between complex trauma exposure and psychopathology. Results suggest that complex trauma exposure in childhood and/or adolescence can have a lasting impact on mental health in later life and can be negatively associated with stress coping. Findings emphasize the relevance of a lifespan perspective in research and clinical practice for addressing consequences of complex trauma exposure.
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Affiliation(s)
- Viviane Pfluger
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Shauna L. Rohner
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Carla M. Eising
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Myriam V. Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
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29
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Okwori G, Stewart S, Quinn M, Lawson D. Health Care Burden and Expenditure Associated with Adverse Childhood Experiences in Tennessee and Virginia. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:727-739. [PMID: 35958731 PMCID: PMC9360380 DOI: 10.1007/s40653-021-00390-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 06/15/2023]
Abstract
To estimate attributable burden and costs of conditions associated with exposure to Adverse Childhood Experiences (ACEs) in Tennessee (TN) and Virginia (VA) during 2017. This is a cross-sectional study of individuals aged 18+ having exposure to ACEs using Behavioral Risk Factor Surveillance System (BRFSS) data. Eight chronic diseases (asthma, obesity, hypertension, diabetes, chronic obstructive pulmonary disease (COPD), depression, cardiovascular disease, and arthritis) and two risk factors (smoking and drinking) associated with ACEs were analyzed. Pearson's chi-square tests analyzed the association between ACEs, risk factors and chronic diseases. The population attributable risks (PAR) were estimated for the ACEs related diseases and risk factors and combined with health care expenses and Disability Adjusted-Life-Years (DALYs). Among those who experienced at least 1 ACE in TN, 10% had COPD, 17% had diabetes, 36% had obesity, and 30% had depression. Individuals who experienced at least 1 ACE in VA had higher percentages for COPD, obesity and depression diseases compared to those who had no ACE (p< .0001). ACEs' exposure resulted in a burden of about 115,000 years and 127,000 years in terms of DALYs in TN and VA, respectively. The total health spending associated with ACEs based on PARs was about $647 million ($165 per adult) and $942 million ($292 per adult) in TN and VA respectively. The total costs associated with ACEs was about $15.5 billion ($3948) per person) and $20.2 billion ($6288 per person) in TN and VA, respectively. This study emphasizes the need to reduce ACEs due to high health and financial costs.
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Affiliation(s)
- Glory Okwori
- Department of Health Services Management and Policy, East Tennessee State University, Johnson City, TN USA
| | - Steven Stewart
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN USA
| | - Megan Quinn
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN USA
| | - Delaney Lawson
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN USA
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Clemens V, Köhler-Dauner F, Keller F, Ziegenhain U, Fegert JM. Adverse childhood experiences are associated with a higher risk for increased depressive symptoms during Covid-19 pandemic - a cross-sectional study in Germany. BMC Psychiatry 2022; 22:540. [PMID: 35948968 PMCID: PMC9365680 DOI: 10.1186/s12888-022-04177-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Covid-19 pandemic has been profoundly affecting people around the world. While contact restrictions, school closures and economic shutdown were effective to reduce infection rates, these measures go along with high stress for many individuals. Persons who have experienced adverse childhood experiences (ACEs) have an increased risk for mental health problems already under normal conditions. As ACEs can be associated with a higher vulnerability to stress we aimed to assess the role of ACEs on depressive symptoms during the Covid-19 pandemic. METHODS In a cross-sectional online survey, 1399 participants above the age of 18 years were included during the first lockdown in Germany. Via two-way repeated measures ANOVA, differences in depressive symptoms before (retrospectively assessed) and during the pandemic were analyzed. Linear regression analyses were performed in order to identify predictors for increase of depressive symptoms. RESULTS Compared to prior to the Covid-19 pandemic, depressive symptoms increased among all participants. Participants with ACEs and income loss reported about a stronger increase of depressive symptoms. Other predictors for increased depressive symptoms were young age and a lack of social support. CONCLUSIONS Based on these results, ACEs are a significant predictor for an increase in depressive symptoms during the pandemic, indicating that personss with ACEs may be a risk group for mental health problems during the current and potential later pandemics. These findings underline the relevance of support for persons who have experienced ACEs and may help to provide more targeted support in possible scenarios due to the current or possible other pandemics. Besides, economic stability seems to be of prior importance for mental health.
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Affiliation(s)
- Vera Clemens
- Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany.
| | - Franziska Köhler-Dauner
- grid.6582.90000 0004 1936 9748Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstraße 5, 89075 Ulm, Germany
| | - Ferdinand Keller
- grid.6582.90000 0004 1936 9748Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstraße 5, 89075 Ulm, Germany
| | - Ute Ziegenhain
- grid.6582.90000 0004 1936 9748Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstraße 5, 89075 Ulm, Germany
| | - Jörg M. Fegert
- grid.6582.90000 0004 1936 9748Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstraße 5, 89075 Ulm, Germany
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31
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Higher hair cortisol concentrations associated with shorter leukocyte telomere length in high-risk young adults. Sci Rep 2022; 12:11730. [PMID: 35821228 PMCID: PMC9276815 DOI: 10.1038/s41598-022-14905-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/14/2022] [Indexed: 01/01/2023] Open
Abstract
Chronic stress is associated with accelerated biological aging as indexed by short age-adjusted leukocyte telomere length (LTL). Exploring links of biological stress responses with LTL has proved challenging due to the lack of biological measures of chronic psychological stress. Hair cortisol concentration (HCC) has emerged as a measure of chronic hypothalamic pituitary adrenal (HPA) axis activation, allowing the examination of relationships between aggregate cortisol concentrations over time and LTL. Our sample includes 92 participants (38% women, Mage = 26 ± 3.7 years) from a high-risk sample of young adults with previous residential care placements. Two cm hair was collected for HCC, reflecting approximately eight weeks of cortisol secretion. LTL was measured with quantitative polymerase chain reaction (qPCR) in whole blood samples. All samples for LTL were run in triplicate and assayed twice. Linear and polynomial regression models were used to describe the association between HCC and LTL, adjusting for age and sex. HCC and LTL showed negative associations (std. ß = − 0.67, 95% CI [− 0.83, − 0.52], p < .001) in age- and sex-adjusted analyses, indicating that higher HCCs are associated with shorter LTL. Using polynomial regression, we found a curvilinear relationship indicating a stronger negative association at lower cortisol concentrations. Higher HCCs were associated with shorter LTL, supporting the hypothesized involvement of prolonged cortisol secretion in telomere attrition. Thus, HCC may prove useful as a biological indicator of chronic stress associated with aging-related processes in samples exposed to high levels of stress.
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Schär S, Mürner-Lavanchy I, Schmidt SJ, Koenig J, Kaess M. Child maltreatment and hypothalamic-pituitary-adrenal axis functioning: A systematic review and meta-analysis. Front Neuroendocrinol 2022; 66:100987. [PMID: 35202606 DOI: 10.1016/j.yfrne.2022.100987] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/11/2022] [Accepted: 02/17/2022] [Indexed: 11/04/2022]
Abstract
Alterations in hypothalamic-pituitary-adrenal (HPA) axis and its effector hormone cortisol have been proposed as one possible mechanism linking child maltreatment experiences to health disparities. In this series of meta-analyses, we aimed to quantify the existing evidence on the effect of child maltreatment on various measures of HPA axis activity. The systematic literature search yielded 1,858 records, of which 87 studies (k = 132) were included. Using random-effects models, we found evidence for blunted cortisol stress reactivity in individuals exposed to child maltreatment. In contrast, no overall differences were found in any of the other HPA axis activity measures (including measures of daily activity, cortisol assessed in the context of pharmacological challenges and cumulative measures of cortisol secretion). The impact of several moderators (e.g., sex, psychopathology, study quality), the role of methodological shortcomings of existing studies, as well as potential directions for future research are discussed.
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Affiliation(s)
- Selina Schär
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Ines Mürner-Lavanchy
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stefanie J Schmidt
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany; Section for Experimental Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Clinic for Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany.
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33
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Maier A, Fegert JM, Hoffmann U. "An uncomfortable topic": Health professionals' perspectives on child protection capacities, training offers and the potential need for action in Germany. BMC Health Serv Res 2022; 22:571. [PMID: 35484623 PMCID: PMC9052563 DOI: 10.1186/s12913-022-07905-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 04/04/2022] [Indexed: 11/22/2022] Open
Abstract
Background Child maltreatment, due to its high prevalence and often long-lasting (health and/or psycho-social) consequences, is one of the main reasons for global health inequalities. The medical field offers many opportunities to support affected children. This gives physicians and other health professionals the opportunity to provide protective measures and therapies to affected children at an early stage. However, the level of training concerning child protection is often too low among health professionals. This can affect the quality of care as well as providing the appropriate treatment and thus, the long-term (health) burden. The present work aims to survey the state of knowledge and capacities of health professionals regarding child protection in medicine and elicit health professionals' perspectives who absolved a child protection online course on a potential need for action in Germany. Methods From June 2016 until February 2021, 3,360 health professionals were interviewed. Using quantitative and qualitative items, the questionnaire assessed demographic and professional background information as well as assessments regarding the awareness of child protection, abilities in child protection among health professionals and training offers in medicine. Results The analysis indicates that the topic of child protection in medicine is not as present as the high prevalence of child maltreatment would imply. The majority (94.0%; n = 3.159) of the health professionals stated that they need more knowledge and capacities regarding child protection in medicine. More than half of the health professionals assessed the importance of the issue of child protection as low among health professionals. The reasons cited included child protection as an uncomfortable topic, an unwillingness among managers, and a lack of training on the topic. Conclusions There is too little awareness and importance regarding child protection in the medical field in Germany. Hence, it is difficult to ensure adequate care for those affected. Child protection topics should be mandatory in the training curricula of all health professionals, and quality standards for prevention and intervention should be implemented in medical institutions. Furthermore, networking in child protection has to be improved, and medical campaigns should address the topic to sensitize health professionals and society to the issue and to destigmatize the topic.
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Affiliation(s)
- Anna Maier
- Ulm University Hospital, Department of Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstr. 5, Ulm, 89075, Germany.
| | - Jörg M Fegert
- Ulm University Hospital, Department of Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstr. 5, Ulm, 89075, Germany
| | - Ulrike Hoffmann
- Ulm University Hospital, Department of Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstr. 5, Ulm, 89075, Germany
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Klein S, Fegert JM, Geprägs A, Brähler E, Clemens V. The Impact of the COVID-19 Pandemic on Health, Quality of Life and Intrafamilial Relations - A Population-Based Survey in Germany. Front Psychol 2022; 13:844057. [PMID: 35360600 PMCID: PMC8963202 DOI: 10.3389/fpsyg.2022.844057] [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] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/16/2022] [Indexed: 12/28/2022] Open
Abstract
The occurrence of the novel severe acute respiratory syndrome coronavirus-2 (COVID-19) at the end of 2019 comes along with many challenges. Besides worry for one's own health and the well-being of the family, all measures applied to limit the spread of the coronavirus affected daily life. School closures, economic shutdown and contact restrictions have led to high levels of stress. The impact on health and families has been widely discussed. However, population-based data are scarce. Here, we have assessed health, quality of life and intrafamilial relations depending on the COVID-19 pandemic. Using a three-step random-route approach, a population-based sample of 2,515 persons (52.6% female, average age of 50.3 years) was recruited during the second COVID-19 wave in Germany in winter 2020/21. While the majority of participants reported no change in their health status and the relationship with their partner and children, more than half of participants reported a decreased quality of life since the beginning of the pandemic. Female gender, age above 60 years, a low household income, not living with a partner and the experience of childhood adversity were associated with a higher risk for a worsening of health, quality of life and intrafamilial relations. These had already been well-established risk factors ahead of the pandemic. In order to avoid further increase of inequality in our society and more devastating impact of the pandemic on health and intrafamilial relations, low-level support and intervention programs are urgently needed.
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Affiliation(s)
- Stephanie Klein
- Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Jörg M. Fegert
- Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Alina Geprägs
- Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Elmar Brähler
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Vera Clemens
- Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
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Adulthood asthma as a consequence of childhood adversity: a systematic review of epigenetically affected genes. J Dev Orig Health Dis 2022; 13:674-682. [PMID: 35256035 DOI: 10.1017/s2040174422000083] [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: 11/06/2022]
Abstract
There is an accumulating data that shows relation between childhood adversity and vulnerability to chronic diseases as well as epigenetic influences that in turn give rise to these diseases. Asthma is one of the chronic diseases that is influenced from genetic regulation of the inflammatory biomolecules and therefore the hypothesis in this research was childhood adversity might have caused epigenetic differentiation in the asthma-related genes in the population who had childhood trauma. To test this hypothesis, the literature was systematically reviewed to extract epigenetically modified gene data of the adults who had childhood adversity, and affected genes were further evaluated for their association with asthma. PRISMA guidelines were adopted and PubMed and Google Scholar were included in the searched databases, to evaluate epigenetic modifications in asthma-related genes of physically, emotionally or sexually abused children. After retrieving a total of 5245 articles, 36 of them were included in the study. Several genes and pathways that may contribute to pathogenesis of asthma development, increased inflammation, or response to asthma treatment were found epigenetically affected by childhood traumas. Childhood adversity, causing epigenetic changes in DNA, may lead to asthma development or influence the course of the disease and therefore should be taken into account for the prolonged health consequences.
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36
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Cameranesi M, Shooshtari S, Piotrowski CC. Investigating adjustment profiles in children exposed to intimate partner violence using a biopsychosocial resilience framework: A Canadian population-based study. CHILD ABUSE & NEGLECT 2022; 125:105453. [PMID: 35032822 DOI: 10.1016/j.chiabu.2021.105453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/14/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The variability observed across different profiles of adjustment in children exposed to intimate partner violence (IPV) and the factors associated with resilience in this population are not yet well understood. OBJECTIVE Within a biopsychosocial framework, this study aimed to identify and describe profiles of adjustment in a cohort of children who had previously experienced IPV exposure, as well as the specific risk and promotive factors that significantly predicted membership in the identified adjustment profiles. The moderating effect of children's biological sex was also tested. PARTICIPANTS AND SETTING Population-based administrative data on all residents of the Province of Manitoba (Canada) over a 12-year period (2006-2017) were used to create a cohort of 3886 children aged 6-11 years who experienced IPV exposure and to extract information on these children and their mothers. METHOD Within a retrospective cohort study design, all study variables were extracted by linking multiple administrative health, social and justice datasets that were available in the Manitoba Population Research Data Repository. RESULTS Person-centered latent class analysis revealed four distinct adjustment profiles in the cohort of children, which differed for boys and girls. These included a resilient profile in which children showed no adjustment problems, as well as three profiles showing different combinations of children's externalizing problems and physical health problems. Positive maternal mental and physical health were the strongest predictors of resilient profile membership in both boys and girls. CONCLUSIONS Study results suggest interconnectedness among biological, psychological and social domains in shaping the adjustment of children exposed to IPV and corroborate existing evidence on the key role that mothers play in promoting the resilience of these children. Thus, future resilience research with this group and resilience-promoting programming for IPV-affected families would benefit from adopting a multisystemic biopsychosocial resilience framework that simultaneously accounts for factors at all levels of human ecologies.
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Affiliation(s)
- Margherita Cameranesi
- Faculty of Health, School of Social Work, Dalhousie University, Halifax, NS, Canada.
| | - Shahin Shooshtari
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Caroline C Piotrowski
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
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Lepsy N, Dering MR, Fuge J, Meltendorf T, Hoeper MM, Heitland I, Kamp JC, Park DH, Richter MJ, Gall H, Ghofrani HA, Ellermeier D, Kulla HD, Olsson KM, Kahl KG. Childhood Maltreatment, Mental Well-Being, and Healthy Lifestyle in Patients With Chronic Thromboembolic Pulmonary Hypertension. Front Psychiatry 2022; 13:821468. [PMID: 35280158 PMCID: PMC8908105 DOI: 10.3389/fpsyt.2022.821468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/31/2022] [Indexed: 01/29/2023] Open
Abstract
Introduction Chronic thromboembolic pulmonary hypertension (CTEPH) is a potentially life-threatening condition associated with high morbidity and mortality. However, advances in medical, surgical and interventional treatment have markedly improved the outcome of patients with CTEPH. Additional factors potentially influencing quality of life (QoL) and outcome in CTEPH are yet to be defined. Child maltreatment is a major risk factor for unfavorable behavioral, mental as well as physical health outcomes and has been associated with decreased QoL. To date, no study assessed the impact of childhood trauma in patients with CTEPH. Methods Patients with CTEPH were invited to complete the Childhood Trauma Questionnaire (CTQ). Data were compared to prevalence data from the German population. Mental well-being was assessed using the Hospital Anxiety and Depression Scale (HADS) and quality of life was measured using the WHO Quality of Life Questionnaire (WHOQOL). Furthermore, lifestyle factors and physical health parameters were studied.Logistic regression analysis was used to investigate a possible impact of child maltreatment on markers of disease severity. Results One-hundred and seven patients with CTEPH completed the CTQ. These patients reported higher rates of emotional abuse and physical abuse and emotional neglect compared to the German population while rates of physical neglect and sexual abuse did not differ between patients and German population with prevalence of 20.6% for emotional abuse, 20% for physical abuse, 22% for emotional neglect, 46% for physical neglect, and 6% for sexual abuse in patients with CTEPH. Higher CTQ scores were associated with anxiety symptoms as well as negatively associated with QoL. No direct impact of childhood trauma on CTEPH severity was found. Conclusion We found a higher rate of child maltreatment in patients with CTEPH in comparison to the German population. Correlations suggest moderate associations between CTQ scores and mental health and QoL. Child maltreatment had no significant impact on disease severity. Further investigation on proper interventions to support affected patients is needed.
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Affiliation(s)
- Nicole Lepsy
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Madelaine-Rachel Dering
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Jan Fuge
- Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL/BREATH), Hannover, Germany
| | - Tanja Meltendorf
- Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL/BREATH), Hannover, Germany
| | - Marius M. Hoeper
- Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL/BREATH), Hannover, Germany
| | - Ivo Heitland
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Jan C. Kamp
- Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL/BREATH), Hannover, Germany
| | - Da-Hee Park
- Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL/BREATH), Hannover, Germany
| | - Manuel J. Richter
- Department of Internal Medicine, German Center for Lung Research (DZL), Justus Liebig University Giessen, Universities of Gießen and Marburg Lung Center, Giessen, Germany
| | - Henning Gall
- Department of Internal Medicine, German Center for Lung Research (DZL), Justus Liebig University Giessen, Universities of Gießen and Marburg Lung Center, Giessen, Germany
| | - Hossein A. Ghofrani
- Department of Internal Medicine, German Center for Lung Research (DZL), Justus Liebig University Giessen, Universities of Gießen and Marburg Lung Center, Giessen, Germany
- Department of Pneumology, Kerckhoff Heart, Rheuma and Thoracic Center, German Center for Lung Research, Universities of Giessen and Marburg Lung Center, Bad Nauheim, Germany
| | | | | | - Karen M. Olsson
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
- Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL/BREATH), Hannover, Germany
| | - Kai G. Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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Park DH, Meltendorf T, Kahl KG, Kamp JC, Richter MJ, Gall H, Ghofrani HA, Hoeper MM, Olsson KM, Fuge J. Childhood Trauma in Patients With PAH-Prevalence, Impact on QoL, and Mental Health-A Preliminary Report. Front Psychiatry 2022; 13:812862. [PMID: 35222119 PMCID: PMC8866231 DOI: 10.3389/fpsyt.2022.812862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/17/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/OBJECTIVE Child maltreatment is associated with increased risk of psychological consequences, contributes to morbidity and has long lasting effects on mental health and quality of life. Child maltreatment has not been assessed in patients with pulmonary arterial hypertension (PAH). We examined the prevalence of child maltreatment and determined their impact on disease severity in patients with PAH. METHODS A cross-sectional observational multicenter study at two PH centers in Germany was conducted. Patients with a confirmed diagnosis of PAH were given a self-administered questionnaire. Child maltreatment using the Childhood Trauma Questionnaire (CTQ), quality of life (QoL), anxiety, depression, and lifestyle factors were assessed and enhanced by clinical parameters 6-min walk distance (6MWD), WHO functional class (WHO FC), and serum levels of N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP). Prevalence rates of child maltreatment were compared to the general population and impact of child maltreatment on disease severity was calculated by logistic regression analysis. RESULTS Two-hundred and seventeen patients, 71% female and a median age of 56 years were enrolled in this study. Patients with PAH had higher rates of emotional abuse and lower rates of physical neglect compared to the German population while rates of emotional neglect, physical abuse, and sexual abuse did not differ between patients and German population. Patients with any form of child maltreatment were more likely to be active smokers, had a worse QoL and more anxiety or depression. Moderate associations between child maltreatment, mental health, QoL, lifestyle factors and clinical parameters could be observed. Logistic regression analysis showed a significant impact of CTQ-total score on disease severity with an OR of 1.022 (95%-CI: 1.001-1.042, p = 0.035). CONCLUSION We found a higher rate of child maltreatment in patients with PAH in comparison to the German population. Correlations suggest moderate associations between CTQ-scores and mental health as well as QoL. Child maltreatment had significant impact on disease severity. However, effects were moderate. We conclude that child maltreatment has effects on mental health and quality of life in patients with PAH and may have limited effect on disease severity.
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Affiliation(s)
- Da-Hee Park
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
| | - Tanja Meltendorf
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Kai G. Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Jan C. Kamp
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
| | - Manuel J. Richter
- Department of Internal Medicine, Justus Liebig University Giessen, Giessen, Germany
- German Center for Lung Research, Universities of Giessen and Marburg Lung Center, Giessen, Germany
| | - Henning Gall
- Department of Internal Medicine, Justus Liebig University Giessen, Giessen, Germany
- German Center for Lung Research, Universities of Giessen and Marburg Lung Center, Giessen, Germany
| | - Hossein A. Ghofrani
- Department of Internal Medicine, Justus Liebig University Giessen, Giessen, Germany
- German Center for Lung Research, Universities of Giessen and Marburg Lung Center, Giessen, Germany
| | - Marius M. Hoeper
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
| | - Karen M. Olsson
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
| | - Jan Fuge
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
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Fernández‐Arana A, Olórtegui‐Yzú A, Vega‐Dienstmaier JM, Cuesta MJ. Depression and anxiety symptoms and perceived stress in health professionals in the context of COVID-19: Do adverse childhood experiences have a modulating effect? Brain Behav 2022; 12:e2452. [PMID: 34910383 PMCID: PMC8785635 DOI: 10.1002/brb3.2452] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/01/2021] [Accepted: 11/11/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACE) have a great impact on mental health outcomes of adults. However, little is known whether ACE may act as modulators of the mental health of health professionals caring for patients with COVID-19. METHODS Data were collected through an online cross-sectional survey administered to health professionals in Lima (Peru) between May and July 2020. The survey included standardized self-assessment instruments for anxiety, depression, acute stress (AS) and history of ACE. RESULTS A total of 542 health professionals completed the survey. Caring for patients with COVID-19 was significantly associated with depression and anxiety and when caring for patients with COVID-19 was combined with a history of early sexual abuse, its effect on the risk of anxiety increased (OR = 7.71, p = .010). Mental health problems were associated with female gender in almost all the analyses and with the majority of ACEs. CONCLUSIONS Health workers in the context of the COVID-19 pandemic presented a high risk of mental health disorders. Antecedents of sexual abuse acted as a potentiating factor of anxiety in professionals providing COVID-19 care. These findings suggest that the burden of ACE modulates mental health problems in health professionals during the pandemic.
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Affiliation(s)
| | - Adriel Olórtegui‐Yzú
- Universidad Nacional Mayor de San MarcosFacultad de Medina de San FernandoLimaPeru
- Instituto Nacional Cardiovascular ‐ INCOR ‐ EsSaludLimaPeru
| | | | - Manuel J. Cuesta
- Department of PsychiatryComplejo Hospitalario de NavarraPamplonaSpain
- Navarra Institute for Health Research (IdiSNA)Mental health areaPamplonaSpain
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Schmid M, Fegert JM, Clemens V, Seker S, d’Huart D, Binder M, Schröder M, Friden L, Boonmann C, Jenkel N, Schmeck K, Bürgin D. Misshandlungs- und Vernachlässigungserfahrungen in der Kindheit: Ein Risikofaktor für die soziale Teilhabe ehemals außerfamiliär platzierter junger Erwachsener. KINDHEIT UND ENTWICKLUNG 2022. [DOI: 10.1026/0942-5403/a000366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Eine Reihe von Studien zeigen soziale Folgen von Misshandlung und Vernachlässigung in der Kindheit im weiteren Lebenslauf. Fragestellung: Diese Studie zielt darauf ab, die langfristigen Auswirkungen von Misshandlungs- und Vernachlässigungserfahrungen auf die soziale Teilhabe in einer Stichprobe von ehemals fremdplatzierten jungen Erwachsenen in der Schweiz zu untersuchen. Methode: Im Rahmen der Studie wurden 218 ehemals fremdplatzierte junge Erwachsene ( MAlter=26.1, 32.6 % weiblich) mit einer psychometrischen Testbatterie befragt. Dabei wurden Misshandlungserfahrungen in der Kindheit erfasst sowie die soziale Teilhabe bezüglich psychischer Gesundheit, Legalbewährung, sozio-ökonomische Lage und Beziehungen untersucht. Ergebnisse: Die Ergebnisse zeigen die hohe Prävalenz und negativen Folgen von kumulierten Misshandlungserfahrungen bei ehemals fremdplatzierten jungen Menschen. Eine höhere Anzahl von Misshandlungserfahrungen ging mit signifikant mehr Problemen in gesundheitlichen, finanziellen und sozialen Lebensbereichen einher. Diskussion und Schlussfolgerung: Die gravierenden Folgen von Misshandlungserfahrungen in der Kindheit unterstreichen die Bedeutung der Prävention und frühzeitigen Intervention. Sie zeigen aber auch, dass viele schwer betroffene junge Menschen neben therapeutischen auch konkrete und lebensweltorientierte Hilfen benötigen, um ihre Entwicklungsaufgaben adäquat zu bewältigen und erfolgreich an der Gesellschaft teilzuhaben.
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Affiliation(s)
- Marc Schmid
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Jörg M. Fegert
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitäre Kliniken Ulm, Universität Ulm
| | - Vera Clemens
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitäre Kliniken Ulm, Universität Ulm
| | - Süheyla Seker
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Delfine d’Huart
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Melanie Binder
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Martin Schröder
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Liz Friden
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Cyril Boonmann
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Nils Jenkel
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Klaus Schmeck
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - David Bürgin
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
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Brown M, Worrell C, Pariante CM. Inflammation and early life stress: An updated review of childhood trauma and inflammatory markers in adulthood. Pharmacol Biochem Behav 2021; 211:173291. [PMID: 34695507 DOI: 10.1016/j.pbb.2021.173291] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/10/2021] [Accepted: 10/13/2021] [Indexed: 10/20/2022]
Abstract
Inflammation, as a neurobiological consequence of childhood trauma, has frequently been reported across research, however, recent investigations suggest this relationship may be dependent on specificities such as type of trauma, type of inflammatory marker, and additional mediatory variables - such as body mass index (BMI), age, and sex. As an updated version of a previous review by Baumeister et al., the current review comprised a search of PubMed, which identified 37 articles that collectively assessed 4 inflammatory markers (CRP, IL-6, TNFα and IL-1β). A review of the studies revealed predominantly non-significant associations between childhood trauma and elevated levels of all inflammatory markers in adulthood. However, in line with previous research, discrepancies in significance arose when considering type of trauma, type of inflammatory marker, and additional variables. Compared to neglect, abuse showed greater significant associations with elevated inflammatory markers in adulthood, though this was dependent on the individual subtypes (emotional, physical or sexual). Mediation analyses reported BMI as a significant mediator, though, when controlled for, no significant differences were found. Sex differences were reported but investigations were sparse. Future research should investigate the mediatory role of sex differences in the inflammatory effects of childhood trauma. Many studies in the review were restricted by use of the same trauma measure - the Childhood Trauma Questionnaire. To assess greater variety of trauma types, future studies should utilize other standardized measures to explore these avenues.
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Affiliation(s)
- Mollie Brown
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Courtney Worrell
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Carmine M Pariante
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
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Evaluation of an Early Intervention Model for Child and Adolescent Victims of Interpersonal Violence. CHILDREN-BASEL 2021; 8:children8100941. [PMID: 34682206 PMCID: PMC8534372 DOI: 10.3390/children8100941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022]
Abstract
Only the minority of youth exposed to traumatic events receive mental health care, as trauma-informed clinical services are lacking or are poorly accessible. In order to bridge this gap, the Outpatient Trauma Clinic (OTC) was founded, an easily accessible early, short-time intervention, with onward referral to follow-up treatment. This report presents the OTC's interventional approach and first outcome data. Using a retrospective naturalistic design, we analyzed trauma- and intervention-related data of the sample (n = 377, 55.4% female, mean age 10.95, SD = 4.69). Following drop-out analyses, predictors for treatment outcome were identified by logistic regression. The majority (81.9%) was suffering from posttraumatic stress disorder (PTSD) or adjustment disorders. Around one forth dropped out of treatment; these cases showed higher avoidance symptoms at presentation. In 91%, psychological symptoms improved. Experience of multiple traumatic events was the strongest predictor for poor treatment outcome (B = -0.823, SE = 0.313, OR = 0.439, 95% CI 0.238-0.811). Around two thirds were connected to follow-up treatment. The OTC realized a high retention rate, initial improvement of symptoms and referral to subsequent longer-term psychotherapeutic treatment in the majority. Further dissemination of comparable early intervention models is needed, in order to improve mental health care for this vulnerable group.
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Clemens V, Köhler-Dauner F, Ziegenhain U, Fegert JM. Predictors of Parental Coping During the Covid-19 Pandemic: A Survey in Germany. Front Psychol 2021; 12:715327. [PMID: 34566797 PMCID: PMC8460925 DOI: 10.3389/fpsyg.2021.715327] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/10/2021] [Indexed: 12/27/2022] Open
Abstract
The Covid-19 pandemic has been profoundly affecting nearly everybody, but families with minors have been hit particularly. Closure of schools and kindergartens, home schooling, and working from home have led to a profound upheaval in family life. Parental adverse childhood experiences (ACEs) are an important determinant for parenting behavior. Importantly, ACEs can increase the vulnerability to stress and impair coping strategies. The current pandemic leads to increased parental stress, a risk factor for harsh parenting behavior, Therefore, we aimed to assess the role of ACEs and sociodemographic factors associated to parental coping during the current pandemic. In a cross-sectional online survey, 687 parents of minors in Germany were included. Demographic and psychosocial factors associated to parental coping during the first lockdown due to the Covid-19 pandemic were assessed. Results show that younger age of the respective child, income loss, dissatisfaction with the sharing of childcare duties, and ACEs were significantly associated with an increase of potential harmful parenting behavior during the Covid-19 pandemic. An increase of dissatisfaction with the sharing of childcare duties during the pandemic was predicted by working from home and taking care of the children mainly by oneself, while sharing childcare duties with the partner equally resulted even in an increase of satisfaction with sharing of childcare duties during the pandemic. These findings demonstrate that a history of childhood adversity in a parent is a risk factor for harmful parenting during the pandemic. Parental satisfaction with sharing of caregiving is an important factor for parental coping during the pandemic. Sharing of caregiving between partners should be encouraged.
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Affiliation(s)
- Vera Clemens
- Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | | | - Ute Ziegenhain
- Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Jörg M Fegert
- Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
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Clemens V, Bürgin D, Huber-Lang M, Plener PL, Brähler E, Fegert JM. The Interplay between Child Maltreatment and Stressful Life Events during Adulthood and Cardiovascular Problems-A Representative Study. J Clin Med 2021; 10:jcm10173937. [PMID: 34501385 PMCID: PMC8432252 DOI: 10.3390/jcm10173937] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/28/2021] [Accepted: 08/29/2021] [Indexed: 01/01/2023] Open
Abstract
Psychological stress is a major risk factor for cardiovascular diseases. While the relevance of early life stress, such as that which is due to child maltreatment (CM), is well known to impact individual stress responses in the long-term, and data on the interplay between CM and stressful events in adulthood on cardiovascular health are sparse. Here, we aimed to assess how stressful life events in adulthood are associated with cardiovascular health infarction in later life and whether this association is independent of CM. In a cross-sectional design, a probability sample of the German population above the age of 14 was drawn using different sampling steps. The final sample included 2510 persons (53.3% women, mean age: 48.4 years). Participants were asked about sociodemographic factors, adult life events, CM, and health conditions in adulthood. Results indicate that the number of experienced adverse life events in adulthood is associated with significantly increased odds for obesity (Odds Ration (OR)women = 1.6 [1.3; 2.0], ORmen = 1.4 [1.1; 1.9]), diabetes (ORwomen = 1.5 [1.1; 2.1], ORmen = 1.5 [1.1; 2.3]) and myocardial infarction (ORwomen = 2.1 [1.0; 4.3], ORmen = 1.8 [1.1; 2.8]). This association is not moderated by the experience of CM, which is associated with cardiovascular problems independently. Taken together, adult stressful life events and CM are significantly and independently associated with cardiovascular health in men and women in the German population in a dose-dependent manner. General practitioners, cardiologists and health policy-makers should be aware of this association between psychosocial stressors during childhood and adulthood and cardiovascular health.
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Affiliation(s)
- Vera Clemens
- Department for Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstraße 5, University of Ulm, 89075 Ulm, Germany; (P.L.P.); (J.M.F.)
- Correspondence: ; Tel.: +49-731-500-61611
| | - David Bürgin
- Department of Child and Adolescent Psychiatry, Psychiatric Hospitals of the University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland;
| | - Markus Huber-Lang
- Institute of Clinical and Experimental Trauma Immunology, Ulm University Medical Centre, Helmholtzstraße 8/1, 89081 Ulm, Germany;
| | - Paul L. Plener
- Department for Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstraße 5, University of Ulm, 89075 Ulm, Germany; (P.L.P.); (J.M.F.)
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Elmar Brähler
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany;
- Integrated Research and Treatment Center (IFB) Adiposity Diseases-Behavioral Medicine, Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
| | - Jörg M. Fegert
- Department for Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstraße 5, University of Ulm, 89075 Ulm, Germany; (P.L.P.); (J.M.F.)
- Head of the Competence Area Mental Health Prevention Network Baden-Württemberg, Steinhövelstraße 5, 89075 Ulm, Germany
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Kuhar M, Zager Kocjan G. Associations of adverse and positive childhood experiences with adult physical and mental health and risk behaviours in Slovenia. Eur J Psychotraumatol 2021; 12:1924953. [PMID: 34262663 PMCID: PMC8253200 DOI: 10.1080/20008198.2021.1924953] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/17/2021] [Indexed: 11/19/2022] Open
Abstract
Background: Many studies demonstrated the relationship between adverse childhood experiences (ACEs) and diminished health functioning in adulthood. A growing literature has shown that positive childhood experiences (PCEs) co-occurring with ACEs reduce the risks for negative outcomes. Objective: The aim was to investigate how ACEs and PCEs are simultaneously associated with health outcomes in adulthood, including self-rated health, physical and mental health outcomes, and health-risk behaviours. Methods: A panel sample of 4,847 Slovenian adults was used and the data were weighted to closely resemble the Slovenian population. A series of logistic regression analyses were performed to examine how ACEs and PCEs predict the risk of various health outcomes. Results: Significant associations, as measured by adjusted odds ratios, were found between higher ACEs exposure and each of the 16 health outcomes evaluated. Adjusting for above median PCEs attenuated the association between ACEs and 6 health outcomes (poor self-rated physical and mental health, depression, anxiety, suicide attempt, physical inactivity; OR for ≥ 4 vs. 0 ACEs, 1.48-9.34). Mirroring these findings, above median PCEs were associated with lowered odds of these 6 health outcomes after adjusting for ACEs (OR for above vs. below median PCEs, 0.46-0.67), but not with odds of physical health outcomes and most of the health-risk behaviours. Stratified analyses by ACEs exposure level showed that the association between PCEs and self-rated health remained stable across ACEs exposure levels, while the association between PCEs and mental health outcomes and physical inactivity varied across ACEs exposure levels. Conclusions: Our results suggest that above median PCEs attenuate the association between ACEs and poor self-rated health, mental health problems, and physical inactivity in later life, and are negatively associated with these health problems even in the concurrent presence of ACEs. Interventions to promote PCEs can help to reduce unfavourable long-term health outcomes following childhood adversity.
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Affiliation(s)
- Metka Kuhar
- Faculty of Social Sciences, University of Ljubljana, Ljubljana, Slovenia
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Frewen P, McPhail I, Schnyder U, Oe M, Olff M. Global Psychotrauma Screen (GPS): psychometric properties in two Internet-based studies. Eur J Psychotraumatol 2021; 12:1881725. [PMID: 34992750 PMCID: PMC8725737 DOI: 10.1080/20008198.2021.1881725] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 01/11/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Potentially traumatic stressors can lead to various transdiagnostic outcomes beyond PTSD alone but no brief screening tools exist for measuring posttraumatic responses in a transdiagnostic manner. Objective: Assess the psychometric characteristics of a new 22-item transdiagnostic screening measure, the Global Psychotrauma Screen (GPS). Method: An internet survey was administered with English speaking participants recruited passively via the website of the Global Collaboration on Traumatic Stress (GC-TS) (nGC-TS = 1,268) and actively via Amazon's MTurk (nMTurk = 1,378). Exploratory factor analysis, correlational analysis, sensitivity and specificity analysis, and comparisons in response between the two samples and between male and female respondents were conducted. Results: Exploratory factor analysis revealed a single factor underlying symptom endorsements in both samples, suggesting that such problems may form a unitary transdiagnostic, posttraumatic outcome. Convergent validity of the GPS symptom and risk factors was established with measures of PTSD and dissociative symptoms in the MTurk sample. Gender differences were seen primarily at the item level with women more often endorsing several symptoms and specific risk factors in the MTurk sample, and the GC-TS recruited sample endorsed more symptoms and risk factors than the MTurk sample, suggesting that the GPS may be sensitive to group differences. A GPS symptom cut-off score of 8 identified optimized sensitivity and specificity relative to probable PTSD based on PCL-5 scores. Conclusions: The current results provide preliminary support for the validity of the GPS as a screener for the concurrent measurement of several transdiagnostic outcomes of potentially traumatic stressors and the apparent unifactorial structure of such symptoms is suggestive of a single or unitary posttraumatic outcome. Future research is needed to evaluate whether similarly strong psychometric properties can be yielded in response to completion of the GPS in other languages.
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Affiliation(s)
- Paul Frewen
- Departments of Psychiatry & Psychology, Western University, London, Canada
| | - Ian McPhail
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
| | - Ulrich Schnyder
- Department of Psychiatry & Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Misari Oe
- Department of Neuropsychiatry, Kurume University, Kurume, Japan
| | - Miranda Olff
- Department of Psychiatry, University Medical Center, Amsterdam, The Netherlands
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Köhler-Dauner F, Clemens V, Lange S, Ziegenhain U, Fegert JM. Mothers' daily perceived stress influences their children's mental health during SARS-CoV-2-pandemic-an online survey. Child Adolesc Psychiatry Ment Health 2021; 15:31. [PMID: 34134733 PMCID: PMC8208071 DOI: 10.1186/s13034-021-00385-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 06/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The current situation caused by the SARS-CoV-2-pandemic is associated with serious losses for everyone and has been affecting social life, politics, the economy and the media worldwide. Preventive isolation and social distancing strategies have confronted families with a large number of different challenges. The current epidemic and quarantine restrictions have a verifiable influence on the emotional and social development of children and adolescents. During this ongoing situation children of parents, who already were mentally stressed, seem particularly at risk. OBJECTIVE We aimed to assess the role of maternal daily perceived stress on children's mental health during the SARS-CoV-2-pandemic. METHODS An online "SARS-CoV-2-pandemic survey" was developed to assess children's mental health since the beginning of the SARS-CoV-2 pandemic. To describe maternal perceived everyday stress, data from a longitudinal survey was utilized. Our survey includes elements and versions of the Childhood Trauma Questionnaire, the Strengths and Difficulties Questionnaire and the Perceived Stress Scale. We furthermore collected socio-demographic data. Due to our limited dependent variables we applied Tobit models for estimation. RESULTS We found a positive and significant effect of the maternal perceived everyday stress on children's emotional problems during the pandemic. Furthermore, results provide empirical evidence for an increase of the children's hyperactivity level dependent on the mother's perceived stress before the SARS-COV-2 crisis. We could not find significant effects for the relationship between mother's perceived everyday stress and the children's behavioral problems. CONCLUSIONS Analyses illustrate the effects on children's mental distress during everyday life in the SARS-CoV-2 pandemic. Future research needs to identify influencing factors with regard to political, economic and social restrictions, in order to prevent children's mental health problems.
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Affiliation(s)
- Franziska Köhler-Dauner
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, University of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany.
| | - Vera Clemens
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, University of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
| | - Stephanie Lange
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, University of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, University of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, University of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
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Pfaff A, Jud A, Schlarb A. Systematic review on the association between sleep-related hyperarousal and child maltreatment. Sleep Med 2021; 84:219-226. [PMID: 34171796 DOI: 10.1016/j.sleep.2021.05.041] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 05/25/2021] [Accepted: 05/31/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Various outcomes like sleep deficiencies can endure into adulthood as consequences from child maltreatment (CM). Hyperarousal as an explanation for the development of insomnia can be applied on this association. However, research on this link is lacking. METHOD A PRISMA-guided systematic literature review was conducted by searching academic literature databases. Empirical studies with no restriction of publishing year were eligible. Search terms were predefined and related to CM. RESULTS Of 602 records, 13 studies met the inclusion criteria. Sample sizes ranged from 39 to 304, with a total of 1469 participants. The studies were heterogenous, therefore comparability was diminished. Yet tendencies for sleep-related hyperarousal in maltreated individuals were found especially for somatic hyperarousal. Cortical and cognitive hyperarousal was rarely examined. CONCLUSION Hyperarousal (heightened nighttime acticity and heart rate, diminished heart rate variability) was found in individuals with CM experiences in several studies. The insights into mechanisms of how CM and sleep problems are interrelated, can help to sensitize therapists to not oversee CM experiences when a patient reports sleep difficulties. Yet, more studies with more rigorous methods are needed to illuminate this topic. This gap in research regarding the consequences of CM is not acceptable.
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Warrier V, Kwong ASF, Luo M, Dalvie S, Croft J, Sallis HM, Baldwin J, Munafò MR, Nievergelt CM, Grant AJ, Burgess S, Moore TM, Barzilay R, McIntosh A, van IJzendoorn MH, Cecil CAM. Gene-environment correlations and causal effects of childhood maltreatment on physical and mental health: a genetically informed approach. Lancet Psychiatry 2021; 8:373-386. [PMID: 33740410 PMCID: PMC8055541 DOI: 10.1016/s2215-0366(20)30569-1] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Childhood maltreatment is associated with poor mental and physical health. However, the mechanisms of gene-environment correlations and the potential causal effects of childhood maltreatment on health are unknown. Using genetics, we aimed to delineate the sources of gene-environment correlation for childhood maltreatment and the causal relationship between childhood maltreatment and health. METHODS We did a genome-wide association study meta-analysis of childhood maltreatment using data from the UK Biobank (n=143 473), Psychiatric Genomics Consortium (n=26 290), Avon Longitudinal Study of Parents and Children (n=8346), Adolescent Brain Cognitive Development Study (n=5400), and Generation R (n=1905). We included individuals who had phenotypic and genetic data available. We investigated single nucleotide polymorphism heritability and genetic correlations among different subtypes, operationalisations, and reports of childhood maltreatment. Family-based and population-based polygenic score analyses were done to elucidate gene-environment correlation mechanisms. We used genetic correlation and Mendelian randomisation analyses to identify shared genetics and test causal relationships between childhood maltreatment and mental and physical health conditions. FINDINGS Our meta-analysis of genome-wide association studies (N=185 414) identified 14 independent loci associated with childhood maltreatment (13 novel). We identified high genetic overlap (genetic correlations 0·24-1·00) among different maltreatment operationalisations, subtypes, and reporting methods. Within-family analyses provided some support for active and reactive gene-environment correlation but did not show the absence of passive gene-environment correlation. Robust Mendelian randomisation suggested a potential causal role of childhood maltreatment in depression (unidirectional), as well as both schizophrenia and ADHD (bidirectional), but not in physical health conditions (coronary artery disease, type 2 diabetes) or inflammation (C-reactive protein concentration). INTERPRETATION Childhood maltreatment has a heritable component, with substantial genetic correlations among different operationalisations, subtypes, and retrospective and prospective reports of childhood maltreatment. Family-based analyses point to a role of active and reactive gene-environment correlation, with equivocal support for passive correlation. Mendelian randomisation supports a (primarily bidirectional) causal role of childhood maltreatment on mental health, but not on physical health conditions. Our study identifies research avenues to inform the prevention of childhood maltreatment and its long-term effects. FUNDING Wellcome Trust, UK Medical Research Council, Horizon 2020, National Institute of Mental Health, and National Institute for Health Research Biomedical Research Centre.
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Affiliation(s)
- Varun Warrier
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
| | - Alex S F Kwong
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, UK; Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Mannan Luo
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands; Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Shareefa Dalvie
- South Africa MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jazz Croft
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hannah M Sallis
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, UK; Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jessie Baldwin
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marcus R Munafò
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, UK; School of Psychological Science, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Andrew J Grant
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Stephen Burgess
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK; Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Tyler M Moore
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute of the Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Ran Barzilay
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute of the Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK
| | - Marinus H van IJzendoorn
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands; Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Charlotte A M Cecil
- Department of Child and Adolescent Psychiatry, Erasmus MC, Rotterdam, Netherlands; Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands; Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, Netherlands
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50
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Clemens V, Köhler-Dauner F, Keller F, Ziegenhain U, Fegert JM, Kölch M. [Violence in intimate partnerships and mental problems in children and adolescents]. PSYCHOTHERAPEUT 2021; 66:209-216. [PMID: 33758468 PMCID: PMC7972021 DOI: 10.1007/s00278-021-00501-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/11/2021] [Indexed: 11/28/2022]
Abstract
Hintergrund Die durch die „coronavirus disease 2019“ (COVID-19) ausgelöste Pandemie hat das Leben von Familien in beispielloser Weise verändert. Während des ersten Lockdowns wurden außerfamiliäre Kontakte erheblich reduziert. Viele Eltern mussten parallel ihre Kinder betreuen und von zu Hause aus arbeiten, während der ökonomische Druck zunahm. Ziel der Arbeit (Fragestellung) Das Ziel der vorliegenden Studie war es, den Zusammenhang von Gewalt in intimen Partnerschaften und psychischen Problemen bei Kindern und Jugendlichen vor und während der COVID-19-Pandemie zu untersuchen. Material und Methoden Mithilfe einer Online-Querschnittsumfrage wurden die Daten von 687 Eltern minderjähriger Kinder in Deutschland erhoben. Demografische und psychosoziale Prädiktoren für Gewalt in intimen Partnerschaften und Assoziationen mit psychischen Gesundheitsproblemen von Kindern vor, während und nach dem ersten Lockdown aufgrund der COVID-19-Pandemie wurden analysiert. Die Umfrage fand vom 18.05.2020 bis zum 21.07.2020 statt. Der Lockdown in Deutschland begann am 23.03.2020 und endete über schrittweise Lockerungen – die ersten Schulen öffneten am 22.04.2020 wieder; die Öffnungen von Schulen, Kindergärten und Kitas zog sich bis Ende Juni 2020. Ergebnisse Ein geringeres Haushaltseinkommen und das Erleben von eigenen belastenden Kindheitserfahrungen erhöhen das Risiko, dass Studienteilnehmende Gewalt in ihrer Beziehung erfahren haben und darüber berichten. Kinder und Jugendliche, die in Familien leben, in denen Gewalt in intimen Partnerschaften vorkommt, wiesen nach Angaben der teilnehmenden Eltern vor und während der Pandemie häufiger höhere Werte für externalisierende Probleme auf, hinsichtlich emotionaler Probleme zeigten sich keine signifikanten Unterschiede. Diskussion Belastende Kindheitserlebnisse erhöhen das Risiko für Gewalt in intimen Partnerschaften – und diese wiederum das Risiko für psychische Probleme der eigenen Kinder. Insofern sollte auch in der psychotherapeutischen Praxis systematisch nach entsprechenden Erfahrungen gefragt und entsprechende Behandlungsangebote sollte empfohlen werden.
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Affiliation(s)
- Vera Clemens
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm, Steinhövelstr. 5, 89073 Ulm, Deutschland
| | - Franziska Köhler-Dauner
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm, Steinhövelstr. 5, 89073 Ulm, Deutschland
| | - Ferdinand Keller
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm, Steinhövelstr. 5, 89073 Ulm, Deutschland
| | - Ute Ziegenhain
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm, Steinhövelstr. 5, 89073 Ulm, Deutschland
| | - Jörg M Fegert
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm, Steinhövelstr. 5, 89073 Ulm, Deutschland
| | - Michael Kölch
- Klinik für Psychiatrie, Neurologie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Universitätsmedizin Rostock, Rostock, Deutschland
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