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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. [PMID: 38651545 DOI: 10.1111/bjop.12705] [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: 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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2
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Fares-Otero NE, Halligan SL, Vieta E, Heilbronner U. Pupil size as a potential marker of emotion processing in child maltreatment. J Affect Disord 2024; 351:392-395. [PMID: 38290582 DOI: 10.1016/j.jad.2024.01.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 01/08/2024] [Accepted: 01/26/2024] [Indexed: 02/01/2024]
Affiliation(s)
- Natalia E Fares-Otero
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (UBNeuro), Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Catalonia, Spain; Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain.
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (UBNeuro), Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Catalonia, Spain; Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain.
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Munich, Germany
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Tamman AJF, Abdallah CG, Dunsmoor JE, Cisler JM. Neural differentiation of emotional faces as a function of interpersonal violence among adolescent girls. J Psychiatr Res 2024; 172:90-101. [PMID: 38368703 DOI: 10.1016/j.jpsychires.2024.02.015] [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: 04/04/2023] [Revised: 01/29/2024] [Accepted: 02/02/2024] [Indexed: 02/20/2024]
Abstract
Interpersonal violence (IV) is associated with altered neural threat processing and risk for psychiatric disorder. Representational similarity analysis (RSA) is a multivariate approach examining the extent to which differences between stimuli correspond to differences in multivoxel activation patterns to these stimuli within each ROI. Using RSA, we examine overlap in neural patterns between threat and neutral faces in youth with IV. Participants were female adolescents aged 11-17 who had a history of IV exposure (n = 77) or no history of IV, psychiatric diagnoses, nor psychiatric medications (n = 37). Participants completed a facial emotion processing task during fMRI. Linear mixed models indicated that increasing hippocampal differentiation of fear and neutral faces was associated with increasing IV severity. Increased neural differentiation of these facial stimuli in the left and right hippocampus was associated with increasing physical abuse severity. Increased differentiation by the dACC correlated with increasing physical assault severity. RSA for most ROIs were not significantly associated with univariate activity, except for a positive association between amygdala RSA and activity to fear faces. Differences in statistically significant ROIs for physical assault and physical abuse may highlight distinct effects of trauma type on encoding of threat vs. neutral faces. Null associations between RSA and univariate activation in most ROIs suggest unique contributions of RSA for understanding IV compared to traditional activation. Implications include understanding mechanisms of risk in IV and trauma-specific treatment selection. Future work should replicate these findings in longitudinal studies and identify sensitive periods for neural alterations in RSA.
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Affiliation(s)
- Amanda J F Tamman
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, Houston, TX 77030, USA.
| | - Chadi G Abdallah
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, Houston, TX 77030, USA; Yale School of Medicine, New Haven, CT 06510, USA; Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA; US Department of Veterans Affairs, National Center for PTSD - Clinical Neurosciences Division, VA Connecticut, West Haven, CT 06516, USA; Core for Advanced Magnetic Resonance Imaging (CAMRI), Baylor College of Medicine, Houston, TX 77030, USA
| | - Joseph E Dunsmoor
- Institute for Neuroscience, University of Texas at Austin, Austin, TX 78712, USA; Center for Learning and Memory, Department of Neuroscience, University of Texas at Austin, Austin, TX 78712, USA; Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, TX 78712, USA
| | - Josh M Cisler
- Institute for Neuroscience, University of Texas at Austin, Austin, TX 78712, USA; Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, TX 78712, USA; Institute for Early Life Adversity Research, The University of Texas at Austin, Dell Medical School, Department of Psychiatry and Behavioral Sciences, Austin, TX 78712, USA
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4
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Fares-Otero NE, O J, Spies G, Womersley JS, Gonzalez C, Ayas G, Mossie TB, Carranza-Neira J, Estrada-Lorenzo JM, Vieta E, Schalinski I, Schnyder U, Seedat S. Child maltreatment and resilience in adulthood: a protocol for a systematic review and meta-analysis. Eur J Psychotraumatol 2023; 14:2282826. [PMID: 38010898 PMCID: PMC10993816 DOI: 10.1080/20008066.2023.2282826] [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: 06/26/2023] [Accepted: 11/05/2023] [Indexed: 11/29/2023] Open
Abstract
Background: Although child maltreatment (CM) has been linked to health problems and poor psychosocial functioning, not all individuals exposed to CM develop or experience negative consequences later in life. This suggests that some individuals show resilience after being exposed to CM. However, conclusions have been limited by inconsistent findings across different CM subtypes and resilience domains.Objective: To develop a protocol for conducting a systematic review and meta-analysis to quantify associations between CM (overall and its subtypes) and resilience (global and its multiple domains) in adulthood, and to examine moderators and mediators of these associations.Method: PubMed, PsycINFO, Embase, Scopus, and Web of Science will be searched to identify relevant studies on the association between CM (exposure) and resilience (outcome) in adults (≥ 18 years). Data will be screened and extracted by at least two independent reviewers. The methodological quality of the included studies will be independently assessed with a modified version of the Newcastle-Ottawa Scale (NOS). If deemed viable, a meta-analysis will be conducted using a random effects model. Heterogeneity of evidence will be estimated with the I2 statistic, and publication bias will be assessed. The effects of potential moderators (e.g. timing and severity of CM, age, sex, family cohesion, socio-economic status, country/region) will be analysed using meta-regression and subgroup analyses, and meta-analytical structural equation modelling will be employed to synthesise indirect mediation effects. Candidate moderators and mediators (e.g. genetic factors, brain functioning, attachment style, personality traits, physical activity, and social support) will be also examined qualitatively.Conclusions: This protocol will facilitate a systematic review and meta-analysis that has the potential to enhance our knowledge about the association between CM exposure in early life and resilience in adulthood. Understanding associations and underlying mechanisms between CM and resilience is potentially important in informing prevention and interventions to sustain health and improve outcomes among adults with a history of CM.PROSPERO registration: CRD42023394120.
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Affiliation(s)
- Natalia E. Fares-Otero
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (UBNeuro), Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Spain
| | - Jiaqing O
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Georgina Spies
- South African PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Jacqueline S. Womersley
- South African PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Carolina Gonzalez
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Australia
| | - Görkem Ayas
- Graduate School of Health Sciences, Koç Üniversitesi, Istanbul, Turkey
| | - Tilahun Belete Mossie
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Julia Carranza-Neira
- Faculty of Health Sciences, School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | | | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (UBNeuro), Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Spain
| | - Inga Schalinski
- Universität der Bundeswehr München, Department of Human Sciences, Munich, Germany
| | | | - Soraya Seedat
- South African PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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5
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Pfaltz MC, Schnyder U. Allostatic Load and Allostatic Overload: Preventive and Clinical Implications. PSYCHOTHERAPY AND PSYCHOSOMATICS 2023; 92:279-282. [PMID: 37931612 PMCID: PMC10716872 DOI: 10.1159/000534340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 11/08/2023]
Affiliation(s)
- Monique C Pfaltz
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
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6
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Thomas M, Whittle S, Tian YE, van Rheenen TE, Zalesky A, Cropley VL. Pathways from threat exposure to psychotic symptoms in youth: The role of emotion recognition bias and brain structure. Schizophr Res 2023; 261:304-313. [PMID: 37898031 DOI: 10.1016/j.schres.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/21/2023] [Accepted: 10/11/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Research supports an association between threatening experiences in childhood and psychosis. It is possible that early threat exposure disrupts the development of emotion recognition (specifically, producing a bias for facial expressions relating to threat) and the brain structures subserving it, contributing to psychosis development. METHODS Using data from the Philadelphia Neurodevelopmental Cohort, we examined associations between threat exposure and both the misattribution of facial expressions to fear/anger in an emotion recognition task, and gray matter volumes in key emotion processing regions. Our sample comprised youth with psychosis spectrum symptoms (N = 304), control youth (N = 787), and to evaluate specificity, youth with internalizing symptoms (N = 92). The moderating effects of group and sex were examined. RESULTS Both the psychosis spectrum and internalizing groups had higher levels of threat exposure than controls. In the total sample, threat exposure was associated with lower left medial prefrontal cortex (mPFC) volume but not misattributions to fear/anger. The effects of threat exposure did not significantly differ by group or sex. CONCLUSIONS The findings of this study provide evidence for an effect of threat exposure on mPFC morphology, but do not support an association between threat exposure and a recognition bias for threat-related expressions, that is particularly pronounced in psychosis. Future research should investigate factors linking transdiagnostic alterations related to threat exposure with psychotic symptoms, and attempt to clarify the mechanisms underpinning emotion recognition misattributions in threat-exposed youth.
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Affiliation(s)
- Megan Thomas
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia.
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia
| | - Ye E Tian
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia
| | - Tamsyn E van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia; Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia
| | - Vanessa L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia
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7
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Fares-Otero NE, Alameda L, Pfaltz MC, Martinez-Aran A, Schäfer I, Vieta E. Examining associations, moderators and mediators between childhood maltreatment, social functioning, and social cognition in psychotic disorders: a systematic review and meta-analysis. Psychol Med 2023; 53:5909-5932. [PMID: 37458216 PMCID: PMC10520610 DOI: 10.1017/s0033291723001678] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/11/2023] [Accepted: 05/23/2023] [Indexed: 07/24/2023]
Abstract
Childhood maltreatment (CM) has been related to social functioning and social cognition impairment in people with psychotic disorders (PD); however, evidence across different CM subtypes and social domains remains less clear. We conducted a systematic review and meta-analysis to quantify associations between CM, overall and its different subtypes (physical/emotional/sexual abuse, physical/emotional neglect), and domains of social functioning and social cognition in adults with PD. We also examined moderators and mediators of these associations. A PRISMA-compliant systematic search was performed on 24 November 2022 (PROSPERO CRD42020175244). Fifty-three studies (N = 13 635 individuals with PD) were included in qualitative synthesis, of which 51 studies (N = 13 260) with 125 effects sizes were pooled in meta-analyses. We found that CM was negatively associated with global social functioning and interpersonal relations, and positively associated with aggressive behaviour, but unrelated to independent living or occupational functioning. There was no meta-analytic evidence of associations between CM and social cognition. Meta-regression analyses did not identify any consistent moderation pattern. Narrative synthesis identified sex and timing of CM as potential moderators, and depressive symptoms and maladaptive personality traits as possible mediators between CM and social outcomes. Associations were of small magnitude and limited number of studies assessing CM subtypes and social cognition are available. Nevertheless, adults with PD are at risk of social functioning problems after CM exposure, an effect observed across multiple CM subtypes, social domains, diagnoses and illness stages. Maltreated adults with PD may thus benefit from trauma-related and psychosocial interventions targeting social relationships and functioning.
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Affiliation(s)
- Natalia E. Fares-Otero
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic Barcelona, Institute of Neurosciences (UBNeuro), Barcelona, Catalonia, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences University of Barcelona (UB), Barcelona, Catalonia, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Luis Alameda
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, University Hospital (CHUV), Lausanne, Switzerland
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Department of Psychiatry, CIBERSAM, Institute of Biomedicine of Sevilla (IBIS), University Hospital Virgen del Rocio, University of Seville, Seville, Spain
| | - Monique C. Pfaltz
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Anabel Martinez-Aran
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic Barcelona, Institute of Neurosciences (UBNeuro), Barcelona, Catalonia, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences University of Barcelona (UB), Barcelona, Catalonia, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic Barcelona, Institute of Neurosciences (UBNeuro), Barcelona, Catalonia, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences University of Barcelona (UB), Barcelona, Catalonia, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
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8
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Schmitz SE, Niedtfeld I, Lane SP, Seitz KI, Hepp J. Negative affect provides a context for increased distrust in the daily lives of individuals with a history of childhood maltreatment. J Trauma Stress 2023; 36:808-819. [PMID: 37437133 DOI: 10.1002/jts.22951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 02/11/2023] [Accepted: 04/17/2023] [Indexed: 07/14/2023]
Abstract
Evidence on individuals affected by posttraumatic stress disorder (PTSD) following childhood maltreatment (CM) supports cognitive models suggesting that trauma engenders distrust and interpersonal threat sensitivity. We examined the associations between CM and both distrust and interpersonal threat sensitivity in daily life and investigated whether momentary negative affect (NA) provides a context that strengthens this association. Hypotheses were based on cognitive models of trauma and the feelings-as-information theory. In a 7-day ambulatory assessment study with six semirandom daily prompts (2,295 total), we measured self-reported momentary NA and assessed behavioral trust as well as interpersonal threat sensitivity via facial emotion ratings with two novel experimental paradigms in 61 participants with varying levels of CM (45,900 total trials). As hypothesized, NA was associated with increased momentary distrust, β = .03, p = .002, and interpersonal threat sensitivity, β = -.01, p = .021. Higher levels of CM were associated with more negative emotion ratings, independent of affective context, β = -.07, p = .003. Momentary behavioral distrust was associated with CM at high levels of momentary NA, β = .02, p = .027. The findings for both tasks support the feelings-as-information theory and suggest that cognitive alterations surrounding distrust and interpersonal threat, which were originally proposed for PTSD, likely also affect individuals with a history of CM.
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Affiliation(s)
- Sara E Schmitz
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Inga Niedtfeld
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Sean P Lane
- Department of Psychological Sciences, University of Missouri, Missouri, USA
| | - Katja I Seitz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany
| | - Johanna Hepp
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
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Caouette J, Cossette L, Hébert M. Do You See What I See? Emotion Recognition Competencies in Sexually Abused School-Aged Children and Non-Abused Children. JOURNAL OF CHILD SEXUAL ABUSE 2023; 32:813-828. [PMID: 37545166 DOI: 10.1080/10538712.2023.2243926] [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: 03/08/2023] [Accepted: 07/13/2023] [Indexed: 08/08/2023]
Abstract
Child sexual abuse (CSA) is a worldwide phenomenon that has been linked to deleterious consequences. Adverse life events, such as sexual abuse, can compromise the development of emotional competencies, an important dimension of children's psychosocial development. This study aimed at evaluating emotion recognition competencies in sexually abused and non-abused children. The sample consisted of 97 sexually abused children (65 girls) and 78 non-abused children (56 girls) aged between 6 and 12 years. They were recruited in specialized intervention centers and elementary schools from the Montreal area. Recognition of joy, anger, fear, sadness, and neutral expressions was assessed using the Developmental Emotional Faces Stimulus Set (DEFSS; Meuwissen et al., 2017). Results of an ANCOVA revealed that the total scores of emotion recognition were significantly lower for victims of SA (M = 18.12, SE = 0.33) relative to non-abused children (M = 19.36, SE = 0.37), F(1,170) = 5.70, p < .05. Analyses performed on specific expressions yielded lower scores for the recognition of anger, F(1, 170) = 6.12, p = .014, partial η2 = .03, and joy, F(1, 170) = 8.04, p =.005, partial η2 = .04. Our findings highlight the importance of assessing emotion recognition competencies to improve intervention programs provided to sexually abused children and prevent the development of severe psychosocial problems.
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Affiliation(s)
- Justine Caouette
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Louise Cossette
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Martine Hébert
- Department of Sexology, Université du Québec à Montréal, Montréal, Canada
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Zhang L, Chen Y, Wei Y, Leng J, Kong C, Hu P. Kick Cat Effect: Social Context Shapes the Form and Extent of Emotional Contagion. Behav Sci (Basel) 2023; 13:531. [PMID: 37503978 PMCID: PMC10376848 DOI: 10.3390/bs13070531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/08/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
Emotional contagion refers to the transmission and interaction of emotions among people. Researchers have mainly focused on its process and mechanism, often simplifying its social background due to its complexity. Therefore, in this study, we attempt to explore whether the presence and clarity of social context affect emotional contagion and the related neural mechanisms. In Experiment 1, participants were asked to report their subjective experiences after being exposed to the facial expressions of emotional expressers, with or without the corresponding social context being presented. The results revealed that positive or negative expressions from the expressers elicited corresponding emotional experiences in the receivers, regardless of the presence of social context. However, when the social context was absent, the degree of emotional contagion was greater. In Experiment 2, we further investigated the effect of the clarity of social contexts on emotional contagion and its neural mechanisms. The results showed an effect consistent with those in Experiment 1 and highlighted the special role of N1, N2, P3, and LPP components in this process. According to the emotions as social information theory, individuals may rely more on social appraisal when they lack sufficient contextual information. By referencing the expressions of others and maintaining emotional convergence with them, individuals can adapt more appropriately to their current environment.
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Affiliation(s)
- Ling Zhang
- Department of Psychology, Renmin University of China, No. 59 of Zhongguancun Street, Haidian District, Beijing 100872, China
| | - Ying Chen
- Department of Psychology, Renmin University of China, No. 59 of Zhongguancun Street, Haidian District, Beijing 100872, China
| | - Yanqiu Wei
- Department of Psychology, Renmin University of China, No. 59 of Zhongguancun Street, Haidian District, Beijing 100872, China
| | - Jie Leng
- Department of Psychology, Renmin University of China, No. 59 of Zhongguancun Street, Haidian District, Beijing 100872, China
| | - Chao Kong
- Department of Psychology, Renmin University of China, No. 59 of Zhongguancun Street, Haidian District, Beijing 100872, China
| | - Ping Hu
- Department of Psychology, Renmin University of China, No. 59 of Zhongguancun Street, Haidian District, Beijing 100872, China
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11
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Hautle LL, Kurath J, Jellestad L, Lüönd AM, Wingenbach TSH, Frühholz S, Jansson B, Niedtfeld I, Pfaltz MC. Individuals with and without child maltreatment experiences are evaluated similarly and do not differ in facial affect display at zero- and first-acquaintance. Borderline Personal Disord Emot Dysregul 2023; 10:17. [PMID: 37210564 DOI: 10.1186/s40479-023-00222-3] [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: 10/26/2022] [Accepted: 04/27/2023] [Indexed: 05/22/2023] Open
Abstract
BACKGROUND Individuals with a history of child maltreatment (CM) are more often disliked, rejected and victimized compared to individuals without such experiences. However, contributing factors for these negative evaluations are so far unknown. OBJECTIVE Based on previous research on adults with borderline personality disorder (BPD), this preregistered study assessed whether negative evaluations of adults with CM experiences, in comparison to unexposed controls, are mediated by more negative and less positive facial affect display. Additionally, it was explored whether level of depression, severity of CM, social anxiety, social support, and rejection sensitivity have an influence on ratings. METHODS Forty adults with CM experiences (CM +) and 40 non-maltreated (CM-) adults were filmed for measurement of affect display and rated in likeability, trustworthiness, and cooperativeness by 100 independent raters after zero-acquaintance (no interaction) and 17 raters after first-acquaintance (short conversation). RESULTS The CM + and the CM- group were neither evaluated significantly different, nor showed significant differences in affect display. Contrasting previous research, higher levels of BPD symptoms predicted higher likeability ratings (p = .046), while complex post-traumatic stress disorder symptoms had no influence on ratings. CONCLUSIONS The non-significant effects could be attributed to an insufficient number of participants, as our sample size allowed us to detect effects with medium effect sizes (f2 = .16 for evaluation; f2 = .17 for affect display) with a power of .95. Moreover, aspects such as the presence of mental disorders (e.g., BPD or post-traumatic stress disorder), might have a stronger impact than CM per se. Future research should thus further explore conditions (e.g., presence of specific mental disorders) under which individuals with CM are affected by negative evaluations as well as factors that contribute to negative evaluations and problems in social relationships.
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Affiliation(s)
- Lara-Lynn Hautle
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
- Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Jennifer Kurath
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
- Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Lena Jellestad
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
- Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Antonia M Lüönd
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
- Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Tanja S H Wingenbach
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
- Medical Faculty, University of Zurich, Zurich, Switzerland
- School of Human Sciences, Faculty of Education, Health, and Human Sciences, University of Greenwich, London, UK
| | - Sascha Frühholz
- Department of Psychology, Cognitive and Affective Neuroscience, University of Zurich, Zurich, Switzerland
| | - Billy Jansson
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Inga Niedtfeld
- Department of Psychosomatic Medicine, Medical Faculty Mannheim at, Central Institute of Mental Health, Heidelberg University, J5, 68159, Mannheim, Germany
| | - Monique C Pfaltz
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland.
- Medical Faculty, University of Zurich, Zurich, Switzerland.
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden.
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12
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Fares-Otero NE, De Prisco M, Oliva V, Radua J, Halligan SL, Vieta E, Martinez-Aran A. Association between childhood maltreatment and social functioning in individuals with affective disorders: A systematic review and meta-analysis. Acta Psychiatr Scand 2023. [PMID: 37105552 DOI: 10.1111/acps.13557] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE Childhood maltreatment has been linked to impairments in social functioning and social cognition in adults with affective disorders. However, conclusions have been limited by inconsistent findings across different maltreatment subtypes and social domains. We conducted a systematic review and meta-analysis to quantify associations between childhood maltreatment (overall and subtypes - physical, emotional and/or sexual abuse, and/or physical and/or emotional neglect) and different domains of social functioning and social cognition in adults with affective disorders (bipolar disorder or major depressive disorder). We also examined effect moderators and mediators of these associations. METHODS A systematic search was performed on 12.12.2022 which identified 29 studies included in qualitative synthesis (n = 3022 individuals with affective disorders), of which 27 (n = 2957) were pooled in meta-analyses. Across studies, five social functioning and five social cognition domains were examined, of which four domains of social functioning and two domains of social cognition had sufficient data for meta-analysis (PROSPERO CRD42022288976). RESULTS Social functioning: childhood maltreatment was associated with lower global social functioning (r = -0.11 to -0.20), poorer interpersonal relations (r = -0.18 to -0.33), and with aggressive behaviour (r = 0.20-0.29) but was unrelated to vocational functioning. Emotional abuse and emotional neglect showed the largest magnitudes of effect. Social cognition: there was no meta-analytic evidence of associations between maltreatment and social cognition domains. Exploratory moderation analyses did not identify any consistent moderators. Narrative synthesis identified attachment style as possible moderator, and sensory patterns, anxiety, and depressive symptoms as possible mediators between childhood maltreatment and social outcomes. Overall, the available evidence was limited, particularly in relation to social cognition. CONCLUSIONS Adults with affective disorders are at risk of social functioning difficulties after childhood maltreatment exposure, an effect observed across multiple maltreatment subtypes, social functioning domains, and diagnoses. Addressing social functioning problems may benefit maltreated adults with both bipolar disorder and major depressive disorder.
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Affiliation(s)
- Natalia E Fares-Otero
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Michele De Prisco
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Vincenzo Oliva
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Joaquim Radua
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Anabel Martinez-Aran
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
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13
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Dubé V, Tremblay-Perreault A, Allard-Cobetto P, Hébert M. Alexithymia as a Mediator between Intimate Partner Violence and Post-Traumatic Stress Symptoms in Mothers of Children Disclosing Sexual Abuse. JOURNAL OF FAMILY VIOLENCE 2023:1-9. [PMID: 36811013 PMCID: PMC9934503 DOI: 10.1007/s10896-023-00512-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Purpose The unveiling of child sexual abuse (CSA) can elicit symptoms of post-traumatic stress disorder (PTSD) in non-offending parents. The impact of disclosure is stronger for mothers who have already experienced interpersonal trauma, such as CSA or intimate partner violence (IPV). Alexithymia often serves as a coping mechanism in the aftermath of a trauma, as it creates a distance between oneself and distressing events. It could prevent individuals from resolving their trauma, be a risk factor for PTSD symptoms and compromise mothers' capacity to support their child. The objective of this study was to examine whether alexithymia mediated the relationship between the experiences of interpersonal violence (IPV and CSA) of mothers of sexually abused children, and mothers' PTSD symptoms following disclosure of their child's abuse. Method A sample of 158 mothers of sexually abused children completed questionnaires assessing CSA and IPV and the Toronto Alexithymia Scale, which measures the capacity to identify and express emotions. The Modified PTSD symptom Scale-Self-Report evaluated PTSD symptoms related to their child's disclosure of sexual abuse. Results Results of a mediation model revealed that alexithymia significantly mediated the relationship between IPV and PTSD symptoms. Mothers' CSA was directly associated with higher levels of PTSD following their child's disclosure of abuse, but the relationship was not mediated by alexithymia. Conclusions Our findings highlight the importance of assessing mothers' history of interpersonal trauma and ability to recognize and identify emotions as well as the need to offer support and specific intervention programs to mothers.
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Affiliation(s)
- Valéry Dubé
- Département de psychologie, Université du Québec à Montréal, Montréal, Québec Canada
- Canada Research Chair in Interpersonal Traumas and Resilience, Montréal, Québec Canada
| | | | - Pénélope Allard-Cobetto
- Canada Research Chair in Interpersonal Traumas and Resilience, Montréal, Québec Canada
- Département de sexologie, Université du Québec à Montréal, C.P. 8888, Succursale Centre-Ville, Montréal, Québec H3C 3P8 Canada
| | - Martine Hébert
- Canada Research Chair in Interpersonal Traumas and Resilience, Montréal, Québec Canada
- Département de sexologie, Université du Québec à Montréal, C.P. 8888, Succursale Centre-Ville, Montréal, Québec H3C 3P8 Canada
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14
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Rutter LA, Lind C, Howard J, Lakhan P, Germine L. Posttraumatic stress symptom severity is associated with impaired processing of emotional faces in a large international sample. J Trauma Stress 2022; 35:1263-1272. [PMID: 35366020 PMCID: PMC9543058 DOI: 10.1002/jts.22834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 11/24/2022]
Abstract
Trauma exposure and posttraumatic stress symptoms (PTSS) are associated with biases in emotional face processing. Existing research has utilized a variety of methodological techniques to demonstrate hyperreactivity to threatening cues in posttraumatic stress disorder (PTSD; i.e., fearful faces), but studies to date have shown conflicting findings, including both increased and decreased time fixating on fearful faces. Moreover, the impact of PTSS severity on emotional face processing in the general population is unknown, as the generalizability of prior work is limited. The current study aimed to examine the associations between PTSS and sensitivity to detecting differences in fearful, angry, and happy faces in a large international sample. Participants were 1,182 visitors (Mage = 31.13 years, SD = 13.57, range: 18-85 years) to TestMyBrain.org who completed three emotion sensitivity tasks and the PTSD Checklist for DSM-5. The results indicated that higher PTSS scores were associated with poorer performance in detecting happiness, fear, and anger, ps < .001, with the largest effect for fear, f 2 = .06, controlling for age and gender. Participants who experienced more recent and more direct trauma exposure displayed higher levels of PTSS, with a small but significant effect whereby more direct trauma exposure was associated with higher (i.e., better) scores for anger and fear, f2 s = .02. Women showed heightened sensitivity to detecting fear compared to men, d = 0.17. The present findings underscore the value of citizen science initiatives that allow researchers to obtain clinical data from diverse samples with a high degree of PTSS variability.
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Affiliation(s)
- Lauren A. Rutter
- Department of Psychological and Brain SciencesIndiana University BloomingtonBloomingtonIndianaUSA,Center for Social and Biomedical ComplexityIndiana University BloomingtonBloomingtonIndianaUSA
| | - Colton Lind
- Department of Psychological and Brain SciencesIndiana University BloomingtonBloomingtonIndianaUSA
| | - Jacqueline Howard
- Department of Psychological and Brain SciencesIndiana University BloomingtonBloomingtonIndianaUSA
| | - Prabhvir Lakhan
- Department of Psychological and Brain SciencesIndiana University BloomingtonBloomingtonIndianaUSA
| | - Laura Germine
- Institute for Technology in PsychiatryMcLean HospitalBelmontMassachusettsUSA,Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA
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15
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Adverse Childhood Experiences and Neurocognition in Borderline Personality Disorder: A Call-to-Action Perspective Review. Harv Rev Psychiatry 2022; 30:248-260. [PMID: 35849742 DOI: 10.1097/hrp.0000000000000344] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Adverse childhood experiences (ACEs) contribute to the development of personality traits leading to adult borderline personality disorder (BPD). Neurocognitive changes could partly mediate the association between ACEs and BPD. We discuss how exposure to ACEs could induce alterations in neurocognition, which, in turn, would contribute to the development of BPD. We conducted a review of MEDLINE articles through 2021, documenting a link between ACEs, neurocognitive impairments, and BPD, and also focusing on the pairwise associations. ACEs appear to have a strong impact on neurocognition and are a predictive factor for BPD. Maltreated, abused, and emotionally invalidated children are more likely to present BPD traits. Neurocognitive impairments in adults exposed to ACEs and in patients with BPD arise from similar brain alterations in the amygdala, hippocampus, and prefrontal cortex. These impairments seem to be linked with clinical dimensions of BPD: increased impulsivity to altered inhibitory control; dissociative experiences to nonspecific autobiographical memory; and emotionally biased facial recognition to unstable interpersonal relationships. This perspective review highlights the contributory role of neurocognition in the association between ACEs and BPD. Additional research is needed, however, on the interconnections among ACEs, neurocognition, and BPD. Future studies could also focus on developing tools to assess early adversity in BPD specifically and on psychotherapeutic approaches to promptly remedy neurocognitive impairments.
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16
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Waters RC, Gould E. Early Life Adversity and Neuropsychiatric Disease: Differential Outcomes and Translational Relevance of Rodent Models. Front Syst Neurosci 2022; 16:860847. [PMID: 35813268 PMCID: PMC9259886 DOI: 10.3389/fnsys.2022.860847] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/19/2022] [Indexed: 12/02/2022] Open
Abstract
It is now well-established that early life adversity (ELA) predisposes individuals to develop several neuropsychiatric conditions, including anxiety disorders, and major depressive disorder. However, ELA is a very broad term, encompassing multiple types of negative childhood experiences, including physical, sexual and emotional abuse, physical and emotional neglect, as well as trauma associated with chronic illness, family separation, natural disasters, accidents, and witnessing a violent crime. Emerging literature suggests that in humans, different types of adverse experiences are more or less likely to produce susceptibilities to certain conditions that involve affective dysfunction. To investigate the driving mechanisms underlying the connection between experience and subsequent disease, neuroscientists have developed several rodent models of ELA, including pain exposure, maternal deprivation, and limited resources. These studies have also shown that different types of ELA paradigms produce different but somewhat overlapping behavioral phenotypes. In this review, we first investigate the types of ELA that may be driving different neuropsychiatric outcomes and brain changes in humans. We next evaluate whether rodent models of ELA can provide translationally relevant information regarding links between specific types of experience and changes in neural circuits underlying dysfunction.
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17
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Pfaltz MC, Halligan SL, Haim-Nachum S, Sopp MR, Åhs F, Bachem R, Bartoli E, Belete H, Belete T, Berzengi A, Dukes D, Essadek A, Iqbal N, Jobson L, Langevin R, Levy-Gigi E, Lüönd AM, Martin-Soelch C, Michael T, Oe M, Olff M, Ceylan D, Raghavan V, Ramakrishnan M, Sar V, Spies G, Wadji DL, Wamser-Nanney R, Fares-Otero NE, Schnyder U, Seedat S. Social Functioning in Individuals Affected by Childhood Maltreatment: Establishing a Research Agenda to Inform Interventions. PSYCHOTHERAPY AND PSYCHOSOMATICS 2022; 91:238-251. [PMID: 35381589 PMCID: PMC9393832 DOI: 10.1159/000523667] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/12/2022] [Indexed: 12/30/2022]
Abstract
Childhood maltreatment (CM) is linked to impairments in various domains of social functioning. Here, we argue that it is critical to identify factors that underlie impaired social functioning as well as processes that mediate the beneficial health effects of positive relationships in individuals exposed to CM. Key research recommendations are presented, focusing on: (1) identifying attachment-related alterations in specific inter- and intrapersonal processes (e.g., regulation of closeness and distance) that underlie problems in broader domains of social functioning (e.g., lack of perceived social support) in individuals affected by CM; (2) identifying internal (e.g., current emotional state) and external situational factors (e.g., cultural factors, presence of close others) that modulate alterations in specific social processes; and (3) identifying mechanisms that explain the positive health effects of intact social functioning. Methodological recommendations include: (1) assessing social processes through interactive and (close to) real-life assessments inside and outside the laboratory; (2) adopting an interdisciplinary, lifespan perspective to assess social processes, using multi-method assessments; (3) establishing global research collaborations to account for cultural influences on social processes and enable replications across laboratories and countries. The proposed line of research will contribute to globally develop and refine interventions that prevent CM and further positive relationships, which - likely through buffering the effects of chronic stress and corresponding allostatic load - foster resilience and improve mental and physical health, thereby reducing personal suffering and the societal and economic costs of CM and its consequences. Interventions targeting euthymia and psychological well-being are promising therapeutic concepts in this context.
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Affiliation(s)
- Monique C. Pfaltz
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital, University of Zurich, Zurich, Switzerland
| | - Sarah L. Halligan
- Department of Psychology, University of Bath, Bath, United Kingdom
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Marie R. Sopp
- School of Education, Bar-Ilan University, Bar-Ilan, Israel
- Division of Clinical Psychology and Psychotherapy, Saarland University, Saarland, Germany
| | - Fredrik Åhs
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Rahel Bachem
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Eleonora Bartoli
- Faculty of Psychology, Goethe University of Frankfurt, Frankfurt, Germany
| | - Habte Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tilahun Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Azi Berzengi
- University of East Anglia, Norwich, United Kingdom
| | - Daniel Dukes
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
- Department of Special Education, University of Fribourg, Fribourg, Switzerland
| | - Aziz Essadek
- Interpsy EA4432, University of Lorraine, Lorraine, France
| | - Naved Iqbal
- Department of Psychology, Jamia Millia islamia, New Delhi, India
| | - Laura Jobson
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Monash, Australian Capital Territory, Australia
| | - Rachel Langevin
- Department of Educational and Counselling Psychology, McGill University, Montreal, Québec, Canada
| | | | - Antonia M. Lüönd
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital, University of Zurich, Zurich, Switzerland
| | | | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Saarland University, Saarland, Germany
| | - Misari Oe
- Department of Neuropsychiatry, School of Medicine, Kurume University, Kurume, Japan
| | - Miranda Olff
- Department of Psychiatry, Amsterdam Neuroscience and Public Health, Amsterdam UMC, Amsterdam, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Deniz Ceylan
- Department of Psychiatry, Koç University School of Medicine, Koç, Turkey
| | | | | | - Vedat Sar
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Georgina Spies
- DSI/NRF South African Research Chairs Initiative in PTSD, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- Department of Psychology, University of Yaounde 1, Yaounde, Cameroon
| | - Dany Laure Wadji
- Department of Psychological Sciences, University of Missouri St. Louis, St. Louis, Missouri, USA
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Rachel Wamser-Nanney
- CIBERSAM: Biomedical Research Networking Center for Mental Health Network, Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Ulrich Schnyder
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital, University of Zurich, Zurich, Switzerland
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
- DSI/NRF South African Research Chairs Initiative in PTSD, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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18
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Michalek J, Lisi M, Binetti N, Ozkaya S, Hadfield K, Dajani R, Mareschal I. War-related trauma linked to increased sustained attention to threat in children. Child Dev 2022; 93:900-909. [PMID: 35147214 PMCID: PMC9542223 DOI: 10.1111/cdev.13739] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Experiences of war and displacement can have profound effects on children's affective development and mental health, although the mechanism(s) underlying these effects remain unknown. This study investigated the link between early adversity and attention to affective stimuli using a free-viewing eye-tracking paradigm with Syrian refugee (n = 31, Mage = 9.55, 12 female) and Jordanian non-refugee (n = 55, Mage = 9.98, 30 female) children living in Jordan (March 2020). Questionnaires assessed PTSD, anxiety/depression, insecurity, distress, and trauma. Refugee children showed greater initial avoidance of angry and happy faces compared to non-refugee children, and higher trauma exposure was linked to increased sustained attention to angry stimuli. These findings suggest that war-related trauma may have differential effects on the early and later stages of affective processing in refugee children.
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Affiliation(s)
- Julia Michalek
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Matteo Lisi
- Department of Psychology, Royal Holloway University of London, London, UK
| | - Nicola Binetti
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK.,International School for Advanced Studies (SISSA), Trieste, Italy
| | - Sumeyye Ozkaya
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Kristin Hadfield
- School of Psychology, Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - Rana Dajani
- Department of Biology and Biotechnology, Hashemite University, Zarqa, Jordan
| | - Isabelle Mareschal
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
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19
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Mitzkovitz C, Dowd SM, Cothran T, Musil S. The Eyes Have It: Psychotherapy in the Era of Masks. J Clin Psychol Med Settings 2022; 29:886-897. [PMID: 35118604 PMCID: PMC8812949 DOI: 10.1007/s10880-022-09856-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2022] [Indexed: 11/24/2022]
Abstract
Nonverbal communication is integral to the success of psychotherapy and facial expression is an important component of nonverbal communication. The SARS CoV-2 pandemic has caused alterations in how psychotherapy services are provided. In this paper, potential issues that may arise from conducting psychotherapy when both the patient and therapist are wearing masks are explored. These include higher likelihood of misidentifying facial expression, especially when expression is incongruent with body language, and when the lower face is more important for correct identification of emotion. These issues may be particularly problematic for patient populations for whom emotion recognition may be a problem at baseline, or for those more prone to biases in emotional recognition. Suggestions are made for therapists to consider when seeing patients in-person when masks are necessary.
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Affiliation(s)
- Cayla Mitzkovitz
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Sheila M Dowd
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Thomas Cothran
- Office of Neuropsychology, Community Care Network, Inc., Munster, IN, USA
| | - Suzanne Musil
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA. .,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd, Ste. 400, Chicago, IL, 60612, USA.
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20
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Milan S, Carlone C, Printz D, Perez SD. Understanding Children's Emotions: Differences in Mothers With a History of Childhood Maltreatment. CHILD MALTREATMENT 2022; 27:33-42. [PMID: 33176473 DOI: 10.1177/1077559520972188] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Experiencing maltreatment in childhood can have a lasting impact on how individuals identify and understand emotions in others. Research in this area has not examined parents' understanding of children's emotions, although emotion processing deficits may be one mechanism linking childhood maltreatment to subsequent parenting problems. In a matched case-control design, we test whether mothers with (n = 50) and without (n = 96) childhood maltreatment differ in their understanding of children's emotions on self-report measures and computer-based tasks. Compared to the control group, mothers who experienced maltreatment labeled more children with sad or angry emotions when given limited facial information and made different interpersonal inferences about children they labeled angry. They also reported more subjective difficulty interpreting emotions in unknown children and their own child. Results provide further evidence of emotion processing biases associated with childhood maltreatment. Interventions aimed at improving parental emotion understanding and mentalization may be particularly useful for mothers with a history of childhood maltreatment.
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Affiliation(s)
- Stephanie Milan
- Department of Psychological Sciences, 7712University of Connecticut, Storrs, CT, USA
| | - Christina Carlone
- Department of Psychological Sciences, 7712University of Connecticut, Storrs, CT, USA
| | - Destiny Printz
- Department of Psychological Sciences, 7712University of Connecticut, Storrs, CT, USA
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21
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Krause-Utz A, Frost R, Chatzaki E, Winter D, Schmahl C, Elzinga BM. Dissociation in Borderline Personality Disorder: Recent Experimental, Neurobiological Studies, and Implications for Future Research and Treatment. Curr Psychiatry Rep 2021; 23:37. [PMID: 33909198 PMCID: PMC8081699 DOI: 10.1007/s11920-021-01246-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The aim of this review article is to give an overview over recent experimental neurobiological research on dissociation in borderline personality disorder (BPD), in order to inform clinicians and to stimulate further research. First, we introduce basic definitions and models that conceptualize dissociation from a transdiagnostic perspective. Then, we discuss recent findings in BPD. RECENT FINDINGS Stress-related dissociation is a key symptom of BPD, closely linked to other core domains of the disorder (emotion dysregulation, identity disturbances, and interpersonal disturbances). The understanding of neurobiological correlates of dissociation across different psychiatric disorders (e.g., dissociative disorders, post-traumatic stress disorder) is steadily increasing. At the same time, studies explicitly focusing on dissociation in BPD are still scarce. There is evidence for adverse effects of dissociation on affective-cognitive functioning (e.g., interference inhibition), body perception, and psychotherapeutic treatment response in BPD. On the neural level, increased activity in frontal regions (e.g., inferior frontal gyrus) and temporal areas (e.g., inferior and superior temporal gyrus) during symptom provocation tasks and during resting state was observed, although findings are still diverse and need to be replicated. Conceptual differences and methodological differences in study designs and sample characteristics (e.g., comorbidities, trauma history) hinder a straightforward interpretation and comparison of studies. Given the potentially detrimental impact of dissociation in BPD, more research on the topic is strongly needed to deepen the understanding of this complex clinical condition.
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Affiliation(s)
- Annegret Krause-Utz
- Institute of Clinical Psychology, Leiden University, Leiden, The Netherlands.
- Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands.
| | - Rachel Frost
- Department of Psychology, King's College London, Institute of Psychiatry Psychology & Neuroscience, London, UK
| | - Elianne Chatzaki
- Institute of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Dorina Winter
- Pain and Psychotherapy Research Lab, University of Koblenz-Landau, Landau, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Bernet M Elzinga
- Institute of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands
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22
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Haim-Nachum S, Sopp MR, Michael T, Shamay-Tsoory S, Levy-Gigi E. No distance is too far between friends: associations of comfortable interpersonal distance with PTSD and anxiety symptoms in Israeli firefighters. Eur J Psychotraumatol 2021; 12:1899480. [PMID: 33889312 PMCID: PMC8043555 DOI: 10.1080/20008198.2021.1899480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background: Previous research indicates that PTSD patients may show alterations in interpersonal distance regulation (IDR). However, it is not clear whether altered IDR is correlated with psychopathology after trauma and whether attentional processes might be involved in these alterations. Objective: The current study investigated IDR and attentional processing in a sample of Israeli firefighters. Method: Twenty-four participants completed an experimental IDR task as well as measures of PTSD and anxiety. During the task, event-related potentials were recorded to assess attentional processing as reflected in the P1 and N1 components. Results: Participants who did not choose a closer distance towards friends than strangers experienced greater anxiety. Moreover, participants who showed attentional avoidance towards strangers reported more PTSD symptoms. By contrast, participants who showed hypervigilant attention towards strangers reported greater anxiety. Conclusions: Our results demonstrate an association between IDR, PTSD, and anxiety after trauma. Future studies should re-investigate these associations in larger samples and explore potential implications for prevention and treatment.
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Affiliation(s)
| | - M Roxanne Sopp
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | | | - Einat Levy-Gigi
- School of Education, Bar-Ilan University, Ramat-Gan, Israel.,The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
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23
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Hepp J, Schmitz SE, Urbild J, Zauner K, Niedtfeld I. Childhood maltreatment is associated with distrust and negatively biased emotion processing. Borderline Personal Disord Emot Dysregul 2021; 8:5. [PMID: 33536068 PMCID: PMC7856450 DOI: 10.1186/s40479-020-00143-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/21/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cognitive models of post-traumatic stress disorder (PTSD) propose that trauma entails cognitive alterations of increased distrust and perceived threat from others. We tested whether these predictions also hold in individuals with varying levels of childhood maltreatment (CM), which is much more prevalent than traumatic events as required for a PTSD diagnosis. We hypothesized that higher levels of CM would entail greater distrust and perceived threat, and that distrust would be more change-resistant in participants with more CM. METHODS The study was pre-registered; the pre-registration protocol, data, and code are available at https://osf.io/pufy2/ . We recruited 549 participants (M age = 29.2, 74.5% women) for an online study via websites related to CM, Borderline Personality Disorder, and via snowball method on social media. Participants self-reported their level of CM on the childhood trauma questionnaire (CTQ). Next, they played two rounds of a hypothetical distrust game, indicating the perceived trustworthiness of avatars by way of estimating expected monetary deductions from them (i.e. higher amounts indicating greater distrust). After the first round, we provided participants with the feedback that very little money was taken from them. We expected those with more CM to be less responsive to the positive feedback and to adapt their estimates less in the subsequent round. Following the distrust game, participants completed an emotion rating task in which they rated the emotional expressions of 60 faces on a scale from 'very negative' to 'very positive'. We included angry, fearful, and happy facial expressions, and expected individuals with higher CM levels to provide more negative ratings. We conducted linear mixed effects models with random intercepts for raters and stimuli (crossed), and modelled random slopes for all within-person predictors. RESULTS As hypothesized, higher levels of CM were associated with higher levels of distrust and a weaker decrease in distrust following positive feedback. Further supporting our hypotheses, individuals with higher levels of CM showed more negatively shifted emotion ratings. CONCLUSIONS Increased distrust and perceived interpersonal threat following trauma, as proposed in cognitive models of PTSD, likely also apply to individuals with CM, following a dose-response relationship. We discuss clinical implications of considering any level of CM as a potentially relevant treatment-factor, even when a trauma-related disorder is not the main diagnosis, and propose future research avenues.
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Affiliation(s)
- Johanna Hepp
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany.
| | - Sara E Schmitz
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
| | | | | | - Inga Niedtfeld
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
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24
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Fares-Otero NE, Pfaltz MC, Rodriguez-Jimenez R, Schäfer I, Trautmann S. Childhood maltreatment and social functioning in psychotic disorders: a systematic review protocol. Eur J Psychotraumatol 2021; 12:1943872. [PMID: 36877473 PMCID: PMC10075514 DOI: 10.1080/20008198.2021.1943872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Background: Childhood maltreatment (CM) is thought to play a key role in the etiology and course of psychotic disorders (PD). In addition, CM is related to neurobiological and clinical characteristics that can lead to poor social functioning. However, the extent to which CM and social functioning are directly associated in individuals with PD, is unclear. Therefore, we aim to systematically review the literature to provide an estimate on the strength of the association between CM and different domains of social functioning in PD and to summarize potential moderators and mediators of this association.Methods and analysis: To identify relevant studies, we will systematically search the following databases: Pubmed (Medline), PsycInfo, Embase, Web of Science (Core Collection), and Pilots (trauma), manually search reference lists and contact experts in the field. Studies will be included if they investigate and report on the association between CM (exposure) and social functioning (outcome) in adults with PD. Two independent reviewers will screen titles, abstracts and full texts according to eligibility criteria, perform data extraction and assess study quality according to a modified version of the Newcastle-Ottawa Scale.Analysis: Effect estimates will be pooled in a meta-analysis. Heterogeneity and publication bias will be assessed and the effects of potential moderators (genetic factors, type of diagnosis, duration of illness, type of CM and age at the time of CM exposure) will be analyzed using meta-regressions. Candidate moderators and mediators (neurocognition, cognitive schemas, comorbidities, stress sensitivity, attachment) will be also examined qualitatively.Ethics and dissemination: Because this review will make use of already published data, ethical approval will not be sought. This work has the potential to inform upcoming investigations on the association between the exposure to CM in PD and social functioning. PROSPERO registration number CRD42020175244.
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Key Words
- abuso infantil, negligencia, cognicivón social, relaciones interpersonales, funcionamiento en la comunidad, psicosis, revisión sistemática
- child abuse, neglect, social cognitive skills, interpersonal relationships, community functioning, psychosis, systematic review
- 人际关系
- 儿童虐待
- 忽视
- 社会功能
- 社会认知技能
- 精神病
- 系统综述
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Affiliation(s)
- Natalia E Fares-Otero
- Department of Psychiatry, Biomedical Research Institute, University Hospital 12 De Octubre (Imas12), Madrid, Spain.,Universidad Internacional de la Rioja, Spain
| | - Monique C Pfaltz
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Faculty of Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roberto Rodriguez-Jimenez
- Department of Psychiatry, Biomedical Research Institute, University Hospital 12 De Octubre (Imas12), Faculty of Medicine, University Complutense de Madrid (UCM), Madrid, Spain, CIBERSAM (Biomedical Research Networking Centre in Mental Health), Madrid, Spain
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Trautmann
- Department of Psychology, Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
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Kuehl LK, Deuter CE, Nowacki J, Ueberrueck L, Wingenfeld K, Otte C. Attentional bias in individuals with depression and adverse childhood experiences: influence of the noradrenergic system? Psychopharmacology (Berl) 2021; 238:3519-3531. [PMID: 34605959 PMCID: PMC8629860 DOI: 10.1007/s00213-021-05969-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 08/19/2021] [Indexed: 11/26/2022]
Abstract
RATIONALE Major depressive disorder (MDD) is a severe mental disorder with affective, cognitive, and somatic symptoms. Mood congruent cognitive biases, including a negative attentional bias, are important for development, maintenance, and recurrence of depressive symptoms. MDD is associated with maladaptive changes in the biological stress systems such as dysregulations of central noradrenergic alpha2-receptors in the locus coeruleus-noradrenergic system, which can affect cognitive processes including attention. Patients with adverse childhood experiences (ACE), representing severe stress experiences in early life, might be particularly affected. OBJECTIVES With an experimental design, we aimed to gain further knowledge about the role of noradrenergic activity for attentional bias in MDD patients with and without ACE. METHODS We tested the effect of increased noradrenergic activity induced by the alpha2-receptor blocker yohimbine on attentional bias in a placebo-controlled repeated measures design. Four groups were included as follows: MDD patients with and without ACE, and healthy participants with and without ACE (total N = 128, all without antidepressant medication). RESULTS A significant effect of MDD on attentional bias scores of sad face pictures (p = .037) indicated a facilitated attentional processing of sad face pictures in MDD patients (compared to non-MDD individuals). However, we found no such effect of ACE. For attentional bias of happy face pictures, we found no significant effects of MDD and ACE. Even though a higher increase of blood pressure and salivary alpha-amylase following yohimbine compared to placebo indicated successful noradrenergic stimulation, we found no significant effects of yohimbine on attentional bias of happy or sad face pictures. CONCLUSIONS Our results are consistent with the hypothesis of a negative attentional bias in MDD patients. However, as we found no effect of ACE or yohimbine, further research is needed to understand the mechanisms by which ACE increases the risk of MDD and to understand the biological basis of the MDD-related negative attentional bias.
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Affiliation(s)
- Linn K Kuehl
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Department of Psychiatry and Psychotherapy, Berlin, Germany.
- Department of Psychology, Clinical Psychology and Psychotherapy, MSB Medical School Berlin, Berlin, Germany.
| | - Christian E Deuter
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Jan Nowacki
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Lisa Ueberrueck
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Katja Wingenfeld
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Christian Otte
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Department of Psychiatry and Psychotherapy, Berlin, Germany
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