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Huffhines L, Jackson Y, Stone KJ. Internalizing, Externalizing Problems and Psychiatric Hospitalizations: Examination of Maltreatment Chronicity and Coping Style in Adolescents in Foster Care. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:429-441. [PMID: 33269043 PMCID: PMC7683672 DOI: 10.1007/s40653-020-00305-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Child maltreatment is associated with internalizing and externalizing problems in adolescents, as well as psychiatric hospitalizations, which represent severe mental health difficulties and substantial burden on individuals and the health care system. These negative outcomes are especially prevalent in youth in foster care. Not all youth exposed to maltreatment, however, demonstrate poor mental health outcomes. Additional factors, such as maltreatment chronicity and coping style, may help explain why some (but not all) youth develop major psychiatric problems. The purpose of the present study was to examine how maltreatment chronicity and coping style were associated with internalizing, externalizing, and psychiatric hospitalizations, and whether coping style moderated the relation between maltreatment chronicity and mental health in a sample of foster adolescents. Participants were 283 adolescents ages 12-19 residing in foster care. Youth reported on maltreatment, coping, and mental health; caregivers reported on mental health. Psychiatric hospitalizations were obtained from medical records. Youth who experienced more maltreatment had higher caregiver- and self-reported internalizing, and more psychiatric hospitalizations. Youth who approached problems directly had lower caregiver-reported internalizing and externalizing, while youth who dealt with stressors alone had higher self-reported internalizing and externalizing, and more psychiatric hospitalizations. Youth who avoided facing their problems had less psychiatric hospitalizations. Further, a significant interaction revealed that youth with more maltreatment who avoided problems had less psychiatric hospitalizations, suggesting that avoiding problems may be more protective for youth with the most chronic abuse and neglect. Findings highlight the importance of examining both maltreatment and coping.
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Affiliation(s)
- Lindsay Huffhines
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI USA
- Bradley/Hasbro Children’s Research Center, E.P. Bradley Hospital, Providence, RI USA
| | - Yo Jackson
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS USA
- Department of Psychology, Pennsylvania State University, State College, PA USA
| | - Katie J. Stone
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS USA
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Angelakis I, Austin JL, Gooding P. Association of Childhood Maltreatment With Suicide Behaviors Among Young People: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e2012563. [PMID: 32756929 PMCID: PMC7407092 DOI: 10.1001/jamanetworkopen.2020.12563] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/22/2020] [Indexed: 12/17/2022] Open
Abstract
Importance Children and young people's reports of experiences of adverse childhood events have increased in recent years, and this trend has been associated with an elevated risk for suicide behaviors. However, a systematic review and meta-analysis is needed to confirm the significance of this association in young people. Objective To quantify the association between core types of childhood maltreatment, including sexual, physical, and emotional abuse and/or neglect and suicide behaviors in children and young adults. Data Sources Medline, PsychInfo, Embase, Web of Science, and CINAHL (Cumulative Index to Nursing and Allied Health) databases were searched from January 1, 1980, until December 31, 2019. The reference lists of all the included studies were also checked. Study Selection Quantitative studies that focused on the association between core types of childhood abuse and/or neglect and suicide ideation, plans, and attempts. Data Extraction and Synthesis Data were extracted by 2 independent raters. Publication bias and risk of bias across studies were assessed. Meta-analyses using random-effect models were applied, and heterogeneity was quantified using the I2 statistic. Data were analyzed from January to May 2020 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines. Main Outcomes and Measures The association between core types of childhood maltreatment and suicide behaviors. Results Seventy-nine studies with 337 185 young individuals (mean [SD] age, 15.67 [2.11] years; 63.19% female) were included. The findings demonstrated that sexual abuse (odds ratio [OR], 3.41; 95% CI, 2.90-4.00), physical abuse (OR, 2.18; 95% CI, 1.75-2.71), emotional abuse (OR, 2.21; 95% CI, 1.37-3.57), emotional neglect (OR, 1.93; 95% CI, 1.36-2.74), physical neglect (OR, 1.79; 95% CI, 1.27-2.53), and combined abuse (OR, 3.38; 95% CI, 2.09-5.47) were significantly associated with higher rates of suicide attempts. Core types of childhood maltreatment were also associated with as much as 2.5-fold greater odds for suicide ideation, and sexual abuse with a 4.0-fold increase for suicide plans. Studies based on community samples (β [SE] = -1.68 [0.79]; P = .04) or with lower methodological quality (β [SE] = -2.86 [1.30]; P = .03) were associated more strongly with suicide attempts in those reporting experiences of sexual abuse, whereas young age was associated with both suicide attempts (β [SE] = -0.59 [0.27]; P = .03) and ideation (β [SE] = -0.41 [0.18]; P = .03). Conclusions and Relevance These findings suggest that policy actions should focus on raising public awareness and offering proactive suicide prevention therapies for children and young adults who have experienced abuse and/or neglect.
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Affiliation(s)
- Ioannis Angelakis
- School of Psychology, University of South Wales, Pontypridd, United Kingdom
| | - Jennifer L. Austin
- School of Psychology, University of South Wales, Pontypridd, United Kingdom
| | - Patricia Gooding
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom
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LeMoult J, Humphreys KL, Tracy A, Hoffmeister JA, Ip E, Gotlib IH. Meta-analysis: Exposure to Early Life Stress and Risk for Depression in Childhood and Adolescence. J Am Acad Child Adolesc Psychiatry 2020; 59:842-855. [PMID: 31676392 DOI: 10.1016/j.jaac.2019.10.011] [Citation(s) in RCA: 253] [Impact Index Per Article: 63.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/21/2019] [Accepted: 10/22/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Early life stress (ELS) is associated with increased risk for the development of major depressive disorder (MDD) in adulthood; however, the degree to which ELS is associated with an early onset of MDD (ie, during childhood or adolescence) is not known. In this meta-analysis, we estimated the associations between ELS and the risk for onset of MDD before age 18 years. In addition, we examined the associations between eight specific forms of ELS (ie, sexual abuse, physical abuse, poverty, physical illness/injury, death of a family member, domestic violence, natural disaster, and emotional abuse) and risk for youth-onset MDD. METHOD We conducted a systematic search in scientific databases for studies that assessed both ELS and the presence or absence of MDD before age 18 years. We identified 62 journal articles with a total of 44,066 unique participants. We assessed study quality using the Newcastle-Ottawa Scale. When heterogeneous effect sizes were detected, we tested whether demographic and/or methodological factors moderated the association between ELS and MDD. RESULTS Using a random-effects meta-analysis, we found that individuals who experienced ELS were more likely to develop MDD before the age of 18 years than were individuals without a history of ELS (odds ratio = 2.50; 95% confidence interval 2.08, 3.00). Separate meta-analyses revealed a range of associations with MDD: whereas some types of ELS (eg, poverty) were not associated with MDD, other types (eg, emotional abuse) were associated more strongly with MDD than was ELS considered more broadly. CONCLUSION These findings provide important evidence that the adverse effect of ELS on MDD risk manifests early in development, prior to adulthood, and varies by type of ELS.
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Affiliation(s)
| | | | | | | | - Eunice Ip
- University of British Columbia, Vancouver
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Maniglio R. Significance, Nature, and Direction of the Association Between Child Sexual Abuse and Conduct Disorder: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2015; 16:241-257. [PMID: 24626460 DOI: 10.1177/1524838014526068] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
To elucidate the significance, nature, and direction of the potential relationship between child sexual abuse and conduct disorder, all the pertinent studies were reviewed. Ten databases were searched. Blind assessments of study eligibility and quality were performed by two independent researchers. Thirty-six studies including 185,358 participants and meeting minimum quality criteria that were enough to ensure objectivity and to not invalidate results were analyzed. Across the majority of studies, conduct disorder was significantly and directly related to child sexual abuse, especially repeated sexual molestation and abuse involving penetration, even after controlling for various sociodemographic, family, and clinical variables. The association between child sexual abuse and conduct disorder was not confounded by other risk factors, such as gender, socioeconomic status, school achievement, substance problems, physical abuse, parental antisocial behavior or substance problems, parent-child relationships, and family disruption, conflict, or violence. Evidence for a significant interactive effect between child sexual abuse and monoamine oxidase A gene on conduct disorder was scant. Early sexual abuse might predispose to the subsequent onset of conduct disorder which, in turn, may lead to further sexual victimization through association with sexually abusive peers or involvement in dangerous situations or sexual survival strategies.
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Affiliation(s)
- Roberto Maniglio
- Department of History, Society, and Human Studies, University of Salento, Lecce, Italy
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Hannigan B, Edwards D, Evans N, Gillen E, Longo M, Pryjmachuk S, Trainor G. An evidence synthesis of risk identification, assessment and management for young people using tier 4 inpatient child and adolescent mental health services. HEALTH SERVICES AND DELIVERY RESEARCH 2015. [DOI: 10.3310/hsdr03220] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BackgroundInpatient child and adolescent mental health services are one part of a complex system, and exist to meet the needs of young people with the greatest mental health difficulties.ObjectivesThe research question was ‘What is known about the identification, assessment and management of risk (where “risk” is broadly conceived) in young people (aged 11–18 years) with complex mental health needs entering, using and exiting inpatient child and adolescent mental health services in the UK?’Data sourcesThe two-phase Evidence for Policy and Practice Information and Co-ordinating Centre approach was used. In phase 1, scoping searches were made using two databases with an end date of March 2013. Phase 2 centred on the search for citations relating to the risks to young people of ‘dislocation’ and ‘contagion’. Searches were made using 17 databases, with time limits from 1995 to September 2013. Websites were searched, a call for evidence circulated and references of included citations reviewed.Review methodsPriority risk areas for phase 2 were decided in collaboration with stakeholders including through consultations with young people and the mother of a child who had been in hospital. All types of evidence relating to outcomes, views and experiences, costs and cost-effectiveness, policies, and service and practice responses in the areas of ‘dislocation’ and ‘contagion’ for young people (11–18 years) using inpatient mental health services were considered. A staged approach to screening was used. Data were extracted into tables following guidance from the Centre for Reviews and Dissemination or tables developed for the review. Quality was assessed using appraisal checklists from the Effective Public Health Practice Project or the Critical Skills Appraisal Programme or devised by previous reviewers. No papers were excluded on the grounds of quality, and all materials identified were narratively synthesised.ResultsIn phase 1, 4539 citations were found and 124 included. Most were concerned with clinical risks. In phase 2, 15,662 citations were found and 40 addressing the less obvious risks of ‘dislocation’ and ‘contagion’ were included, supplemented by 20 policy and guidance documents. These were synthesised using these categories: Dislocation: Normal Life; Dislocation: Identity; Dislocation: Friends; Dislocation: Stigma; Dislocation: Education; Dislocation: Families; and Contagion. No studies included an economic analysis or economic evaluation. The importance to stakeholders of these less obvious risks contrasted with the limited quantity and quality of research capable of informing policy, services and practice in these areas.LimitationsIncluded studies were of variable quality. Data derived could not be used to inform an economic modelling of NHS costs or to analyse cost-effectiveness. Other limitations were the search for only English-language materials and the use of umbrella concepts (‘dislocation’ and ‘contagion’).ConclusionsThe less obvious risks are important, but little evidence exists to support their identification, assessment and management. This has implications for services, and a programme of research is recommended to generate new knowledge.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Ben Hannigan
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Deborah Edwards
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Nicola Evans
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | | | - Mirella Longo
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Steven Pryjmachuk
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - Gemma Trainor
- Greater Manchester West Mental Health NHS Foundation Trust, Prestwich, UK
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Dyads and triads of abuse, bereavement and separation: a survey in children attending a child and family centre. Ir J Psychol Med 2014. [DOI: 10.1017/s0790966700004833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectives: To determine the frequency with which abuse, parental separation and bereavement occur on their own or together in children attending child psychiatry services and to assess the relationship between these traumas and attendance and outcome.Method: A review of all case notes over a 12 month period (n = 435) was conducted and a proforma completed. Information was gathered on clinical presentation, rate of attendance, the presence of sexual abuse, non-sexual abuse including bullying, bereavement and parental separation and a measurement of outcome by subjective assessment was made.Results: Fifty-nine per cent of the children had experienced at least one of the specified traumas; 13% had experienced two and 2.5% had experienced three. The children who had been abused or bereaved were more likely to require fairly long-term work; those who were adjusting to parental separation required less intervention over time. The children who had been sexually abused had, relatively, the poorest outcome in contrast to those adjusting to bereavement where 87% were considered to have made significant improvement.Conclusions: Bereavement, abuse and parental separation are common in children referred to the child psychiatric services and these children often require long-term intervention. Increased resources will be required in order to continue to provide adequate intervention and treatment for these children.
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Temiz M, Beştepe E, Yildiz Ö, Küçükgöncü S, Yazici A, Çalikuşu C, Erkoç Ş. The Effect of Violence on the Diagnoses and the Course of Illness Among Female Psychiatric Inpatients. Noro Psikiyatr Ars 2014; 51:1-10. [PMID: 28360588 DOI: 10.4274/npa.y6120] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Accepted: 08/13/2012] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION The aim of the study was to determine the rate of exposure to domestic violence among female inpatients at any period of their lives; to investigate the effect of different forms of violence on the diagnoses and the course of the illness. METHOD The study was conducted on 102 female inpatients treated at Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was administered and socio-demographic and clinical data was collected. A form designed for the assessment of violence was used to evaluate domestic violence. RESULTS Ninety patients reported that they had been subjected to some kind of violence at some period of their lives. The parents or husbands were the most frequently reported persecutors. Seventy-three patients reported that they had been subjected to violence before the onset of their illness. Seventy-one had been subjected to physical, 79 to verbal, 42 to sexual, 52 to economic violence, and 49 to constraints on social relationship formation. Comorbid diagnosis of post traumatic stress disorder (PTSD) was related to all types of violence. The rate of suicide attempt was found to be significantly related to verbal-emotional violence. Only 12 patients had previously reported being subjected to domestic violence to their psychiatrist. CONCLUSION Domestic violence, an often overlooked phenomenon, is prevalent among women with psychiatric disorders. Subjection to domestic violence is found to be correlated with PTSD and suicidal attempt.
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Affiliation(s)
- Meltem Temiz
- Clinic of Psychatry, Taksim German Hospital, İstanbul, Turkey
| | - Emrem Beştepe
- Erenköy Mental Health and Neurology Training and Research Hospital, İstanbul, Turkey
| | - Özlem Yildiz
- Clinic of Psychatry Outpatient, International Hospital, İstanbul, Turkey
| | - Suat Küçükgöncü
- Department of Psychiatry, Yale University, New Haven CT, USA
| | - Ayla Yazici
- Bakırköy Prof. Dr. Mazhar Osman Mental Health and Neurology Training and Research Hospital, İstanbul, Turkey
| | - Celal Çalikuşu
- Bakırköy Prof. Dr. Mazhar Osman Mental Health and Neurology Training and Research Hospital, İstanbul, Turkey
| | - Şahap Erkoç
- Bakırköy Prof. Dr. Mazhar Osman Mental Health and Neurology Training and Research Hospital, İstanbul, Turkey
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Keeshin BR, Strawn JR, Luebbe AM, Saldaña SN, Wehry AM, DelBello MP, Putnam FW. Hospitalized youth and child abuse: a systematic examination of psychiatric morbidity and clinical severity. CHILD ABUSE & NEGLECT 2014; 38:76-83. [PMID: 24041456 DOI: 10.1016/j.chiabu.2013.08.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 08/13/2013] [Accepted: 08/17/2013] [Indexed: 06/02/2023]
Abstract
Many children and adolescents who require psychiatric hospitalization have been physically or sexually abused, yet the association between reported histories of abuse and the complexity and severity of mental illness among psychiatrically hospitalized youth is poorly described with regard to current inpatient psychiatric practice. We sought to determine the association between histories of abuse and psychiatric complexity and severity in psychiatrically hospitalized youth including comorbidity patterns, psychotropic medication use, reason for admission and length of hospitalization. A systematic chart review was performed on 1433 consecutive psychiatric hospitalizations of children and adolescents that occurred over a 10-month period. Children with a history of abuse were more likely to be diagnosed with multiple DSM-IV-TR disorders than non-traumatized children. A history of sexual abuse was associated with more medication use than in their non-traumatized peers and a higher likelihood of treatment with antipsychotic medications, both at admission and discharge. Physical and sexual abuse were independently associated with increased length of stays, with exposure to both physical and sexual abuse associated with a 2-day increase in duration of hospitalization compared to non-traumatized patients. The findings from this study draw attention to the adverse impact of abuse on psychiatric morbidity and complexity and suggest the need for trauma-informed treatment in psychiatric hospital settings.
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Affiliation(s)
| | | | | | | | - Anna M Wehry
- University of Cincinnati College of Medicine, United States
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9
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Prevalence of Sexual Abuse Among Children with Conduct Disorder: A Systematic Review. Clin Child Fam Psychol Rev 2013; 17:268-82. [DOI: 10.1007/s10567-013-0161-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Goren J, Phillips L, Chapman M, Salo B. Dissociative and psychotic experiences of adolescents admitted to a psychiatric inpatient unit. J Trauma Dissociation 2012; 13:554-67. [PMID: 22989243 DOI: 10.1080/15299732.2012.694840] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A positive correlation between the incidences of dissociative and psychotic experiences has been consistently reported in a variety of adult populations. The present study was a preliminary investigation of the association between dissociative and psychotic experiences in adolescents requiring inpatient mental health care. No previous research has investigated this relationship in an adolescent cohort. Adolescents currently under inpatient care (n = 18) completed questionnaires assessing their experience of dissociative and psychotic phenomena. In line with previous research, a significant positive correlation was found between dissociative and psychotic experiences that remained highly significant once similarities between measures were taken into account. Recognizing the relationship between psychotic and dissociative experiences may be important in developing appropriate and effective treatment for young people experiencing mental health difficulties. Although the study is cross-sectional in nature and has a small sample, the results offer further evidence of the robust relationship between dissociative and psychotic experiences.
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Affiliation(s)
- Jessica Goren
- Psychological Sciences, University of Melbourne, Melbourne, Australia
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Olsson GI. Violence in the lives of suicidal adolescents: a comparison between three matched groups of suicide attempting, depressed, and nondepressed high school students. Int J Adolesc Med Health 2011; 11:369-380. [PMID: 22912264 DOI: 10.1515/ijamh.1999.11.3-4.369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Ji J, Trickett PK, Negriff S. Multidimensional Self-Perception of Sexually Abused Girls: Factor Models and Differences Between Sexual Abuse and Comparison Groups. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2009. [DOI: 10.1007/s10862-009-9137-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Colins O, Vermeiren R, Vreugdenhil C, Schuyten G, Broekaert E, Krabbendam A. Are psychotic experiences among detained juvenile offenders explained by trauma and substance use? Drug Alcohol Depend 2009; 100:39-46. [PMID: 19010608 DOI: 10.1016/j.drugalcdep.2008.08.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2008] [Revised: 08/28/2008] [Accepted: 08/29/2008] [Indexed: 11/28/2022]
Abstract
OBJECTIVE High rates of psychotic experiences among detained adolescents have been reported. However, the significance of psychotic experiences in detained juveniles is still poorly understood. The current study, therefore, (1) examines whether psychotic experiences could be explained by substance use and/or traumatic experiences, and (2) investigates this objective without taking into account the frequently occurring paranoia-related symptoms that may not be psychosis-related in detained minors. METHOD Data were derived from 231 detained adolescents. By means of the Diagnostic Interview Schedule for Children, psychotic experiences, life-threatening events and substance use were assessed while the Child Traumatic Questionnaire was used for a history of abuse and neglect. RESULTS In univariate logistic regression analyses, having psychotic experiences was positively associated with substance-related (e.g. past year intense marihuana use) and trauma-related (e.g. emotional abuse) variables. However, without taken paranoia-related experiences into account, different associations between psychotic experiences and substance-related and/or trauma-related variables were found. After building best fitting models, logistic regression analyses demonstrated a preponderance of trauma-related over substance-related variables in predicting the number of psychotic experiences (i.e. 0, 1-2, >2). CONCLUSION These findings suggest that psychotic experiences in detained adolescents may be explained by trauma and substance use. In addition, paranoia-related experiences seemed to be particularly associated with emotional abuse.
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Affiliation(s)
- Olivier Colins
- Department of Special Education, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium.
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Read J, Fink P, Rudegeair T, Felitti V, Whitfield C. Child Maltreatment and Psychosis: A Return to a Genuinely Integrated Bio-Psycho-Social Model. ACTA ACUST UNITED AC 2008. [DOI: 10.3371/csrp.2.3.5] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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15
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Boxer P, Terranova AM. Effects of multiple maltreatment experiences among psychiatrically hospitalized youth. CHILD ABUSE & NEGLECT 2008; 32:637-47. [PMID: 18582936 PMCID: PMC2581753 DOI: 10.1016/j.chiabu.2008.02.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2007] [Revised: 01/18/2008] [Accepted: 02/25/2008] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Relying on indicators coded from information collected routinely during intake assessments at a secure inpatient psychiatric facility, this study examined the extent to which different forms of maltreatment accounted for variations in youths' emotional and behavioral problems. METHODS Clinical information was reviewed for a large (N=401) and diverse sample (mean age=13.9 years; 53% male; 54.6% racial/ethnic minority) of youth admitted to a publicly funded psychiatric hospital. Data were drawn from intake narratives, standardized psychopathology rating scales, and psychiatric diagnostic ratings. RESULTS Findings provide some support for a hierarchical classification of multiple maltreatment experiences with sexual abuse identified as the specific form of maltreatment most reliably associated with poor adjustment. Support also was obtained for a cumulative classification approach, as the number of different types of maltreatment experiences was linked positively to elevated psychopathology ratings. CONCLUSIONS Even in this high-risk, atypical sample, maltreatment experiences account for variation in levels of psychopathology. These results have implications for classifying multiple maltreatment and enhancing clinical care for atypical youth who have been maltreated. PRACTICE IMPLICATIONS Clinicians working in youth psychiatric populations should implement maltreatment-specific psychotherapy approaches for maltreated youth, even as adjunctive treatments in a therapeutic milieu.
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Affiliation(s)
- Paul Boxer
- Department of Psychology, Rutgers University
- To whom correspondence should be sent: Dr. Paul Boxer, Department of Psychology, Rutgers University, Newark; 101 Warren Street, Newark NJ 07102. . FAX: 973-353-1171. Telephone: 973-353-5440, x231
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Bendall S, Jackson HJ, Hulbert CA, McGorry PD. Childhood trauma and psychotic disorders: a systematic, critical review of the evidence. Schizophr Bull 2008; 34:568-79. [PMID: 18003630 PMCID: PMC2632421 DOI: 10.1093/schbul/sbm121] [Citation(s) in RCA: 235] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
There is controversy over whether childhood trauma (CT) is a causal factor in the development of psychosis. This review aims to identify and critically analyze the association between CT and psychotic disorders. Studies investigating CT and psychotic disorder were identified by searches of electronic databases and manual searches of references lists, and 46 studies were identified. Forty studies had no control group, only psychiatric control groups, or unmatched, nonpopulation control groups and thus had methodologies that were inadequate to determine the relationship between CT and psychosis. Six studies used appropriate control groups. Three studies found an association between CT and psychosis, 2 found potentially real associations that failed to reach statistical significance, and 1 found no association, tentatively suggesting a relationship between CT and psychotic disorders. Several methodological problems were found in the studies in the review, including the highest quality studies, which limit the strength of the conclusions that can be drawn from them. These were lack of statistical power, lack of attention to moderating or mediating variables, the way in which CT was measured, and the use of cross-sectional research designs. These problems, some of which may be unavoidable in CT research, suggest the need for new and innovative methodologies in the investigation of CT and psychosis. Directions for further research are explored.
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Affiliation(s)
- Sarah Bendall
- ORYGEN Research Centre, 35 Poplar Road, Parkville, Victoria 3056, Australia.
| | - Henry J. Jackson
- ORYGEN Research Centre, 35 Poplar Road, Parkville, Victoria 3056, Australia,Department of Psychology, The University of Melbourne, Parkville 3056, Australia
| | - Carol A. Hulbert
- Department of Psychology, The University of Melbourne, Parkville 3056, Australia
| | - Patrick D. McGorry
- ORYGEN Research Centre, 35 Poplar Road, Parkville, Victoria 3056, Australia
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Fishbein DH, Herman-Stahl M, Eldreth D, Paschall MJ, Hyde C, Hubal R, Hubbard S, Williams J, Ialongo N. Mediators of the stress-substance-use relationship in urban male adolescents. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2006; 7:113-26. [PMID: 16791520 DOI: 10.1007/s11121-006-0027-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Exposure to chronic or severe acute stressors throughout the lifespan has been linked with numerous negative behavioral, emotional, cognitive, and physical consequences. Adolescence is considered to be a particularly vulnerable period given that the brain is experiencing dramatic developmental change during this time. The present study examined a sample of adolescents (N=125) considered to be at high risk for stress exposures and drug use by virtue of their environment and low income levels to identify possible neurocognitive (i.e., impulsivity, delay of gratification, emotional perception, and risky decision-making) and social competency mechanisms that may mediate this relationship. Using Mplus, a mediational model was tested using full information maximum likelihood estimates. Risky decision-making and poor social competency skills were related to previous stressful experiences; however, only social competencies mediated the effect of stressors on reports of past year marijuana, alcohol, and polydrug use. As such, stress appears to exert its negative impact through alterations in abilities to generate and execute prosocial decisions and behaviors. Interventions that directly address the effects of stress on social competencies may be especially important for children who have experienced adversity including those exposed to parental divorce, parental psychopathology, neglect or abuse, parental death, and poverty.
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Affiliation(s)
- Diana H Fishbein
- Behavioral Health Research Division, RTI International, Baltimore, Maryland 21224, USA.
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18
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Alloy LB, Abramson LY, Smith JM, Gibb BE, Neeren AM. Role of Parenting and Maltreatment Histories in Unipolar and Bipolar Mood Disorders: Mediation by Cognitive Vulnerability to Depression. Clin Child Fam Psychol Rev 2006; 9:23-64. [PMID: 16718583 DOI: 10.1007/s10567-006-0002-4] [Citation(s) in RCA: 135] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In this article, we review empirical research on the role of individuals' parenting and maltreatment histories as developmental antecedents for symptoms and diagnosable episodes of unipolar and bipolar spectrum disorders. Our review is focused on the following three overarching questions: (1) Do negative parenting and a history of maltreatment contribute risk to symptoms or diagnosable episodes of unipolar and bipolar disorders? (2) Are the associations of negative parenting and maltreatment histories with bipolar disorders similar to those for unipolar depression? and (3) Are the associations between negative parenting and maltreatment histories and unipolar and bipolar symptoms or disorders mediated by cognitive vulnerability to depression? We begin by discussing the methodological requirements for demonstrating a psychosocial risk factor and the methodological issues that plague the parenting and maltreatment literatures. Next, we review the extant studies on the role of parenting histories in unipolar and bipolar disorders. We consider the specificity and possible moderators of the parenting-mood disorder relationship, as well as cognitive vulnerability to depression as a mediator of this relationship. Then, we review studies on the association of maltreatment histories with unipolar and bipolar disorders and the role of cognitive vulnerability to depression as a mediator of this association. We conclude with an assessment of the state of the parenting and maltreatment literatures in unipolar and bipolar disorder with regard to our guiding questions.
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Affiliation(s)
- Lauren B Alloy
- Temple University, Philadelphia, Pennsylvania 19122, USA.
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19
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Grant KE, Compas BE, Thurm AE, McMahon SD, Gipson PY, Campbell AJ, Krochock K, Westerholm RI. Stressors and child and adolescent psychopathology: evidence of moderating and mediating effects. Clin Psychol Rev 2005; 26:257-83. [PMID: 16364522 DOI: 10.1016/j.cpr.2005.06.011] [Citation(s) in RCA: 254] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2005] [Revised: 06/06/2005] [Accepted: 06/06/2005] [Indexed: 11/29/2022]
Abstract
This paper reviews studies that have tested for moderators or mediators of the relation between stressors and child and adolescent psychopathology. Many studies have tested for moderation, but results of research studying moderators have been inconclusive. There have been few theory-based studies and there have been few consistent findings. Far fewer studies have tested for mediation effects, but these studies have generally been theory-driven, have more often built upon one another in an incremental fashion, and have yielded consistent results. In particular, there is substantial evidence for the mediating role of family relationship in the relation between stressors and child and adolescent psychological symptoms. Future studies should integrate moderator and mediator research by testing for specific mediators in relation to particular moderating contexts, so that we can better understand the complex ways in which stressful life experiences affect the well-being of children and adolescents.
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Affiliation(s)
- Kathryn E Grant
- Department of Psychology, DePaul University, Chicago, IL 60614, USA.
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20
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Read J, van Os J, Morrison AP, Ross CA. Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatr Scand 2005; 112:330-50. [PMID: 16223421 DOI: 10.1111/j.1600-0447.2005.00634.x] [Citation(s) in RCA: 883] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To review the research addressing the relationship of childhood trauma to psychosis and schizophrenia, and to discuss the theoretical and clinical implications. METHOD Relevant studies and previous review papers were identified via computer literature searches. RESULTS Symptoms considered indicative of psychosis and schizophrenia, particularly hallucinations, are at least as strongly related to childhood abuse and neglect as many other mental health problems. Recent large-scale general population studies indicate the relationship is a causal one, with a dose-effect. CONCLUSION Several psychological and biological mechanisms by which childhood trauma increases risk for psychosis merit attention. Integration of these different levels of analysis may stimulate a more genuinely integrated bio-psycho-social model of psychosis than currently prevails. Clinical implications include the need for staff training in asking about abuse and the need to offer appropriate psychosocial treatments to patients who have been abused or neglected as children. Prevention issues are also identified.
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Affiliation(s)
- J Read
- Department of Psychology, The University of Auckland, Auckland, New Zealand.
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21
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Buckle SK, Lancaster S, Powell MB, Higgins DJ. The relationship between child sexual abuse and academic achievement in a sample of adolescent psychiatric inpatients. CHILD ABUSE & NEGLECT 2005; 29:1031-47. [PMID: 16165213 DOI: 10.1016/j.chiabu.2004.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2003] [Revised: 12/13/2004] [Accepted: 12/25/2004] [Indexed: 05/04/2023]
Abstract
OBJECTIVES To examine the relationship between sexual abuse and academic achievement in an adolescent inpatient psychiatric population. Individual factors expected to influence this relationship were measured to explore the way they each interacted with sexual abuse and its relationship to academic achievement. METHOD Eighty-one adolescent psychiatric inpatients participated in the study (aged 12--18 years: M=16.0). Participants were administered tests of academic achievement (dependent variable) and intelligence, and completed a number of self-report measures of their experience of different types of maltreatment, their perception of the parenting they received, socio-economic status, substance abuse, and psychopathology. RESULTS Hierarchical regression analysis revealed that intelligence was the main predictor of academic achievement (uniquely explaining 26% of the variance). A number of interaction effects were also significant indicating that intelligence, substance abuse, internalizing behavior problems, externalizing behavior problems all influenced the relationship between sexual abuse and academic achievement. DISCUSSION Examining the impact of sexual abuse is complex because it is typically an experience embedded in a range of other risk factors, such as poverty, family dysfunction, and other types of maltreatment. This study demonstrated coexistence between sexual abuse and a number of other variables, including other maltreatment types and parental overprotection, underscoring the requirement for complex models of research that more accurately reflect the experience of abused children.
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Affiliation(s)
- Sarah K Buckle
- Deakin University, School of Psychology, 221 Burwood Highway, Burwood 3125, Vic., Australia
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22
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Wright J, Friedrich W, Cinq-Mars C, Cyr M, McDuff P. Self-destructive and delinquent behaviors of adolescent female victims of child sexual abuse: rates and covariates in clinical and nonclinical samples. VIOLENCE AND VICTIMS 2004; 19:627-43. [PMID: 16004066 DOI: 10.1891/vivi.19.6.627.66343] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Self-destructive and delinquent behaviors were assessed in three samples of adolescent females. The first sample (N=140) were substantiated victims of sexual abuse recruited from clinical settings. They were contrasted to a second sample (N=430) of secondary school students, and a third sample from the same school setting (N=94), that reported that they had been sexually abused. Few differences were found between the two groups of sexually abused girls, and both groups reported significantly more at-risk behaviors than nonabused girls. Family adversity was a consistent predictor of both self-destructive and delinquent behaviors. However, violence during the abuse, lower quality mother-daughter relationships, and depression were also related to self-destructive behaviors, while family economic problems and self-blame for the abuse were the only correlates of delinquent behavior.
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Affiliation(s)
- John Wright
- Department of Psychology, Université de Montréal Montreal, Quebec, Canada.
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23
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Cheng ST, Chan ACM. Factorial structure of the kidcope in Hong Kong adolescents. The Journal of Genetic Psychology 2004; 164:261-6. [PMID: 14521211 DOI: 10.1080/00221320309597982] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The Kidcope (A. Spirito, L. J. Stark, & C. Williams, 1988), a brief screening measure of coping strategies for children and adolescents, was subjected to exploratory and confirmatory factor analyses in a sample of adolescents in Hong Kong. A 2-factor model was found to fit the data when only the 2 emotional regulation items were treated separately and were allowed to load on the 2 different factors. Further analyses showed that factor loadings, factor variances, and factor covariance were invariant across age and gender. On the basis of the factor analyses, the authors created 2 composite scores, representing control-oriented and escape-oriented coping strategies. Implications for the use of the Kidcope in research and preventive intervention are discussed.
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Affiliation(s)
- Sheung-Tak Cheng
- Department of Applied Social Studies, City University of Hong Kong, Kowloon.
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Braun-Scharm H, Goth K, Freisleder FJ, Althoff A. Jugendliche in stationärer psychiatrischer Behandlung: Parasuizidale Symptome und psychische Störungen. KINDHEIT UND ENTWICKLUNG 2004. [DOI: 10.1026/0942-5403.13.1.26] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Psychische Störungen zählen zu den wichtigsten Ursachen für Parasuizide und Suizide. Dies gilt für das Erwachsenenalter und mit gewissen Abstrichen auch für das Jugendalter. Die häufigsten psychischen Störungen im Zusammenhang mit Suizidalität im Jugendalter sind akute Belastungsreaktionen, affektive Störungen, Substanzmissbrauch sowie Borderline-Syndrome und andere beginnende Persönlichkeitsstörungen. Essstörungen und Schizophrenien sind dagegen im Jugendalter noch nicht mit erhöhten Parasuiziden verknüpft. Anhand einer Gesamtstichprobe von 537 konsekutiv aufgenommenen und nach ICD-10 diagnostizierten stationär behandelten jugendpsychiatrischen Patienten konnten 163 mit parasuizidalen Symptomen bei Aufnahme ermittelt werden, die etwa zur Hälfte aus parasuizidalen Gedanken und parasuizidalen Handlungen bestanden. Der Anteil parasuizidaler Jugendlicher auf der Aufnahmestation lag bei etwa 66 %, auf der Therapiestation (Rottmannshöhe) bei etwa 30 %. Dies spricht für die Relevanz von Selektionsfaktoren bei Häufigkeits- und vermutlich auch Schweregradangaben von Suizidalität im stationären jugendpsychiatrischen Bereich.
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Affiliation(s)
| | - Kirsten Goth
- Abteilung Rottmannshöhe, Heckscher Klinik München
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25
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Cohen JA, Mannarino AP, Zhitova AC, Capone ME. Treating child abuse-related posttraumatic stress and comorbid substance abuse in adolescents. CHILD ABUSE & NEGLECT 2003; 27:1345-1365. [PMID: 14644054 DOI: 10.1016/j.chiabu.2003.08.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE Child abuse is a risk factor for developing Posttraumatic Stress Disorder (PTSD) and subsequent Substance Use Disorder (SUD). The purpose of this review is to summarize current knowledge about effective treatments for adolescent abuse-related PTSD, SUD, and the co-occurrence of these conditions. METHOD The literature on empirical treatment studies for these conditions in adolescence was reviewed, summarized, and synthesized. RESULTS Randomized controlled studies of abuse-related PTSD and SUD in adolescents have supported the efficacy of cognitive behaviorally-based individual and family treatment components. Components overlap considerably in empirically supported treatments for each disorder. An integrated treatment approach is described for use in adolescents with abuse-related PTSD and SUD, with recommendations for optimizing services for this population and for future research. CONCLUSIONS The available evidence on effective treatments suggests that integrated PTSD- and SUD-focused cognitive-behavioral and family treatment for adolescents with comorbid abuse-related PTSD and SUD may optimize outcomes for this population.
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Affiliation(s)
- Judith A Cohen
- Department of Psychiatry, Drexel University College of Medicine, Allegheny General Hospital, Four Allegheny Center, 8th Floor, Pittsburgh, PA 15212, USA
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26
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Haz AM, Castillo R, Aracena M. [Adaptation of the Multidimensional Trauma Recovery and Resilience (MTRR) questionnaire in a sample of Chilean mothers with a history of child abuse]. CHILD ABUSE & NEGLECT 2003; 27:807-820. [PMID: 14627080 DOI: 10.1016/s0145-2134(03)00118-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE Adaptation of the Multidimensional Trauma Recovery and Resilience (MTRR) in a Chilean sample. METHOD Participants were 80 mothers drawn from two large metropolitan areas (Santiago and Temuco). Sample participants (in a case control design) were redivided in two groups: 40 mothers identified as physical abusers with history of physical child abuse and 40 mothers identified as nonabusers with history of physical child abuse. Groups were matched on 5 sociodemographic variables. Reliability analysis, item analysis, and group comparisons on the 8 scales of the instrument were performed. RESULTS Interrater agreement level was .79 (Kendall's W coefficient) and the internal consistency as measured by Cronbach's alpha coefficient was .75. Twenty-five items (26.3%) significantly discriminated between the groups. Group comparison tests (Wilcoxon Rank-sum Test) also indicated that six of the eight domains discriminated between the groups. CONCLUSION In our sample, the instrument has reliable results which discriminate between the studied groups. These preliminary findings support future work toward the development of a Chilean version of this instrument.
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Affiliation(s)
- Ana María Haz
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Vicuña Mackenna, 4860 Santiago, Chile
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27
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McMahon SD, Grant KE, Compas BE, Thurm AE, Ey S. Stress and psychopathology in children and adolescents: is there evidence of specificity? J Child Psychol Psychiatry 2003; 44:107-33. [PMID: 12553415 DOI: 10.1111/1469-7610.00105] [Citation(s) in RCA: 176] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Research on the relations between specific stressors and specific psychological outcomes among children and adolescents is reviewed. Specificity, the notion that particular risk factors are uniquely related to particular outcomes is discussed from a theoretical perspective, and models of specificity are described. Several domains of stressors are examined from a specificity framework (e.g., exposure to violence, abuse, and divorce/marital conflict) in relation to broad-band outcomes of internalizing and externalizing symptoms. Studies that tested for specificity conducted within the past 15 years are examined, and definitional problems are highlighted. Little evidence for specificity was found. Methodological problems in the literature and the lack of theory-driven specificity research are discussed, and directions for future research are identified.
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Affiliation(s)
- Susan D McMahon
- Department of Psychology, DePaul University, Chicago, IL 60614, USA.
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28
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Meyerson LA, Long PJ, Miranda R, Marx BP. The influence of childhood sexual abuse, physical abuse, family environment, and gender on the psychological adjustment of adolescents. CHILD ABUSE & NEGLECT 2002; 26:387-405. [PMID: 12092805 DOI: 10.1016/s0145-2134(02)00315-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE The primary aim of the current study was to examine the contributions of sexual abuse, physical abuse, family cohesion, and conflict in predicting the psychological functioning of adolescents. Additional analyses were conducted to determine whether adolescent victims of child sexual abuse and physical abuse perceive their family environments as more conflictual and less cohesive than nonabused adolescents. METHOD Participants were 131 male and female adolescents, ages 16 years to 18 years, receiving services at a residential vocational training program. Participants completed well established psychological assessment tools to assess abuse history, family environment characteristics, and current adjustment. RESULTS Physically abused adolescent females perceived their family environments as more conflictual and less cohesive than females without physical abuse, and sexually abused females perceived their family environments as more conflictual and less cohesive than females without sexual abuse. Physically abused adolescent males reported more conflict than males without physical abuse, but did not differ with regard to cohesion. Adolescent males with and without a sexual abuse history did not differ on the family dimensions. Multiple regression analyses revealed that both conflict and cohesion, in addition to a history of sexual and physical abuse, predicted depression and distress. Separate analyses by gender revealed these variables differentially impact adjustment in male and female adolescents. Results of a power analysis indicated sufficient power to detect these differences. CONCLUSIONS Findings indicate that in addition to child sexual abuse and physical abuse, family conflict and cohesion are risk factors for the development of psychological distress and depression in adolescence. Implications for treatment and directions for future research are discussed.
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Affiliation(s)
- Lori A Meyerson
- Department of Psychology, Oklahoma State University, Stillwater, USA
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29
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Finzi R, Ram A, Shnit D, Har-Even D, Tyano S, Weizman A. Depressive symptoms and suicidality in physically abused children. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2001; 71:98-107. [PMID: 11271722 DOI: 10.1037/0002-9432.71.1.98] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Depressive symptoms and suicidality were assessed in 114 children 6-12 years old, of whom 41 had been physically abused, 38 neglected, and 35 neither abused nor neglected. The physically abused children manifested significantly higher levels of depressive symptomatology and suicidality than did the other two groups. Implications for research and clinical practice are discussed.
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Affiliation(s)
- R Finzi
- Bob Shapell School of Social Work, Tel Aviv University, Tel Hashomer.
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30
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Ryan KD, Kilmer RP, Cauce AM, Watanabe H, Hoyt DR. Psychological consequences of child maltreatment in homeless adolescents: untangling the unique effects of maltreatment and family environment. CHILD ABUSE & NEGLECT 2000; 24:333-352. [PMID: 10739077 DOI: 10.1016/s0145-2134(99)00156-8] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE This study examined the differential effects of various forms of abuse, as well as their combined effects. The study also sought to separate the factors uniquely associated with abuse from those associated with the more general problems present in an abusive family environment. METHODOLOGY Data were collected from 329 homeless adolescents. Preliminary analyses indicated some degree of matching for family background variables. Any differences in demographic or family characteristics were controlled for statistically. RESULTS Chi-square analyses revealed significant differences across groups for rates of assault, rape, depression/dysthymia, and attempted suicide. Multivariate analyses (MANOVAs) indicated significant differences in severity of internalizing problems and cognitive problems. Without exception, the group with histories of both physical and sexual abuse exhibited the most severe symptomatology and was at greatest risk for revictimization. Multiple regression analyses suggested that abuse histories were predictive of internalizing problems while family characteristics were more predictive of externalizing problems. CONCLUSIONS The findings indicate that both abuse type and family characteristics contribute to the development of symptomatology. Future prospective and longitudinal studies are needed to clarify the sequelae of abuse, as well as the possible cause and effect relations between abuse, family characteristics, and psychological outcome.
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Affiliation(s)
- K D Ryan
- Department of Psychology, University of Washington, Seattle 98195-1525, USA.
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31
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Brown J, Cohen P, Johnson JG, Smailes EM. Childhood abuse and neglect: specificity of effects on adolescent and young adult depression and suicidality. J Am Acad Child Adolesc Psychiatry 1999; 38:1490-6. [PMID: 10596248 DOI: 10.1097/00004583-199912000-00009] [Citation(s) in RCA: 441] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate the magnitude and independence of the effects of childhood neglect, physical abuse, and sexual abuse on adolescent and adult depression and suicidal behavior. METHOD A cohort of 776 randomly selected children was studied from a mean age of 5 years to adulthood in 1975, 1983, 1986, and 1992 during a 17-year period. Assessments included a range of child, family, and environmental risks and psychiatric disorders. A history of abuse was determined by official abuse records and by retrospective self-report in early adulthood on 639 youths. Attrition rate since 1983 has been less than 5%. RESULTS Adolescents and young adults with a history of childhood maltreatment were 3 times more likely to become depressed or suicidal compared with individuals without such a history (p < .01). Adverse contextual factors, including family environment, parent and child characteristics, accounted for much of the increased risk for depressive disorders and suicide attempts in adolescence but not in adulthood (p < .01). The effects of childhood sexual abuse were largest and most independent of associated factors. Risk of repeated suicide attempts was 8 times greater for youths with a sexual abuse history (odds ratio = 8.40, p < .01). CONCLUSIONS Individuals with a history of sexual abuse are at greater risk of becoming depressed or suicidal during adolescence and young adulthood. Adolescence is the most vulnerable period for those youths who may attempt suicide repeatedly. Many of the apparent effects of neglect, in contrast, may be attributable to a range of contextual factors, suggesting broader focus for intervention in these cases.
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Affiliation(s)
- J Brown
- College of Physicians and Surgeons, Columbia University, New York, USA.
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32
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Anderson M. Waiting for harm: deliberate self-harm and suicide in young people--a review of the literature. J Psychiatr Ment Health Nurs 1999; 6:91-100. [PMID: 10455619 DOI: 10.1046/j.1365-2850.1999.620091.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Mental health professionals, particularly nurses, practicing in child and adolescent psychiatry are key players in the continued development of expertise, awareness and understanding of deliberate self-harm (DSH) and suicide in young people. Enhancing this knowledge and the associated skills will contribute to effective, therapeutic relationships with individuals and their families. The purpose of this paper is to review the current literature surrounding the issue of deliberate self-harm and suicide in young people. The paper will address national and international studies selected from a variety of child and adolescent and general psychiatric literature. The research presented highlights important issues to be addressed in practice. In particular, the evidence supports the influence of mental illness in DSH and suicide, particularly depression and substance abuse. However, a clearly important factor is an individual's experience of family and social life. The literature is considered in the light of relevant governmental policy documents relating to DSH and suicide. The future role of the mental health nurse in child and adolescent psychiatry in the United Kingdom (UK) is discussed in the contexts of family work and assessment.
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Affiliation(s)
- M Anderson
- School of Nursing, Postgraduate Division, Faculty of Medicine and Health Sciences, University of Nottingham, Queen's Medical Centre, UK
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