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Lassri D, Gewirtz-Meydan A, Nolte T. Transdiagnostic factors in the COVID-19 pandemic: Examining the role of childhood abuse and neglect in establishing latent profiles of risk and resilience. CHILD ABUSE & NEGLECT 2024:106808. [PMID: 38693009 DOI: 10.1016/j.chiabu.2024.106808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 04/01/2024] [Accepted: 04/18/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Ample studies have focused on the negative consequences of COVID-19 on mental well-being, but fewer have explored the specific role of childhood abuse and neglect in the context of risk and resilience during this unprecedented crisis. OBJECTIVE We aimed to identify distinct profiles of individuals based on their experiences of childhood abuse and neglect, coping strategies, and psycho-social transdiagnostic risk and protective factors, using a person-centered approach. PARTICIPANTS AND SETTING A convenience sample of 914 Israelis completed self-report questionnaires during the second wave of COVID-19. METHODS Latent Profile Analysis was employed based on levels of childhood abuse and neglect, coping strategies, and established factors underpinning risk and resilience in mental health: dissociation, self-criticism, self-efficacy, self-compassion, attachment insecurity, psychological resilience, mentalizing, distress disclosure, psychopathology, and relationship satisfaction. Profiles were compared in COVID-19-related distress and well-being using ANOVAs. RESULTS A four-profile solution was found to be optimal for describing individuals with different profiles of risk and resilience: "risk" (5.1 %)-individuals with meaningfully high levels of childhood abuse and neglect and dissociation; "vulnerable" (14.2 %)-individuals high in risk factors and low in protective factors; "moderately resilient" (47.6 %)-those with moderate levels of protective and risk factors; "highly resilient" (33.1 %)-individuals high in protective factors and low in risk factors; groups differed in mental well-being and COVID-19-related distress. CONCLUSIONS Results highlight the importance of childhood abuse and neglect in differentiating between the two distinct profiles of at-risk individuals. Implications for risk assessment and treatment in the context of potential traumatic stress are discussed.
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Affiliation(s)
- Dana Lassri
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel; Research Department of Clinical, Educational, and Health Psychology, University College London (UCL), United Kingdom.
| | - Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare & Health Sciences, University of Haifa, Israel. agewirtz-@univ.haifa.ac.il
| | - Tobias Nolte
- Research Department of Clinical, Educational, and Health Psychology, University College London (UCL), United Kingdom; Anna Freud, United Kingdom.
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Nan J, Salina N, Chong ST, Jiang HJ. Trajectory of suicidal ideation among medical students during the COVID-19 pandemic: the role of childhood trauma. BMC Psychiatry 2023; 23:90. [PMID: 36747156 PMCID: PMC9900550 DOI: 10.1186/s12888-023-04582-6] [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: 09/30/2022] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The aim of this study was to understand the longitudinal trajectory of suicidal ideation (SI) among Chinese medical students and the role of childhood trauma (CT). METHODS Using a whole-group sampling method, we assessed SI in 2192 (male = 834, female = 1358) medical students on three occasions over a period of one year. The Suicidal Ideation Self-Assessment Scale (SISAS) and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess SI and CT. The growth mixture modeling (GMM) was used to classify the developmental trajectory of SI. RESULTS A greater number of medical students were experiencing suicidal ideation during the COVID-19 pandemic. The trajectory of SI among medical students was divided into two groups: a low risk, slowly rising group and a high risk, continuous group. The low risk, slowly rising group had a significant time effect (B = 1.57, p < 0.001) and showed a slowly increasing trend. Emotional neglect (EN), physical neglect (PN), emotional abuse (EA) and physical abuse (PA) all had significant positive predictive effects for the high risk, continuous group (B = 0.18-0.65, P < 0.01). CONCLUSION The trajectory of SI among medical students can be divided into a low risk, slowly rising group and a high risk, continuous group; the more EN, PN, EA and PA experienced during childhood, the more likely medical students are to develop a high risk, continuous state of SI.
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Affiliation(s)
- Jiang Nan
- grid.412113.40000 0004 1937 1557Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia ,grid.443397.e0000 0004 0368 7493Hainan Medical University, Haikou, 571199 China
| | - Nen Salina
- grid.412113.40000 0004 1937 1557Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia ,grid.412113.40000 0004 1937 1557Counselling Program, Postgraduate Secretariat, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Sheau Tsuey Chong
- Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600, Bangi, Malaysia. .,Counselling Program, Postgraduate Secretariat, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600, Bangi, Malaysia.
| | - Hong-juan Jiang
- grid.443397.e0000 0004 0368 7493Hainan Medical University, Haikou, 571199 China ,grid.443397.e0000 0004 0368 7493The First Affiliated Hospital of Hainan Medical University, Haikou, 571199 China
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3
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Lahav Y. Hyper-Sensitivity to the Perpetrator and the Likelihood of Returning to Abusive Relationships. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1815-NP1841. [PMID: 35499214 PMCID: PMC9709555 DOI: 10.1177/08862605221092075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
STUDY QUESTIONS Although most women who are subjected to intimate partner violence attempt to leave their abusive partners, many return, and resultantly are at risk for even greater violence. Research to date has documented relations between several factors (income and economic dependence, frequency of intimate partner violence (IPV), fear of violence escalations, history of childhood abuse, and post-traumatic stress disorder symptoms) and women's returning to their abusive partners. Nevertheless, the contribution of women's emotional bonds with their violent partners, known as identification with the aggressor (IWA), in explaining their perceived likelihood of going back to the relationship, has remained unclear. SUBJECTS The current study, conducted among 258 Israeli women who had left their violent partners, aimed to fill this void. METHODS An online survey was conducted. Demographic variables, history of childhood abuse, frequency of IPV, economic dependence on former partner, fear of future violence escalation, post-traumatic stress disorder symptoms, IWA, and perceived likelihood of returning to the relationship, were assessed via self-report questionnaire. FINDINGS Results indicated that two aspects of IWA-becoming hyper-sensitive to the perpetrator and adopting the perpetrator's experience-were related to women's perceived likelihood of returning to the relationship. Furthermore, a logistic regression analysis indicated that only two factors-income and becoming hyper-sensitive to the perpetrator-uniquely contributed to explaining the likelihood of returning to abusive partners. Major implications: The current findings suggest that women's tendency to be highly attuned to their partners' feelings and needs, as a part of IWA, may impede their ability to permanently leave abusive relationships.
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Affiliation(s)
- Yael Lahav
- Department of Occupational Therapy,
Sackler Faculty of Medicine, Tel Aviv
University, Israel
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Graham S, Kamitsis I, Kennedy M, Heris C, Bright T, Bennetts SK, Jones KA, Fiolet R, Mohamed J, Atkinson C, Chamberlain C. A Culturally Responsive Trauma-Informed Public Health Emergency Framework for Aboriginal and Torres Strait Islander Communities in Australia, Developed during COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15626. [PMID: 36497699 PMCID: PMC9738974 DOI: 10.3390/ijerph192315626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 06/17/2023]
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic impacted peoples' livelihoods and mental wellbeing. Aboriginal and Torres Strait Islander peoples in Australia continue to experience intergenerational trauma associated with colonization and may experience trauma-related distress in response to government responses to public health emergencies. We aimed to develop a culturally responsive trauma-informed public health emergency response framework for Aboriginal and Torres Strait Islander peoples. This Aboriginal and Torres Strait Islander-led study involved: (i) a review of trauma-informed public health emergency responses to develop a draft framework (ii) interviews with 110 Aboriginal and Torres Strait Islander parents about how COVID-19 impacted their lives, and (iii) a workshop with 36 stakeholders about pandemic experiences using framework analysis to refine a culturally responsive trauma-informed framework. The framework included: an overarching philosophy (cultural humility, safety and responsiveness); key enablers (local leadership and Eldership); supporting strategies (provision of basic needs and resources, well-functioning social systems, human rights, dignity, choice, justice and ethics, mutuality and collective responsibility, and strengthening of existing systems); interdependent core concepts (safety, transparency, and empowerment, holistic support, connectedness and collaboration, and compassion, protection and caring); and central goals (a sense of security, resilience, wellbeing, self- and collective-efficacy, hope, trust, resilience, and healing from grief and loss).
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Affiliation(s)
- Simon Graham
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC 3000, Australia
| | - Ilias Kamitsis
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Michelle Kennedy
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Christina Heris
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2601, Australia
| | - Tess Bright
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Shannon K. Bennetts
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
- Intergenerational Health Group, Murdoch Children’s Research Institute, Parkville, VIC 3000, Australia
| | - Kimberley A Jones
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Renee Fiolet
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
| | | | | | - Catherine Chamberlain
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
- The Lowitja Institute, Collingwood, VIC 3066, Australia
- NGANGK YIRA: Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, WA 6150, Australia
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Maharaj R, Tineo K, Flores-Ortega M, Cordova DA, Iskhakova A, Linn R, Nikulina V. The association between COVID-19-related stressors and mental health outcomes for survivors of past interpersonal and non-interpersonal trauma. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022; 6:100300. [PMID: 37520402 PMCID: PMC9547392 DOI: 10.1016/j.ejtd.2022.100300] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/18/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022]
Abstract
The mental health difficulties of trauma survivors during the COVID-19 pandemic have been under-reported. This study explored the moderating role of trauma history and trauma type (interpersonal and non-interpersonal) in the association between COVID-19-related stressors and depression, anxiety, and stress. A sample of n = 321 participants ages 19 to 71 (M = 36.63, SD = 10.36) was recruited from across the United States through MTurk. Participants reported the number of COVID-19-related stressors, trauma history and psychological symptoms. Hierarchical multiple regression analyses, controlling for age, race, ethnicity, gender, education, and income levels, were used to determine (a) whether COVID-19-related stressors are associated with adverse mental health outcomes; (b) whether trauma history and (c) trauma type moderated this association. Results revealed significant interactions; for those with a trauma history, exposure to COVID-19-related stressors was associated with higher levels of depression (β = .21, p < .05) and anxiety (β = .19, p < .05). For those with a history of interpersonal trauma specifically, COVID-19-related stressors were associated with depression (β = .16, p < .05) more so than for those without a trauma history. These findings highlight the vulnerability of trauma survivors to the unprecedented COVID-19-related stress.
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Affiliation(s)
- Reena Maharaj
- Department of Psychology, Queens College, City University of New York, United States
| | - Katherine Tineo
- Department of Psychology, Queens College, City University of New York, United States
| | - Marisol Flores-Ortega
- Department of Psychology, Queens College, City University of New York, United States
| | - Diego A Cordova
- Department of Psychology, Queens College, City University of New York, United States
| | - Alexandra Iskhakova
- Department of Psychology, Queens College, City University of New York, United States
| | - Rose Linn
- Department of Psychology, Queens College, City University of New York, United States
| | - Valentina Nikulina
- Department of Psychology, Queens College, City University of New York, United States
- The Graduate Center, City University of New York, United States
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Foster JC, Cohodes EM, Brieant AE, McCauley S, Odriozola P, Zacharek SJ, Pierre JC, Hodges H, Kribakaran S, Haberman JT, Holt-Gosselin B, Gee DG. Associations between early-life stress exposure and internalizing symptomatology during the COVID-19 pandemic: Assessing the role of neurobehavioral mediators. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022; 3:S2667-1743(22)00090-8. [PMID: 35959474 PMCID: PMC9356644 DOI: 10.1016/j.bpsgos.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 07/12/2022] [Accepted: 07/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background The ongoing COVID-19 pandemic is a major stressor that has been associated with increased risk for psychiatric illness in the general population. Recent work has highlighted that experiences of early-life stress (ELS) may impact individuals' psychological functioning and vulnerability for developing internalizing psychopathology in response to pandemic-related stress. However, little is known about the neurobehavioral factors that may mediate the association between ELS exposure and COVID-related internalizing symptomatology. The current study sought to examine the mediating roles of pre-pandemic resting-state frontoamygdala connectivity and concurrent emotion regulation (ER) in the association between ELS and pandemic-related internalizing symptomatology. Methods Retrospective life-stress histories, concurrent self-reported ER strategies (i.e., reappraisal and suppression), concurrent self-reported internalizing symptomatology (i.e., depression- and anxiety-related symptomatology), and resting-state functional connectivity data from a sample of adults (N = 64, M age = 22.12, female = 68.75%) were utilized. Results There were no significant direct associations between ELS and COVID-related internalizing symptomatology. Neither frontoamygdala functional connectivity nor ER strategy use mediated an association between ELS and COVID-related internalizing symptomatology (ps > 0.05). Exploratory analyses identified a significant moderating effect of reappraisal use on the association between ELS and internalizing symptomatology (β = -0.818, p = 0.047), such that increased reappraisal use buffered the impact of ELS on psychopathology. Conclusions While frontoamygdala connectivity and ER do not appear to mediate the association between ELS and COVID-related internalizing symptomatology, our findings suggest that the use of reappraisal may buffer against the effect of ELS on mental health during the pandemic.
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Affiliation(s)
- Jordan C. Foster
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Emily M. Cohodes
- Department of Psychology, Yale University, New Haven, Connecticut
| | | | - Sarah McCauley
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Paola Odriozola
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Sadie J. Zacharek
- Department of Psychology, Yale University, New Haven, Connecticut
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | | | - H.R. Hodges
- Department of Psychology, Yale University, New Haven, Connecticut
| | | | | | | | - Dylan G. Gee
- Department of Psychology, Yale University, New Haven, Connecticut
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7
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McLaughlin KA, Rosen ML, Kasparek SW, Rodman AM. Stress-related psychopathology during the COVID-19 pandemic. Behav Res Ther 2022; 154:104121. [PMID: 35642991 PMCID: PMC9110305 DOI: 10.1016/j.brat.2022.104121] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/29/2022] [Accepted: 05/13/2022] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic has introduced widespread societal changes that have required ongoing adaptation. Unsurprisingly, stress-related psychopathology has increased during the pandemic, in both children and adults. We review these patterns through the lens of several leading conceptual models of the link between stress and psychopathology. Some of these models focus on characteristics of environmental stressors-including cumulative risk, specific stressor types, and stress sensitization approaches. Understanding the specific aspects of environmental stressors that are most likely to lead to psychopathology can shed light on who may be in most need of clinical intervention. Other models center on factors that can buffer against the onset of psychopathology following stress and the mechanisms through which stressors contribute to emergent psychopathology. These models highlight specific psychosocial processes that may be most usefully targeted by interventions to reduce stress-related psychopathology. We review evidence for each of these stress models in the context of other widescale community-level disruptions, like natural disasters and terrorist attacks, alongside emerging evidence for these stress pathways from the COVID-19 pandemic. We discuss clinical implications for developing interventions to reduce stress-related psychopathology during the pandemic, with a focus on brief, digital interventions that may be more accessible than traditional clinical services.
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Affiliation(s)
| | - Maya L Rosen
- Department of Psychology, Harvard University, USA
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8
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Xie M, Tang Y, Zhu L, Dai M, Wu Y, Huang Y, Liu Y, Xiao L, Li T, Wang Q. Childhood Trauma and Mental Health Status in General Population: A Series Mediation Examination of Psychological Distress in COVID-19 Pandemic and Global Sleep Quality. Front Psychiatry 2021; 12:782913. [PMID: 34925109 PMCID: PMC8674436 DOI: 10.3389/fpsyt.2021.782913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 10/28/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Coronavirus-2019 (COVID-19) has been coexisting with humans for almost 2 years, consistently impacting people's daily life, medical environment, and mental health. This study aimed to test the series mediation model triggered by childhood trauma, in which perceived psychological impact of COVID-19 pandemic and sleep quality mediated the path sequentially and led to adverse mental health outcomes. Methods: A cross-sectional design involving 817 participants were enrolled via WeChat online survey. Participants completed questionnaires, including demographic features, the Childhood Trauma Questionnaire, Impact of Event Scale-Revised (IES-R) questionnaire, Pittsburgh Sleep Quality Index (PSQI) questionnaire, and Depression, Anxiety, and Stress Scale (DASS-21). Pearson correlations and hierarchical multiple linear regression were employed to examine the association of childhood trauma and psychological stress of COVID-19, sleep quality, and mental health status. In addition, a series mediate analysis was carried out to examine sequence mediating effects of psychological impact of COVID-19 and sleep quality between childhood trauma and mental health status. Results: The results showed that childhood trauma is positively and significantly related to psychological distress of COVID-19 pandemic, sleep quality, and mental health status (p < 0.05). Hierarchical multiple linear regression analysis shown that demographic features explained 4.4, 2.1, and 4.0% of the total variance in DASS-21, IES-R, and PSQI total scale scores, respectively. Adding childhood trauma significantly increased the model variance of DASS-21 (ΔR 2 = 0.129, F = 126.092, p = 0.000), IES-R (ΔR 2 = 0.062, F = 54.771, p = 0.000), and PSQI total scale scores (ΔR 2 = 0.055, F = 48.733, p = 0.000), respectively. Moreover, the series mediation model showed that the perceived impact of the COVID-19 pandemic and sleep quality were sequential mediators between childhood trauma and mental health status (proportion explained: 49.17%, p < 0.05). Conclusion: Amid the ravages of COVID-19, childhood trauma predicts poor mental health status, in part because of greater psychological impact related to COVID-19 and poorer global sleep quality. In order to improve mental health, future researchers should pay more attention to individuals with childhood trauma, for its association with greater stress related to life events and poorer sleep quality.
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Affiliation(s)
- Min Xie
- Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Yiguo Tang
- Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Ling Zhu
- Department of Clinical Psychology, Southwest Hospital, The First Hospital Affiliated to Army Medical University, Third Military Medical University, Chongqing, China
| | - Minhan Dai
- Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Yulu Wu
- Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Yunqi Huang
- Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Yunjia Liu
- Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Liling Xiao
- Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Li
- Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, China.,Affiliated Mental Health Centre and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiang Wang
- Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, China
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