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Leri J, Cisler JM, Dodd CG, Clark SL, Taylor L, Theodorou A, Belford A, Liberzon I, Rathouz PJ, Newport DJ, Devargas C, Wagner K, Nemeroff CB. The role of recurrent trauma on post-traumatic stress disorder symptoms and substance use among trauma exposed youth. Psychiatry Res 2024; 338:115980. [PMID: 38833935 DOI: 10.1016/j.psychres.2024.115980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/17/2024] [Accepted: 05/25/2024] [Indexed: 06/06/2024]
Abstract
Comorbidity between post-traumatic stress disorder (PTSD) and substance use disorder may be explained by a prospective trauma risk conferred by both conditions. The current study modeled concurrent and prospective associations of trauma, PTSD symptoms, and substance use (SU) behavior among trauma exposed youth (ages 8-20). Clinical interviews assessed trauma exposure, PTSD symptom severity, and SU behavior at baseline and at six- and 12-month follow up study visits (N = 2,069). Structural equation models assessed the associations of trauma, PTSD symptoms, and SU behavior. Lifetime trauma was associated with more severe PTSD symptoms and SU behaviors, whereas trauma exposure during the study was only associated with PTSD symptoms. PTSD symptom severity was prospectively associated with trauma exposure. PTSD symptom severity and SU behavior at follow-up study visits were prospectively associated. These results highlight the dynamic interplay between trauma, PTSD symptoms, and SU behavior during youth, a developmental period during which complex psychiatric presentations can have longstanding consequences for health.
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Affiliation(s)
- John Leri
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States.
| | - Josh M Cisler
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States
| | - Cody G Dodd
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical Branch, United States
| | - Shaunna L Clark
- Department of Psychiatry & Behavioral Sciences, Texas A&M University, United States
| | - Leslie Taylor
- Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, United States
| | - Arrian Theodorou
- The University of North Texas Health Science Center, United States
| | - Anissa Belford
- Department of Psychiatry and Behavioral Sciences, The University of Texas at San Antonio, United States
| | - Israel Liberzon
- Department of Psychiatry & Behavioral Sciences, Texas A&M University, United States
| | - Paul J Rathouz
- Department of Population Health, The University of Texas at Austin Dell Medical School, United States
| | - D Jeffrey Newport
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States; Department of Women's Health, The University of Texas at Austin Dell Medical School, United States
| | - Cecilia Devargas
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, United States
| | - Karen Wagner
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical Branch, United States
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States
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Ahad MA, Parry YK, Willis E, Ullah S. Child maltreatment and psycho-social impairments among child laborers in rural Bangladesh. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02671-9. [PMID: 38684514 DOI: 10.1007/s00127-024-02671-9] [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: 02/03/2023] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE The current study focused on exploring the impact of maltreatment of child laborers on their psychosocial health condition from the views of their parents. METHODS A total of 100 parents of child laborers were recruited using snowball sampling. The structured questionnaire comprised two validated scales including ISPCAN Child Abuse Screening Tool (ICAST-P), and Paediatric Symptom Checklist (PSC) were used for the survey. Factor analysis and multivariable linear regression analysis were performed to examine the data using SPSS version 26, and Stata version 16.1. RESULTS A three-factor model consisting of internalizing, externalizing, and attention associated psycho-social impairments of child laborers were derived from the 35-item scale of PSC tool and represented a good fit to the data. A mean estimate of maltreatment indicates that a majority of child laborers are maltreated psychologically, followed by physical maltreatment and neglect. The factor analysis resulted that maltreated child laborers are highly prone to exhibit internalized psycho-social difficulties, followed by externalized and attention-associated emotional and behavioral difficulties among child laborers. The regression model further depicts that child laborers, who had been physically and psychologically maltreated, are significantly more likely to be affected by internalized and attention-related psycho-social impairments. CONCLUSIONS The study concluded that victimized child laborers exhibited significant internalized, as well as attention-related problems. These findings may be useful for future studies that examine emotional and behavioral problems among maltreated child laborers and, therefore, for developing prevention strategies.
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Affiliation(s)
- Md Abdul Ahad
- Department of Rural Sociology and Development, Sylhet Agricultural University, Sylhet, 3100, Bangladesh.
- College of Nursing and Health Sciences, Flinders University, SA, Australia.
| | - Yvonne Karen Parry
- College of Nursing and Health Sciences, Flinders University, SA, Australia
| | - Eileen Willis
- College of Nursing and Health Sciences, Flinders University, SA, Australia
- Research Training Lead, School of Graduate Research, Central Queensland University, Queensland, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, SA, Australia
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Ogle CM, Harmon-Darrow C, Fedina L, Nichols D, Mulford CF, Backes BL. Operational Definitions of Poly-Victimization: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241246522. [PMID: 38655856 DOI: 10.1177/15248380241246522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Throughout the last two decades, research on poly-victimization (PV) has evolved from examinations of a core set of past-year victimization types in youth samples to investigations of a broad range of victimization types experienced during variable time intervals in diverse samples of varying ages. As the concept of PV expands, greater clarity regarding the definition and measurement of PV is needed to advance understanding of its risk and protective factors as well as its associated outcomes. This scoping review aimed to (a) identify approaches used to operationally define and measure PV across studies and (b) synthesize empirical findings concerning risk factors and outcomes associated with PV. A systematic search of peer-reviewed research published before 2022 across 12 databases yielded 98 studies that met inclusion criteria. Study characteristics including the research design, sample type, victimization timeframe, operational definition(s) of PV, measurement of PV, analytic methods, and key findings were synthesized across studies. Findings indicated that the majority of reviewed studies were cross-sectional investigations that utilized categorical measures of lifetime PV in samples of youth. Results also demonstrated that PV is robustly associated with a broad range of predictors, including mental health symptoms and diagnoses as well as family- and community-level factors. PV is also associated with numerous adverse outcomes including depression, anxiety, suicidality, substance use, and delinquency across diverse study types and populations. Future research that examines the conditional effects of PV is needed to identify subgroups of individuals at higher risk of adverse outcomes following PV and modifiable targets for interventions.
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Affiliation(s)
- Christin M Ogle
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | | | | | | | - Carrie F Mulford
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
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Aksan N, Guzick AG, Taylor L, Richmond R, Liberzon I, Cross J, Garza C, Rousseau J, Shahidullah JD, Clark SL, Rathouz PJ, Dodd CG, Cisler J, Newport DJ, Wagner KD, Nemeroff CB. Evaluating traumatic event scoring schemas for their predictive value to concurrent diagnostic profiles: Texas Childhood Trauma Research Network. J Affect Disord 2024; 345:94-102. [PMID: 37848091 DOI: 10.1016/j.jad.2023.10.092] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND To prospectively chart pathways of risk and resiliency following childhood trauma studies need to address three limitations of prior work: 1) recruit beyond social service/ treatment settings; 2) include broad spectrum of trauma types and 3) cast a broad longitudinal measurement framework of both clinical diagnoses and traumatic exposures. The Texas-Childhood Trauma Research Network (TX-CTRN) is a multi-site collaboration that addresses these limitations. In this baseline-only report, we examined domains of trauma and evaluated the concurrent predictive validity of various traumatic event scoring schemas for clinical diagnoses. METHODS Broad-base recruitment of 8-20 year-olds (N = 1289) included trauma centers, emergency departments, pediatric and primary care clinics, and other community settings. Assessments were comprehensive and based on clinical interviews by trained research interviewers. RESULTS Factor analyses supported a five-factor solution of trauma domains including unintentional/acute, intentional/interpersonal, bullying, in-home versus community witnessed interpersonal harms. Trauma burden scoring schemas were examined for their predictive superiority. Domain-specific counts of traumas that met DSM-5 post-traumatic-stress disorder (PTSD) Criterion-A was the best overall schema in distinguishing among youth with no diagnosis, comorbidities, those with depression, suicidality, substance misuse, and PTSD. LIMITATIONS There were no assessments of neglect. CONCLUSIONS Findings largely aligned with earlier studies on the relative importance of intentional interpersonal traumas and showed bullying may be an important source of traumatic stress that independently adds to prediction of several diagnoses and should be considered in clinical practice.
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Affiliation(s)
- Nazan Aksan
- Dept of Population Health, Dell Medical School, University of Texas at Austin, United States of America.
| | - Andrew G Guzick
- Dept of Psychiatry, Baylor College of Medicine, University of Pennsylvania, United States of America
| | - Leslie Taylor
- Dept of Psychiatry & Behavioral Sciences, University of Texas Health Science Center, Houston, United States of America
| | - Robyn Richmond
- Dept of Surgery, Texas Tech University Lubbock, United States of America
| | - Israel Liberzon
- Dept of Psychiatry, Texas A&M University, United States of America
| | - Jeremyra Cross
- Dept of Psychiatry, University of Texas Health Science Center, San Antonio, United States of America
| | - Cynthia Garza
- Adult Primary Care University of Texas Health Science Center Rio Grande Valley, United States of America
| | - Justin Rousseau
- Dept of Population Health, Dell Medical School, University of Texas at Austin, United States of America; Dept of Neurology, Dell Medical School, University of Texas at Austin, United States of America
| | - Jeffrey D Shahidullah
- Dept of Psychiatry, Dell Medical School, University of Texas at Austin, United States of America
| | - Shaunna L Clark
- Dept of Psychiatry, Texas A&M University, United States of America
| | - Paul J Rathouz
- Dept of Population Health, Dell Medical School, University of Texas at Austin, United States of America
| | - Cody G Dodd
- Dept of Psychiatry & Behavioral Sciences, University of Texas Medical Branch, United States of America
| | - Josh Cisler
- Dept of Psychiatry, Dell Medical School, University of Texas at Austin, United States of America
| | - D Jeffrey Newport
- Dept of Psychiatry, Dell Medical School, University of Texas at Austin, United States of America
| | - Karen D Wagner
- Dept of Psychiatry & Behavioral Sciences, University of Texas Medical Branch, United States of America
| | - Charles B Nemeroff
- Dept of Psychiatry, Dell Medical School, University of Texas at Austin, United States of America
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Schwartz A, Galera C, Kerbage H, Montagni I, Tzourio C. Adverse Childhood Experiences and ADHD Symptoms Among French College Students. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:1109-1117. [PMID: 38045835 PMCID: PMC10689313 DOI: 10.1007/s40653-023-00543-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 12/05/2023]
Abstract
To examine the relationship between adverse childhood experiences (ACEs) and Attention-deficit Hyperactivity Disorder (ADHD) among college students. We investigated the association between ACEs and ADHD symptoms among French college students enrolled in the i-Share cohort using multivariate logistic regression models. The sample comprised of 1062 participants with a mean age of 20.3 (SD = 2.3) of which 30.6% had no ACEs exposure, 29.6% had 1 ACE, 19.2% had 2 ACEs, and 20.6% had ≥ 3 ACEs. After controlling for potential confounders, every increase in ACE exposure heightened the risk of ADHD symptoms with the respective adjusted Odds Ratios and 95% confidence intervals: 1 ACE: 2.1 (0.7-6.3) / 2 ACEs: 4.5 (2.6-12.8)/ ≥ 3 ACEs: 5.2 (1.8-14.8). Estimates for ADHD symptoms were higher with sexual abuse, emotional and physical neglect, and bullying. Findings suggest that ACEs heighten the risk for developing ADHD symptoms among college students and bear important implications for prevention and clinical practice.
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Affiliation(s)
- Ashlyn Schwartz
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, 146 Rue Léo Saignat, F-33000 Bordeaux, France
- Department of Public Health, University of Tennessee-Knoxville, Knoxville, USA
| | - Cédric Galera
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, 146 Rue Léo Saignat, F-33000 Bordeaux, France
- Charles Perrens Hospital, Bordeaux, France
| | - Hala Kerbage
- Department of Child and Adolescent Psychiatry, Saint Eloi University Hospital, 34090 Montpellier, France
- Center for Epidemiology and Population Health (CESP) INSERM U1018, Developmental Psychiatry Team, Paris-Saclay University, Villejuif Cedex 94807, Paris, France
| | - Ilaria Montagni
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, 146 Rue Léo Saignat, F-33000 Bordeaux, France
| | - Christophe Tzourio
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, 146 Rue Léo Saignat, F-33000 Bordeaux, France
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Nguyen PT, Gordon CT, Owens EB, Hinshaw SP. Patterns of Childhood Adversity among Women with and without Childhood ADHD: Links to Adult Psychopathology and Global Functioning. Res Child Adolesc Psychopathol 2023; 51:1813-1825. [PMID: 36399241 DOI: 10.1007/s10802-022-00994-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 11/19/2022]
Abstract
We examine the outcomes associated with childhood adversity for women with and without carefully diagnosed childhood ADHD, via an ethnically diverse sample of 140 participants with ADHD (Mage = 9.7) and 88 age- and ethnicity-matched comparisons (Mage = 9.4). At adult follow-up, we retained 211 of the original 228 participants (92.6%; Mage = 25.6). We used latent class analysis to identify patterns of childhood adversity and examine their association with adult global functioning and psychopathology. Key findings: (1) Four childhood adversity classes emerged (Low Exposure, Familial Dysfunction, Emotional Maltreatment, Pervasive Exposure); (2) Childhood ADHD predicted membership in the Emotional Maltreatment class; and (3) Childhood adversity classes were differently associated with adult outcomes, such that membership in both the Emotional Maltreatment and Pervasive Exposure classes predicted significantly higher internalizing and externalizing symptoms as well as significantly lower global functioning than women in the Low Exposure class. Furthermore, compared to the Emotional Maltreatment class, the Familial Dysfunction class had lower externalizing symptoms, whereas the Pervasive Exposure class had lower global functioning and higher internalizing symptoms by adulthood. Findings provide information about girls and women who could be targeted for intervention in terms of ADHD behavior patterns plus adverse experiences in childhood. Beyond limitations, we discuss the need to investigate the confluence of neurodevelopmental conditions and adverse child events with respect to maladaptive outcomes.
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Affiliation(s)
- Phuc T Nguyen
- University of California, Berkeley, Berkeley, CA, USA.
| | - Chanelle T Gordon
- Child and Family Translational Research Center, Boys Town National Research Hospital, Omaha, NE, USA
| | | | - Stephen P Hinshaw
- University of California, Berkeley, Berkeley, CA, USA
- University of California, San Francisco, CA, USA
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Christoffersen MN. Overcoming the Odds: Does Social Support Make a Difference for Young People With ADHD Symptoms? J Atten Disord 2023; 27:1596-1608. [PMID: 37470200 DOI: 10.1177/10870547231188348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
OBJECTIVES Young adults with ADHD symptoms have a risk of negative outcomes in cognitive development, emotional development, and social developmental problems. The research question is: Does social support make a difference for children with ADHD symptoms? METHOD Children born in 1984 were interviewed at age 25. The survey then obtained a 67% response rate which measures up to 2,980 interviewed persons. Validated constructs were used to measure outcomes, mediator, and ADHD symptoms. RESULTS Young people with ADHD symptoms have an increased rate of low educational achievement, low self-esteem, loneliness, suicide considerations, PTSD symptoms, behavioral problems, criminal behavior, peer problems, and substance abuse. Social support is a partial mediator for the negative outcomes except for criminal behavior and substance abuse problems. CONCLUSIONS Loss of social support partly explains the mentioned negative outcomes and we would suggest that future research also look for other mediators. These results indicate potential interventions.
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Clark SL, Dodd CG, Taylor L, Stewart S, Yang N, Shahidullah JD, Guzick AG, Richmond R, Aksan N, Rathouz PJ, Rousseau JF, Newport DJ, Wagner KD, Nemeroff CB. Characterizing patterns of substance use in trauma exposed youth. J Psychiatr Res 2023; 167:1-9. [PMID: 37778242 DOI: 10.1016/j.jpsychires.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/17/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Previous work investigating the impact of childhood trauma on substance use and co-occurring psychiatric disorders has primarily been conducted in adults or on specific trauma types. This limits understanding of traumas impact in childhood and how different types of traumas play a role. We sought to characterize substance use in a sample of trauma-exposed youth in the context of psychiatric comorbidities. METHOD 1152 youth from the Texas Childhood Trauma Research Network (TX-CTRN) that were exposed to at least one trauma meeting DSM-5 Criterion A were assessed for current substance use and psychiatric diagnoses. Latent class analysis was used to identify patterns of substance use. To characterize these patterns, we examined if demographics, number of trauma types experienced, or childhood psychiatric disorders predicted class membership. RESULTS We identified four primary patterns of substance use: Non-use (66.1%), predominantly alcohol use (19.7%), predominantly cannabis use (4.5%), and polysubstance use (9.7%). Compared to the non-users, polysubstance users tended to be older, Non-Hispanic White, have experienced more types of trauma. They were also more likely to have fulfilled diagnostic criteria for suicidality and ADHD. Comparisons among the substance using classes were more nuanced. CONCLUSION The findings highlight the need for universal assessments of trauma, substance misuse, and mental health symptoms in youth as the presence or absence of their co-occurrence has implications for treatment.
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Affiliation(s)
| | - Cody G Dodd
- University of Texas Medical Branch, United States
| | - Leslie Taylor
- University of Texas Health Science Center, United States
| | | | | | | | | | - Robyn Richmond
- Texas Tech University Health Sciences Center, United States
| | - Nazan Aksan
- University of Texas at Austin, United States
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Rockhold MN, Kautz-Turnbull C, Handley ED, Petrenko CLM. The trauma experiences of children with fetal alcohol spectrum disorders: Developmental outcomes utilizing a threat/deprivation child adversity framework. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1722-1735. [PMID: 37423769 DOI: 10.1111/acer.15144] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Individuals with fetal alcohol spectrum disorders (FASD) experience heightened rates of childhood trauma and adversity. Research has examined the negative impact adverse childhood experiences have on developmental outcomes. This study aims to take the field a step further by examining the details of traumatic events, including duration, perpetrator, whether the event significantly impacted the child, and trauma subtype. Subtype is examined using threat/deprivation dimensions and their relation to child behavior and the caregiver-child relationship. METHODS A sample of 84 children aged 4-12 with FASD, all in out-of-home placements, and their families took part in an emotion coaching intervention study. At baseline, caregivers completed questionnaires assessing child trauma, child emotion regulation and behavior, caregiver emotion socialization, and caregiver-child relationships. We used analysis of covariance to examine the differing impacts of threat, deprivation, and a combination of the two on behavioral outcomes, while controlling for age. We also used Pearson's r correlations, controlling for age, to examine whether the duration of threat or deprivation exposure was related to child outcomes. RESULTS Descriptive statistics showed that 87.5% of individuals experienced three or more subtypes of trauma. The average duration of all subtypes was 1.62 years, with a mean onset of 3.94 years. Biological parents were the most common perpetrator. There were significantly worse behavioral and caregiver-child relationship outcomes for children experiencing a combination of threat and deprivation trauma. A r correlations, controlling for age, demonstrated longer duration of deprivation was associated with greater cognitive difficulties. CONCLUSIONS We found unique patterns of behavior in children with FASD when analyzing the impact of traumatic experiences through a threat/deprivation framework. The combination of both threat and deprivation experiences leads to worse outcomes overall. Additionally, vital details surrounding the traumatic experiences point to crucial areas for intervention, including caregiver-child relationships.
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Langevin R, Marshall C, Wallace A, Gagné ME, Kingsland E, Temcheff C. Disentangling the Associations Between Attention Deficit Hyperactivity Disorder and Child Sexual Abuse: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:369-389. [PMID: 34238078 PMCID: PMC10009485 DOI: 10.1177/15248380211030234] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND An association between child sexual abuse (CSA) and attention deficit hyperactivity disorder (ADHD) has been documented. However, the temporal relationship between these problems and the roles of trauma-related symptoms or other forms of maltreatment remain unclear. This review aims to synthesize available research on CSA and ADHD, assess the methodological quality of the available research, and recommend future areas of inquiry. METHODS Studies were searched in five databases including Medline and PsycINFO. Following a title and abstract screening, 151 full texts were reviewed and 28 were included. Inclusion criteria were sexual abuse occurred before 18 years old, published quantitative studies documenting at least a bivariate association between CSA and ADHD, and published in the past 5 years for dissertations/theses, in French or English. The methodological quality of studies was systematically assessed. RESULTS Most studies identified a significant association between CSA and ADHD; most studies conceptualized CSA as a precursor of ADHD, but only one study had a longitudinal design. The quality of the studies varied greatly with main limitations being the lack of (i) longitudinal designs, (ii) rigorous multimethod/ multiinformant assessments of CSA and ADHD, and (iii) control for two major confounders: trauma-related symptoms and other forms of child maltreatment. DISCUSSION Given the lack of longitudinal studies, the directionality of the association remains unclear. The confounding role of other maltreatment forms and trauma-related symptoms also remains mostly unaddressed. Rigorous studies are needed to untangle the association between CSA and ADHD.
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Affiliation(s)
- Rachel Langevin
- Department of Educational and Counselling Psychology, McGill
University, Montreal, Quebec, Canada
- Rachel Langevin, McGill University, 3700
McTavish Street, Education Building, Room 614, Montreal, Quebec, Canada H3A 1Y2.
| | - Carley Marshall
- Department of Educational and Counselling Psychology, McGill
University, Montreal, Quebec, Canada
| | - Aimée Wallace
- Département de sexologie, Université du Québec à Montréal, Quebec,
Canada
| | - Marie-Emma Gagné
- Department of Educational and Counselling Psychology, McGill
University, Montreal, Quebec, Canada
| | | | - Caroline Temcheff
- Department of Educational and Counselling Psychology, McGill
University, Montreal, Quebec, Canada
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Shahidullah JD, Custer J, Widales-Benitez O, Aksan N, Hatchell C, Newport DJ, Wagner KD, Storch EA, Claassen C, Garrett A, Ugalde IT, Weber W, Nemeroff CB, Rathouz PJ. Establishing a training plan and estimating inter-rater reliability across the multi-site Texas childhood trauma research network. Psychiatry Res 2023; 323:115168. [PMID: 36931015 DOI: 10.1016/j.psychres.2023.115168] [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: 01/07/2023] [Revised: 03/09/2023] [Accepted: 03/11/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVE Minimal guidance is available in the literature to develop protocols for training non-clinician raters to administer semi-structured psychiatric interviews in large, multi-site studies. Previous work has not produced standardized methods for maintaining rater quality control or estimating interrater reliability (IRR) in such studies. Our objective is to describe the multi-site Texas Childhood Trauma Research Network (TX-CTRN) rater training protocol and activities used to maintain rater calibration and evaluate protocol effectiveness. METHODS Rater training utilized synchronous and asynchronous didactic learning modules, and certification involved critique of videotaped mock scale administration. Certified raters attended monthly review meetings and completed ongoing scoring exercises for quality assurance purposes. Training protocol effectiveness was evaluated using individual measure and pooled estimated IRRs for three key study measures (TESI-C, CAPS-CA-5, MINI-KID [Major Depressive Episodes - MDE & Posttraumatic Stress Disorder - PTSD modules]). A random selection of video-recorded administrations of these measures was evaluated by three certified raters to estimate agreement statistics, with jackknife (on the videos) used for confidence interval estimation. Kappa, weighted kappa and intraclass correlations were calculated for study measure ratings. RESULTS IRR agreement across all measures was strong (TESI-C median kappa 0.79, lower 95% CB 0.66; CAPS-CA-5 median weighted kappa 0.71 (0.62), MINI-MDE median kappa 0.71 (0.62), MINI-PTSD median kappa 0.91 (0.9). The combined estimated ICC was ≥0.86 (lower CBs ≥0.69). CONCLUSIONS The protocol developed by TX-CTRN may serve as a model for other multi-site studies that require comprehensive non-clinician rater training, quality assurance guidelines, and a system for assessing and estimating IRR.
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Affiliation(s)
- Jeffrey D Shahidullah
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA.
| | - James Custer
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Oscar Widales-Benitez
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Nazan Aksan
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Carly Hatchell
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - D Jeffrey Newport
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA; Department of Women's Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Karen Dineen Wagner
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, Texas, USA
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | | | - Amy Garrett
- Department of Psychiatry, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Irma T Ugalde
- Department of Emergency Medicine, McGovern Medical School at UTHealth Houston, Houston, Texas, USA
| | - Wade Weber
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Paul J Rathouz
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
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Associations of neurodevelopmental risk factors with psychosis proneness: Findings from a non-clinical sample of young adults. Compr Psychiatry 2023; 123:152385. [PMID: 36931184 DOI: 10.1016/j.comppsych.2023.152385] [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: 11/22/2022] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 03/19/2023] Open
Abstract
Psychotic disorders often develop as the continuum of subclinical symptoms that include hallucination-like and delusion-like experiences, and are commonly referred to as psychotic-like experiences (PLEs). To date, a number of neurodevelopmental risk factors of psychosis have been detected, yet their mutual interplay remains unknown. Therefore, we aimed to investigate the additive association of childhood trauma history, reading disabilities and symptoms of attention-deficit/hyperactivity disorder (ADHD) with psychosis proneness. A total of 3000 young adults (58.3% females, aged 18-35 years) with a negative history of psychiatric treatment were recruited to the cross-sectional study through computer-assisted web interview. Self-reports were administered to measure childhood trauma history, ADHD symptoms and reading disabilities. Linear regression analyses revealed significant main associations of childhood trauma history and reading disabilities with higher levels of PLEs. There were no significant main associations of ADHD with the level of PLEs. However, the associations of all possible interactions between neurodevelopmental risk factors with the level of PLEs were significant. Our findings suggest that childhood trauma history and reading disabilities may additively increase a risk of psychosis. The present findings bring new implications for early intervention strategies in psychosis and posit the rationale of recording the accumulation of neurodevelopmental vulnerabilities in clinical practice.
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Kagan R, Pressley J, Espinoza R, Lanktree C, Henry J, Knoverek A, Duffy S, Labruna V, Habib M, Blaustein ME, Spinazzola J. Development of a Differential Assessment Guide to Improve Engagement with Youths & Families Living with Chronic Trauma. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:145-159. [PMID: 36776636 PMCID: PMC9908809 DOI: 10.1007/s40653-022-00479-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 06/18/2023]
Abstract
Youths and parents/caregivers who have experienced multiple forms of severe interpersonal trauma may demonstrate severe and persistent symptoms of complex trauma including high-risk behaviors. Engagement, and sustaining engagement, of these youths and parents/caregivers in evidence-supported trauma treatment is a critical challenge, especially when youths or parents/caregivers have experienced chronic traumas that may be expected to continue into the foreseeable future. An extensive literature review was conducted leading to development of an assessment framework that could increase engagement of youths and parents/caregivers in trauma treatment based on research on chronic trauma, complex trauma, Developmental Trauma Disorder (DTD), and factors that promote engagement. A multi-dimensional assessment guide was developed to enable clinicians to differentiate types of chronic trauma based on a continuum of past, current and expected exposure over time and then to use this guide collaboratively with youths and parents/caregivers to develop priorities for treatment and service planning that matches their needs and strengths. The assessment guide incorporates exposure to intra-familial and community forms of interpersonal trauma, attachment disruptions, established symptoms of PTSD, Complex PTSD and DTD, as well as social-emotional development. The assessment and treatment planning guides proposed in this article expand applicability of evidence-supported trauma-informed therapy to youths and families who have not been engaged by programs offering treatments that are focused on past or single incident traumas or do not address disrupted attachments, multi-generational experiences of adversity, discrimination and community violence, life-threatening dangers or the impact of chronic trauma on youth, parent/caregiver and family development.
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Affiliation(s)
- Richard Kagan
- Training Programs on Traumatic Stress, Family Treatment Center Foundation, The Institute for Adolescent Trauma Treatment and Training at Adelphi University, Garden City, USA
| | - Jana Pressley
- The Foundation Trust, Richmont Graduate University, Chattanooga, USA
| | - Rosa Espinoza
- The Foundation Trust, Children’s Hospital Los Angeles/USC UCEDD, Los Angeles, USA
| | - Cheryl Lanktree
- Department of Psychiatry & Behavioral Sciences, Keck Medical School, University of Southern California Adolescent Trauma Training Center, University of Southern California, Los Angeles, USA
| | - Jim Henry
- School of Social Work and Children’s Trauma Assessment Center, Western Michigan University, Kalamazoo, USA
| | - Angel Knoverek
- School of Counselor Education, Culver-Stockton College, Adams State University, Alamosa, USA
| | | | - Victor Labruna
- The Institute for Adolescent Trauma Treatment and Training at Adelphi University, Garden City, USA
| | - Mandy Habib
- The Institute for Adolescent Trauma Treatment and Training at Adelphi University, Garden City, USA
| | | | - Joseph Spinazzola
- The Foundation Trust, Richmont Graduate University, Chattanooga, USA
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Guidetti C, Brogna P, Chieffo DPR, Turrini I, Arcangeli V, Rausa A, Bianchetti M, Rolleri E, Santomassimo C, Di Cesare G, Ducci G, Romeo DM, Brogna C. Eye Movement Desensitization and Reprocessing (EMDR) as a Possible Evidence-Based Rehabilitation Treatment Option for a Patient with ADHD and History of Adverse Childhood Experiences: A Case Report Study. J Pers Med 2023; 13:jpm13020200. [PMID: 36836434 PMCID: PMC9961224 DOI: 10.3390/jpm13020200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Children with Attention Deficit Hyperactivity Disorder (ADHD) having a history of adverse childhood experiences (ACEs) could be very difficult to treat with standard psychotherapeutic approaches. Some children diagnosed with ADHD may have Post-Traumatic Stress Disorder (PTSD) or have had experienced a significant traumatic event. Trauma and PTSD could exacerbate ADHD core symptoms and be a risk factor of poor outcome response. OBJECTIVE to report for the first time the history of a patient with ADHD and ACE successfully treated with an EMDR approach. CONCLUSION EMDR could be a promising treatment for ADHD children with a history of traumatic experiences in addition to pharmacological treatments.
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Affiliation(s)
- Clotilde Guidetti
- Pediatric Neurology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Patrizia Brogna
- Complex Operative Unit Prevention and Early Interventions (PIPSM), Department of Mental Health ASL ROMA 1, 00193 Rome, Italy
| | - Daniela Pia Rosaria Chieffo
- Clinical Psychology Unit, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, 00168 Rome, Italy
- Department Women Children and Public Health, Catholic University of Sacred Heart, 00168 Rome, Italy
| | - Ida Turrini
- Pediatric Neurology Unit, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, 00168 Rome, Italy
| | - Valentina Arcangeli
- Clinical Psychology Unit, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, 00168 Rome, Italy
| | - Azzurra Rausa
- Pediatric Neurology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | | | - Elisa Rolleri
- Pediatric Neurology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Chiara Santomassimo
- Complex Operative Unit Prevention and Early Interventions (PIPSM), Department of Mental Health ASL ROMA 1, 00193 Rome, Italy
| | - Gianluigi Di Cesare
- Complex Operative Unit Prevention and Early Interventions (PIPSM), Department of Mental Health ASL ROMA 1, 00193 Rome, Italy
| | - Giuseppe Ducci
- Complex Operative Unit Prevention and Early Interventions (PIPSM), Department of Mental Health ASL ROMA 1, 00193 Rome, Italy
| | - Domenico M. Romeo
- Pediatric Neurology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Pediatric Neurology Unit, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, 00168 Rome, Italy
| | - Claudia Brogna
- Pediatric Neurology Unit, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, 00168 Rome, Italy
- Correspondence: or ; Tel.: +39-06-30155340; Fax: +39-06-30154363
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Gómez-Cano S, Zapata-Ospina JP, Arcos-Burgos M, Palacio-Ortiz JD. The role of psychosocial adversity in the aetiology and course of attention deficit hyperactivity disorder. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2023; 52:65-72. [PMID: 37085236 DOI: 10.1016/j.rcpeng.2021.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/05/2021] [Indexed: 04/23/2023]
Abstract
INTRODUCTION Attention deficit/hyperactivity disorder (ADHD) has genetic and environmental aetiological factors. There are few publications on the environmental factors. The objective of this review is to present the role of psychosocial adversity in the aetiology and course of ADHD. METHODS A search was carried out in the following databases: PubMed, ScienceDirect, SciELO, ClinicalKey, EMBASE, Lilacs, OVID, APA and PsycNET. English and Spanish were selected without being limited by type of study or year of publication. Finally, a qualitative synthesis was conducted. RESULTS ADHD development could be related to exposure to adverse factors in the family, school or social environment. It has been proposed as an explanatory mechanism that adversity interacts with genetic variants and leads to neurobiological changes. There may also be a gene-environment correlation whereby individual hereditary characteristics increase the risk of exposure to adversity, and indirectly increase the probability of developing ADHD. Research on psychosocial adversity represents a big challenge, not only due to the complexity of its construct, but also to the effect of subjective perception of a given event. CONCLUSIONS ADHD aetiology is complex and involves the interaction of both genetic and environmental factors, in which these factors correlate and cause the disorder. The study of the role of psychosocial adversity in ADHD is fundamental, but it remains a task that entails great difficulties.
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Affiliation(s)
- Sujey Gómez-Cano
- Hospital San Vicente de Paúl, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan Pablo Zapata-Ospina
- Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Mauricio Arcos-Burgos
- Hospital San Vicente de Paúl, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan David Palacio-Ortiz
- Hospital San Vicente de Paúl, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
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16
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Elklit A, Murphy S, Skovgaard C, Lausten M. Sexual Violence against Children with Disabilities: A Danish National Birth Cohort Prospective Study. Scand J Child Adolesc Psychiatr Psychol 2023; 11:143-149. [PMID: 38107837 PMCID: PMC10724881 DOI: 10.2478/sjcapp-2023-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
Background Children with disabilities are at heightened risk of sexual violence compared to non-disabled peers. Objective We aimed to examine the associations between ten childhood disabilities and sexual victimization. Methods Data were drawn from the Danish Psychiatric Case Register, the Criminal Register, and other population-based registers. Children born between 1994 and 2001 (n=570,351) were followed until 18 years of age. Using logistic regression, the association between the disabilities and risk of sexual victimisation was estimated. Results We identified 8,860 cases of sexual victimization towards children and adolescents. In the fully adjusted models, children with a diagnosis of ADHD, speech disability and intellectual disability were at highest risk of sexual victimization. Children with comorbid disabilities were particularly vulnerable to sexual victimization. Conclusions We found that children with certain types of disability have a higher risk of sexual victimization. Our findings indicate that educational institutions and health care professionals should be aware of and have specialized training in, recognizing and assessing sexual victimization among children with disabilities.
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Affiliation(s)
- Ask Elklit
- National Danish Center for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Siobhan Murphy
- Department of Psychology, Queen’s University Belfast, Belfast, UK
| | - Christian Skovgaard
- Danish Center for Health Economics, University of Southern Denmark, Odense, Denmark
| | - Mette Lausten
- National Danish Centre for Research in Social Welfare, Danish National Institute of Social Research, Copenhagen, Denmark
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Duprey EB, Handley ED, Russotti J, Manly JT, Cicchetti D. A Longitudinal Examination of Child Maltreatment Dimensions, Emotion Regulation, and Comorbid Psychopathology. Res Child Adolesc Psychopathol 2023; 51:71-85. [PMID: 35278164 PMCID: PMC9464798 DOI: 10.1007/s10802-022-00913-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 12/24/2022]
Abstract
Childhood maltreatment is a toxic stressor that occurs in the family context and is related to adverse outcomes including elevations in internalizing symptomology and externalizing symptomology. In the present study, we tested the role of threat and deprivation dimensions of child maltreatment in the etiology of comorbid psychopathology in emerging adulthood. Additionally, we investigated emotion regulation and emotion lability/negativity as mechanisms underlying the relationship between child maltreatment dimensions and emerging adult psychopathology. To address these aims, we used a longitudinal sample of emerging adults (N = 413, Mage = 19.67, 78.0% Black, 51.1% female) who had previously participated in research assessments at age 10-12. Using a person-centered approach with latent profile analysis, we identified three classes of emerging adulthood psychopathology characterized by different levels of symptom severity and comorbidity between internalizing and externalizing symptoms. Emerging adults who experienced deprivation only, compared to those who were not maltreated, were more likely to belong to a comorbid and severe psychopathology class versus the other identified psychopathology classes. There was also a significant indirect pathway from experiences of both threat and deprivation to a high externalizing class via emotion lability/negativity. Our results contribute to current models of childhood adversity and psychopathology and have implications for interventions to prevent psychopathology among emerging adults exposed to child maltreatment.
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Affiliation(s)
- Erinn B Duprey
- Children's Institute, University of Rochester, Rochester, NY, USA.
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA.
| | | | - Justin Russotti
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Jody Todd Manly
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Dante Cicchetti
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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18
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Caceres BA, Huang Y, Barcelona V, Wang Z, Newhall KP, Cerdeña JP, Crusto CA, Sun YV, Taylor JY. The Interaction of Trauma Exposure and DNA Methylation on Blood Pressure Among Black Women in the InterGEN Study. Epigenet Insights 2022; 15:25168657221138510. [PMID: 36466626 PMCID: PMC9716582 DOI: 10.1177/25168657221138510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/21/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Despite evidence that trauma exposure is linked to higher risk of hypertension, epigenetic mechanisms (such as DNA methylation) by which trauma potentially influences hypertension risk among Black adults remain understudied. Methods Data from a longitudinal study of Black mothers were used to test the hypothesis that direct childhood trauma (ie, personal exposure) and vicarious trauma (ie, childhood trauma experienced by their children) would interact with DNA methylation to increase blood pressure (BP). Separate linear mixed effects models were fitted at each CpG site with the DNA methylation beta-value and direct and vicarious trauma as predictors and systolic and diastolic BP modeled as dependent variables adjusted for age, cigarette smoking, and body mass index. Interaction terms between DNA methylation beta-values with direct and vicarious trauma were added. Results The sample included 244 Black mothers with a mean age of 31.2 years (SD = ±5.8). Approximately 45% of participants reported at least one form of direct childhood trauma and 49% reported at least one form of vicarious trauma. Epigenome-wide interaction analyses found that no CpG sites passed the epigenome-wide significance level indicating the interaction between direct or vicarious trauma with DNAm did not influence systolic or diastolic BP. Conclusions This is one of the first studies to simultaneously examine whether direct or vicarious exposure to trauma interact with DNAm to influence BP. Although findings were null, this study highlights directions for future research that investigates epigenetic mechanisms that may link trauma exposure with hypertension risk in Black women.
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Affiliation(s)
| | | | | | - Zeyuan Wang
- Rollins School of Public Health, Department of Epidemiology and Biomedical Informatics, Emory University, Atlanta, GA, USA
| | - Kevin P Newhall
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Cindy A Crusto
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Yan V Sun
- Rollins School of Public Health, Department of Epidemiology and Biomedical Informatics, Emory University, Atlanta, GA, USA
| | - Jacquelyn Y Taylor
- Columbia University School of Nursing, New York, NY, USA,Jacquelyn Y Taylor, Columbia University School of Nursing, 560 West 168th Street, New York, NY 10032, USA.
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19
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Kandeğer A, Boysan M, Karaoğlan G, Tekdemir R, Şen B, Tan Ö, Sağlıyan B, Selvi Y. Heterogeneity of associations between dissociation and attention deficit symptoms. CURRENT PSYCHOLOGY 2022; 42:1-14. [PMID: 36406851 PMCID: PMC9647769 DOI: 10.1007/s12144-022-03836-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 08/09/2022] [Accepted: 09/29/2022] [Indexed: 11/11/2022]
Abstract
Childhood trauma and dissociative experiences are suggested to be predisposing transdiagnostic factors for attention deficit /hyperactivity disorder (ADHD) as well as many psychiatric disorders. Trauma-related symptoms such as motor restlessness, emotional instability, and concentration problems can mimic, trigger, or exacerbate ADHD symptoms. Moreover, given the relationship between ADHD and trauma-induced distress, it has been suggested that dissociative experiences and attention problems may reveal overlapping characteristics. The aim of this study was to investigate the associations between dissociative experiences and attention deficits by carrying out mixture analysis. A thousand and thirty-seven participants volunteered to the online investigation. Participants completed a test battery that included a sociodemographic form as well as the Adult ADHD Severity Rating Scale (ASRS), Wender Utah Rating Scale (WURS), Childhood Trauma Questionnaire (CTQ), Dissociative Experiences Scale (DES), and Somatoform Dissociation Questionnaire (SDQ). Item responses on the DES and attention deficit symptoms as indexed by the ASRS were subjected to latent class analysis. The three-latent-class model outperformed alternative mixture models. Mixture analysis classified the sample into three homogenous subgroups as follows: (1) No/low dissociation or attention problems; (2) Moderate dissociation with attention problems; and (3) High dissociation with attention problems. High dissociators with attention problems were characterized by heightened scores on somatoform dissociation and emotional neglect. No/low dissociation or attention problems latent class reported significantly lower scores on hyperactivity/impulsivity, depression, attention deficit in childhood, and sexual abuse than both moderate and high dissociation latent classes. High dissociators and moderate dissociators significantly differed on conduct problems and physical abuse. We concluded that impulsive hyperactivity, depression, and childhood sexual abuse were common features in heightened dissociation latent classes, as well as attention deficit.
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Affiliation(s)
- Ali Kandeğer
- Department of Psychiatry, Faculty of Medicine, Selçuk University, Konya, Turkey
| | - Murat Boysan
- Department of Psychology, Faculty of Social Sciences and Humanities, Ankara Social Sciences University, Ankara, Turkey
| | - Gizem Karaoğlan
- Department of Psychiatry, Faculty of Medicine, Selçuk University, Konya, Turkey
| | - Rukiye Tekdemir
- Department of Psychiatry, Atatürk Chest Diseases and Thoracic Surgery, Training and Research Hospital, Ankara, Turkey
| | - Barış Şen
- Department of Psychiatry, Biga State Hospital, Çanakkale, Turkey
| | - Özge Tan
- Department of Psychiatry, Faculty of Medicine, Selçuk University, Konya, Turkey
| | - Bilal Sağlıyan
- Department of Psychiatry, Faculty of Medicine, Selçuk University, Konya, Turkey
| | - Yavuz Selvi
- Department of Psychiatry, Faculty of Medicine, Selçuk University, Konya, Turkey
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20
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Correia-Santos P, Sousa B, Martinho G, Morgado D, Ford JD, Pinto RJ, Maia ÂC. The psychometric properties of the adolescent dissociative experiences scale (A-DES) in a sample of Portuguese at-risk adolescents. J Trauma Dissociation 2022; 23:539-558. [PMID: 35416129 DOI: 10.1080/15299732.2022.2064577] [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] [Indexed: 10/18/2022]
Abstract
Dissociation is a process that often occurs as a sequela of psychological trauma, and it is interrelated with psychological and behavioral problems. In the at-risk adolescent population, dissociation is often underdiagnosed and undertreated. Having reliable measures to assess this phenomenon can help in identifying adolescents at-risk and improve treatment outcomes. This study assessed the psychometric properties of the Adolescent Dissociative Experiences Scale (A-DES) with a sample of 402 Portuguese adolescents recruited from three at-risk populations. Participants completed self-report measures of trauma exposure, posttraumatic symptoms, psychological and behavioral problems, and the A-DES. A subset of the sample also completed test-retest measures. Confirmatory factor analyses revealed a best-fitting 3-factor model. Analyses revealed good internal consistencies and good agreement test-retest reliability for the scale overall and the factor-based sub-scales. Construct and predictive validity was supported with results showing that A-DES discriminates between youth reporting high versus low levels of cumulative trauma exposure and youth who meet or do not meet criteria for a probable PTSD diagnosis. Study findings replicate prior research supporting a 3-factor model of dissociation and the usefulness of A-DES to identify adolescents with dissociative symptoms. Clinical and research implications are discussed.
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Affiliation(s)
| | | | | | | | - Julian D Ford
- School of Psychology, University of Connecticut Health Center, Connecticut, Farmington Ave, USA
| | - Ricardo J Pinto
- Faculty of Psychology, HEI-Lab, University Lusófona of Porto, Porto, Portugal
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Zhang X, Gatzke-Kopp LM. Exposure to Parental Aggression and the Development of Psychopathology in Young Children: The Mediating Role of Early Dissociative Symptoms. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP6988-NP7013. [PMID: 33096968 DOI: 10.1177/0886260520967746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Exposure to child-directed parental aggression in early life has been found to increase the risk of later psychopathological symptoms among children and adolescents. However, little is known about intermediate phenotypes and the developmental progression of symptoms, especially across the transition to grade school. Using prospectively collected longitudinal data from a large sample of children enrolled in the Family Life Project (n = 1,166, 49.7% female), the current study examined the mediating role of early dissociative symptoms in the relations between parental aggression and children's psychopathological symptoms. Children's exposure to parental aggression and their dissociative symptoms before school entry were assessed based on primary caregivers' reports. Teacher ratings of children's internalizing and externalizing symptoms were collected in pre-kindergarten as well as in the 1st, 3rd, and 5th grades. Results showed that dissociative symptoms before school entry partially mediated the association between parental aggression and persistent externalizing symptoms in school years. However, no significant associations were found between parental aggression or dissociative symptoms and internalizing symptoms. Findings suggest that dissociative symptoms manifested early in life serve as a mediating mechanism and indicator of risk for persistent impulsivity and behavioral problems. Thus, these symptoms could be an important target of preventive services provided to children with adverse experiences in their families.
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Affiliation(s)
- Xutong Zhang
- The Pennsylvania State University, University Park, PA, USA
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22
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Keeshin BR, Monson E. Assessing and Responding to the Trauma of Child Maltreatment. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:176-183. [PMID: 37153127 PMCID: PMC10153498 DOI: 10.1176/appi.focus.20210033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Child maltreatment is a significant risk factor for severe psychiatric outcomes in childhood and contributes to problematic symptoms that direct parents, teachers, or other invested parties to seek psychiatric intervention. With ongoing workforce shortages, much of the pediatric psychiatric care to this population is delivered by generalists. Child maltreatment and trauma can critically alter a child's development trajectory, affecting potential success in school and other important life pursuits. In addition, child maltreatment and resultant traumatic stress can dramatically disrupt child and adolescent development of healthy emotional regulation, distress tolerance, and the ability to form effective interpersonal relationships. Such disruption can lead to presentations within children and adolescents that mimic other symptoms of psychopathology but that typically respond poorly to traditional psychopharmacology. Ineffective treatment trials can lead to increased risk of polypharmacy and inaccurate expectations for treatment benefits. Such treatment efforts may impede addressing important environmental contributors and delay indicated therapeutic strategies. This article seeks to review child maltreatment-including core features and prevalence, overlap of child maltreatment with adverse childhood experiences, developmental impacts of exposure and resultant traumatic stress, guidance for appropriate assessment, and evidence-based interventions-and provide basic deprescribing guidelines to reduce polypharmacy burden.
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Affiliation(s)
- Brooks R Keeshin
- Department of Pediatrics (Keeshin) and Department of Psychiatry (Monson), Huntsman Mental Health Institute, University of Utah, Salt Lake City
| | - Eric Monson
- Department of Pediatrics (Keeshin) and Department of Psychiatry (Monson), Huntsman Mental Health Institute, University of Utah, Salt Lake City
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23
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Ford JD, Charak R, Karatzias T, Shevlin M, Spinazzola J. Can developmental trauma disorder be distinguished from posttraumatic stress disorder? A symptom-level person-centred empirical approach. Eur J Psychotraumatol 2022; 13:2133488. [PMID: 36340008 PMCID: PMC9635476 DOI: 10.1080/20008066.2022.2133488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Developmental Trauma Disorder (DTD) is a proposed childhood psychiatric diagnosis for psychopathological and developmental sequela of victimization and attachment trauma extending beyond posttraumatic stress disorder (PTSD). OBJECTIVE To determine whether a sub-group of trauma-impacted children is characterized by symptoms of DTD that extend beyond, or co-occur with, the symptoms of PTSD. METHOD Person-centred Latent Class Analyses (LCA) were done with data from 507 children (ages 7-18 years, (M = 12.11, SD = 2/92); 49% female) referred to the study by mental health or paediatric clinicians. RESULTS A four class solution was optimal (LMR = 398.264, p < .001; Entropy = .93): (1) combined DTD + PTSD (n = 150); (2) predominant DTD (n = 156); (3) predominant PTSD (n = 54); (4) minimal symptoms (n = 147). Consistent with prior research, the DTD + PTSD class was most likely to have experienced traumatic emotional abuse and neglect (X2 (3) = 16.916 and 28.016, respectively, p < .001), and had the most psychiatric comorbidity (F(3, 502) = 3.204, p < .05). Predominant DTD class members were most likely to meet criteria for Oppositional Defiant Disorder (ODD) (X2(3) = 84.66, p < .001). CONCLUSION Symptoms of DTD may occur with, or separately from, PTSD symptoms. Children with high DTD|+PTSD symptoms had extensive psychiatric comorbidity, while those with high DTD symptoms and minimal PTSD symptoms were highly likely to meet criteria for ODD. In clinical and research assessment and treatment of children with complex psychiatric comorbidity or disruptive behaviour problems, symptoms of DTD should be considered, both along with, and in the absence of, PTSD symptoms.
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Affiliation(s)
- Julian D Ford
- Department of Psychiatry, University of Connecticut Health Center MC1410, Farmington, CT, USA
| | - Ruby Charak
- University of Texas Rio Grande Valley, Edinburg, TX, USA
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Frost A, Bosquet Enlow M, Malin AJ, Bernard K, Wright RJ. Early Adverse Experiences and Repeated Wheezing From 6 to 30 Months of Age: Investigating the Roles of Hypothalamic-Pituitary-Adrenal Axis Functioning, Child Sex, and Caregiving Sensitivity. Child Dev 2021; 92:e1260-e1274. [PMID: 34128224 PMCID: PMC8599610 DOI: 10.1111/cdev.13606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study examined associations among early adversity, diurnal cortisol, child sex, and caregiver sensitivity at age 6 months in relation to wheezing in children (47% male) followed to 30 months. Analyses included 676 mother-child dyads, 393 of whom completed an observational caregiver sensitivity measure. Participants were primarily ethnic minorities (42.7% Black, 25.4% Hispanic); 22.1% of children had ≥ 1 wheezing episode. Higher adversity was associated with increased wheeze frequency and blunted diurnal cortisol slope. The indirect effect of adversity on wheezing through cortisol slope was significant for females, but not males. Higher caregiver sensitivity was protective against wheezing for males, but not females, with high cortisol. Findings suggest complex associations among adversity, cortisol, child sex, and caregiver sensitivity in predicting wheezing.
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Affiliation(s)
- Allison Frost
- Carolina Population Center, University of North Carolina, Chapel Hill, NC
| | - Michelle Bosquet Enlow
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, MA
| | - Ashley J. Malin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Rosalind J. Wright
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, MA
- Institute for Exposomic Research, New York, NY
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Feasibility of Using Child Maltreatment Measurement Instruments in the Primary Care Setting: A Systematic Review. J Pediatr Nurs 2021; 61:e1-e14. [PMID: 33926746 DOI: 10.1016/j.pedn.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 03/16/2021] [Accepted: 04/01/2021] [Indexed: 01/10/2023]
Abstract
PROBLEM Child maltreatment is a devastating epidemic affecting millions of children and adolescents in the United States (U.S.) every year. Primary care providers (PCPs) encounter these victims but need resources to aid in the recognition of maltreatment. The purpose of this review is to evaluate child maltreatment measurement instruments and determine feasibility of use by U.S. PCPs. ELIGIBILITY CRITERIA A systematic search was conducted in the PubMed, CINAHL, and PsycInfo databases from 2014 until 2020. Eligibility criteria included articles conducted in the U.S., with use of a child maltreatment measurement instrument, and subjects less than 18 years old. Eligible articles were reference searched to find the original studies for each instrument and were included if they were published in a peer-reviewed paper, could be located, and addressed the development or validation of the instrument. SAMPLE Of the 3816 articles, 111 used a child maltreatment measurement instrument. Sixteen of the 27 identified instruments were evaluated for feasibility using a quality rating with criteria including psychometrics, construct measurement, administration, availability, and cost. RESULTS Six instruments were recommended for use by PCPs. CONCLUSIONS This is the first review evaluating the use of child maltreatment measurement instruments by PCPs and it highlights the combination of psychometric evaluation and other pertinent feasibility criteria to recommend several instruments for use by PCPs. IMPLICATIONS Use of these instruments by PCPs may serve to identify children and families who are at risk for or suffering from maltreatment.
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[Inpatient Psychodynamic Therapy for Children and Adolescents with Complex ADHD: Results of a Naturalistic Clinical Trial]. Prax Kinderpsychol Kinderpsychiatr 2021; 70:520-540. [PMID: 34519618 DOI: 10.13109/prkk.2021.70.6.520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The Attention deficit/hyperactivity disorder (ADHD) is a common mental disorder in childhood and adolescence. However, it is a very heterogeneous disorder with subgroups of patients with mild symptoms and others with severe and complex impairments. Patients suffering from complex ADHD are usually characterized by multiple developmental disorders and impaired personality development. Due to the multimodal origin of the disorder, multimodal treatment approaches aimed at reducing the various deficits are usually indicated. The current study evaluated a multimodal inpatient psychodynamic treatment (PDT) for children and adolescents suffering from ADHD. 47 patients (age 9-17 years) were included in the study. Next to complex impairments (comorbid mental disorders, deficits regarding psychic structure, learning disorders and sensorimotor integration disorders), a high number of adverse childhood experiences (M = 11.71) was particularly remarkable in the sample. The PDT led to significant improvements regarding ADHD symptoms and general level of functioning. However, first symptom improvements were already evident at the end of the waiting period. For ten patients who participated in the follow-up assessment effects remained stable six months after treatment. Due to the high drop-out rate, however, the study results have to be regarded as preliminary.
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Fuller-Thomson E, Lewis DA, Agbeyaka S. Attention-Deficit/Hyperactivity Disorder and Alcohol and Other Substance Use Disorders in Young Adulthood: Findings from a Canadian Nationally Representative Survey. Alcohol Alcohol 2021; 57:385-395. [PMID: 34343246 DOI: 10.1093/alcalc/agab048] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 06/21/2021] [Accepted: 06/26/2021] [Indexed: 12/31/2022] Open
Abstract
AIM (a) To document the prevalence and odds of (i) alcohol use disorders, (ii) cannabis use disorders, (iii) other drug use disorders and (iv) any substance use disorder (SUD), among young adults with and without ADHD, and (b) to investigate the degree to which the association between ADHD and SUDs is attenuated by socio-demographics, early adversities and mental health. METHOD Secondary analysis of the nationally representative Canadian Community Health Survey-Mental Health (CCHS-MH). The sample included 6872 respondents aged 20-39, of whom 270 had ADHD. The survey response rate was 68.9%. MEASUREMENTS Substance Use Disorder: World Health Organization's Composite International Diagnostic Interview criteria, SUDs, were derived from lifetime algorithms for alcohol, cannabis and other substance abuse or dependence. ADHD was based on self-report of a health professional's diagnosis. FINDINGS One in three young adults with ADHD had a lifetime alcohol use disorder (36%) compared to 19% of those without ADHD (P < 0.001). After adjusting for all control variables, those with ADHD had higher odds of developing alcohol use disorders (OR = 1.38, 95% CI: 1.05, 1.81), cannabis use disorders (OR = 1.46, 95% CI: 1.06, 2.00), other drug use disorders (OR = 2.07, 95% CI: 1.46, 2.95) and any SUD (OR = 1.69, 95% CI: 1.28, 2.23). History of depression and anxiety led to the largest attenuation of the ADHD-SUD relationship, followed by childhood adversities and socioeconomic status. CONCLUSIONS Young adults with ADHD have a high prevalence of alcohol and other SUDs. Targeted outreach and interventions for this extremely vulnerable population are warranted.
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Affiliation(s)
- Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, Canada.,Department of Family and Community Medicine, 500 University Avenue, 5th Floor University of Toronto, Toronto, Canada.,Institute for Life Course & Aging, University of Toronto, 246 Bloor St. W., Toronto, Canada
| | - Danielle A Lewis
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, Canada
| | - Senyo Agbeyaka
- Toronto General Hospital, 200 Elizabeth St, University Health Network, Toronto, ON, Canada
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Wymbs BT, Canu WH, Sacchetti GM, Ranson LM. Adult ADHD and romantic relationships: What we know and what we can do to help. JOURNAL OF MARITAL AND FAMILY THERAPY 2021; 47:664-681. [PMID: 33421168 DOI: 10.1111/jmft.12475] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/15/2020] [Accepted: 11/22/2020] [Indexed: 05/27/2023]
Abstract
It has been widely maintained that enduring and healthy romantic relationships are critical to quality of life in adulthood, and can buffer the impact of adversity, including psychological disorder. Unfortunately, much research points toward adults with attention-deficit hyperactivity disorder (ADHD) having short-lived and discordant romantic relationships. Despite this ample evidence, relatively little research has focused on identifying specific factors that may strengthen or explain their relational difficulties, which would have obvious relationship distress prevention and intervention implications. The current study reviews the state of the literature on romantic relationships in adults with ADHD, including differences that have been established between ADHD and non-ADHD populations as well as distal and proximal factors that appear to increase risk of relationship distress of adults with ADHD. Finally, notable gaps in the literature are identified and implications are raised with regards to prevention and intervention efforts designed to address functional impairment in adults with ADHD.
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Affiliation(s)
- Brian T Wymbs
- Department of Psychology, Ohio University, Athens, OH, USA
| | - Will H Canu
- Department of Psychology, Appalachian State University, Boone, NC, USA
| | | | - Loren M Ranson
- Department of Psychology, Appalachian State University, Boone, NC, USA
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Gómez-Cano S, Zapata-Ospina JP, Arcos-Burgos M, Palacio-Ortiz JD. The role of psychosocial adversity in the aetiology and course of attention deficit hyperactivity disorder. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 52:S0034-7450(21)00048-2. [PMID: 33849717 DOI: 10.1016/j.rcp.2021.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/05/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Attention deficit/hyperactivity disorder (ADHD) has genetic and environmental aetiological factors. There are few publications on the environmental factors. The objective of this review is to present the role of psychosocial adversity in the aetiology and course of ADHD. METHODS A search was carried out in the following databases: PubMed, ScienceDirect, SciELO, ClinicalKey, EMBASE, Lilacs, OVID, APA and PsycNET. English and Spanish were selected without being limited by type of study or year of publication. Finally, a qualitative synthesis was conducted. RESULTS ADHD development could be related to exposure to adverse factors in the family, school or social environment. It has been proposed as an explanatory mechanism that adversity interacts with genetic variants and leads to neurobiological changes. There may also be a gene-environment correlation whereby individual hereditary characteristics increase the risk of exposure to adversity, and indirectly increase the probability of developing ADHD. Research on psychosocial adversity represents a big challenge, not only due to the complexity of its construct, but also to the effect of subjective perception of a given event. CONCLUSIONS ADHD aetiology is complex and involves the interaction of both genetic and environmental factors, in which these factors correlate and cause the disorder. The study of the role of psychosocial adversity in ADHD is fundamental, but it remains a task that entails great difficulties.
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Affiliation(s)
- Sujey Gómez-Cano
- Hospital San Vicente de Paúl, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan Pablo Zapata-Ospina
- Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Mauricio Arcos-Burgos
- Hospital San Vicente de Paúl, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan David Palacio-Ortiz
- Hospital San Vicente de Paúl, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
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Aguado-Gracia J, Mundo-Cid P, Lopez-Seco F, Acosta-García S, Cortes-Ruiz MJ, Vilella E, Masana-Marín A. Lifetime Victimization in Children and Adolescents With ADHD. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP3241-NP3262. [PMID: 29683076 DOI: 10.1177/0886260518771680] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The objective of this study is to describe the frequency and type of victimization in a Spanish child and adolescent clinical ADHD sample and to analyze the association between the types of victimization and the severity of the symptoms. The sample is composed of 106 outpatients in treatment for ADHD, according to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria. Symptom severity was measured by the Conners-3 scales. ADHD and comorbid diagnostics were evaluated with the Mini-Kid interview. The victimization experiences were studied using the Juvenile Victimization Questionnaire (JVQ). Children with child maltreatment history showed a greater intensity of hyperactivity/impulsivity, aggression and behavioral disorders as well as depression and anxiety disorders. The presence of peer victimization was associated with inattention, learning disorders, executive functioning, and relationship problems. Episodes of victimization should be considered in the treatment of the ADHD. Child maltreatment history is more associated with hyperactivity-impulsivity symptoms, while peer victimization is more associated with attentional symptoms.
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Affiliation(s)
| | - Pilar Mundo-Cid
- Hospital Psiquiàtric Universitari Institut Pere Mata, Tarragona, Spain
| | - Fernando Lopez-Seco
- Hospital Psiquiàtric Universitari Institut Pere Mata, Tarragona, Spain
- Universitat Rovira i Virgili, Tarragona, Spain
| | | | - María José Cortes-Ruiz
- Hospital Psiquiàtric Universitari Institut Pere Mata, Tarragona, Spain
- Universitat Rovira i Virgili, Tarragona, Spain
| | - Elisabet Vilella
- Hospital Psiquiàtric Universitari Institut Pere Mata, Tarragona, Spain
- Universitat Rovira i Virgili, Tarragona, Spain
| | - Adela Masana-Marín
- Hospital Psiquiàtric Universitari Institut Pere Mata, Tarragona, Spain
- Universitat Rovira i Virgili, Tarragona, Spain
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Ford JD, Spinazzola J, van der Kolk B. Psychiatric comorbidity of developmental trauma disorder and posttraumatic Stress disorder: findings from the DTD field trial replication (DTDFT-R). Eur J Psychotraumatol 2021; 12:1929028. [PMID: 34249242 PMCID: PMC8245086 DOI: 10.1080/20008198.2021.1929028] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
Background: Developmental Trauma Disorder (DTD) has extensive comorbidity with internalizing and externalizing disorders distinct from posttraumatic stress disorder (PTSD). Objective: To replicate findings of DTD comorbidity and to determine whether this comorbidity is distinct from, and extends beyond, comorbidities of PTSD. Method: DTD was assessed by structured interview, and probable DSM-IV psychiatric disorders were identified with KSADS-PL screening modules, in a multi-site sample of 271 children (ages 8-18 years old; 47% female) in outpatient or residential mental health treatment for multiple (M = 3.5 [SD = 2.4]) psychiatric diagnoses other than PTSD or DTD. Results: DTD (N = 74, 27%) and PTSD (N = 107, 39%) were highly comorbid and shared several DSM-IV internalizing and externalizing disorder comorbidities. Children with DTD with or without PTSD had more comorbid diagnoses (M = 5.7 and 5.2 [SD = 2.4 and 1.7], respectively) than children with PTSD but not DTD (M = 3.8[SD = 2.1]) or neither PTSD nor DTD (M = 2.1[SD = 1.9]), F[3,267] = 55.49, p < .001. Further, on a multivariate basis controlling for demographics and including all potential comorbid disorders, DTD was associated with separation anxiety disorder, depression, and oppositional defiant disorder after controlling for PTSD, while PTSD was associated only with separation anxiety disorder after controlling for DTD. Both DTD and PTSD were associated with suicidality. Conclusions: DTD is associated with psychiatric comorbidity beyond that of PTSD, and DTD warrants assessment for treatment planning with children in intensive psychiatric services.
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Affiliation(s)
- Julian D Ford
- University of Connecticut School of Medicine, Farmington, CT, USA
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Ormiston HE, Nygaard MA, Heck OC. The Role of School Psychologists in the Implementation of Trauma-Informed Multi-Tiered Systems of Support in Schools. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2020. [DOI: 10.1080/15377903.2020.1848955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Heather E. Ormiston
- Department of Counseling and Educational Psychology, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Malena A. Nygaard
- Department of Counseling and Educational Psychology, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Olivia C. Heck
- Department of Counseling and Educational Psychology, Indiana University Bloomington, Bloomington, Indiana, USA
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Mii AE, McCoy K, Coffey HM, Meidlinger K, Sonnen E, Huit TZ, Flood MF, Hansen DJ. Attention Problems and Comorbid Symptoms following Child Sexual Abuse. JOURNAL OF CHILD SEXUAL ABUSE 2020; 29:924-943. [PMID: 33170112 DOI: 10.1080/10538712.2020.1841353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 07/30/2020] [Accepted: 09/27/2020] [Indexed: 06/11/2023]
Abstract
Treatment utilization following child sexual abuse (CSA) is essential in combatting the various negative consequences of CSA. Youth may present to treatment for CSA with symptoms that cut across multiple diagnostic presentations that impact their ability to successfully engage in treatment. In particular, children who have difficulties with attention may have unique treatment needs following CSA. The purpose of this study was to examine how attention problems interplay with comorbid symptoms and how these clinical presentations impact treatment outcomes for youth who have been sexually abused. Participants included 323 families presenting to treatment for CSA. Youth were 7 to 19 years old, 78.5% female, and 76.6% identified as Caucasian/White. Results indicated that 22.9% of the youth presented with clinically elevated attention problems as collected through parent-report of the Child Behavior Checklist (CBCL). Results demonstrated that child survivors of CSA who presented with attention problems self-reported more psychological concerns (e.g., symptoms of depression, anxiety, and post-traumatic stress). At post-treatment, attention problems, interpersonal problems, and thought problems were significantly reduced for youth initially presenting with attention problems. Further implications for treatment following CSA and unique needs for youth with attention problems are discussed.
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Affiliation(s)
- Akemi E Mii
- University of Nebraska-Lincoln , Lincoln, USA
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Adams Z, Adams T, Stauffacher-Gros K, Mandel H, Wang Z. The Effects of Inattentiveness and Hyperactivity on Posttraumatic Stress Symptoms: Does a Diagnosis of Posttraumatic Stress Disorder Matter? J Atten Disord 2020; 24:1246-1254. [PMID: 25882836 PMCID: PMC4608860 DOI: 10.1177/1087054715580846] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To address the nature of associations between ADHD symptoms and posttraumatic stress disorder (PTSD) psychopathology in adult military veterans. Method: Ninety-five combat veterans, with PTSD (n = 63) and without PTSD (n = 32), were recruited for this study. PTSD was assessed with the Clinician-Administered PTSD Scale (CAPS) and ADHD was assessed with Connors' Adult ADHD Rating Scale-Self-Report: Short Version (CAARS-S:S). Results: PTSD participants endorsed greater hyperactivity or restlessness, inattention or memory problems, and impulsivity or emotional lability scores than participants without PTSD. Among PTSD participants, inattention or memory problems and impulsivity or emotional lability were significant predictors of total PTSD symptoms, but only inattention or memory problems significantly predicted PTSD symptoms when other ADHD symptom clusters were considered simultaneously. Conclusion: Our data suggest that inattention may serve as a risk factor for posttraumatic stress symptoms following combat exposure.
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Affiliation(s)
| | | | | | | | - Zhewu Wang
- Medical University of South Carolina,Ralph H. Johnson VA Medical Center,Please send correspondence to: Zhewu Wang, MD, Ralph H. Johnson VA Medical Center/Medical University of South Carolina, 109 Bee Street, Charleston, SC. USA. Phone: 843-789-7949; Fax: 843-792-3195
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Bernardes ET, Manitto AM, Miguel EC, Pan PM, Batistuzzo MC, Rohde LA, Polanczyk GV. Relationships between childhood maltreatment, impairment in executive functions and disruptive behavior disorders in a community sample of children. Eur Child Adolesc Psychiatry 2020; 29:969-978. [PMID: 31559500 DOI: 10.1007/s00787-019-01408-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 09/13/2019] [Indexed: 11/27/2022]
Abstract
Evidence points to an independent relationship among childhood maltreatment, impairments in executive functions (EF) and disruptive behavior disorders (DBD). However, it is still not fully understood how these three factors are interrelated. This study evaluated the association between childhood maltreatment and DBD testing the role of EF performance as a mediator or moderator. We studied a probabilistic school-based sample of 2016 children from 6 to 12 years. Mental disorders were assessed using the Development and Well-Being Assessment with parents and children. Children answered questions about exposure to child maltreatment and were evaluated with a set of cognitive tasks addressing inhibitory control, working memory, cognitive flexibility and planning. Childhood maltreatment was strongly associated with DBD (OR = 7.7, CI 95% 4.5-12.9). No association was found between childhood maltreatment and EF performance. Children with DBD showed worse performance in cognitive flexibility, which was not identified as a mediator or moderator of the association between childhood maltreatment and DBD. Results indicate that the association between maltreatment and disruptive behavior occurs regardless of performance in executive function in a community sample. Future studies are essential to confirm these findings and elucidate the cognitive mechanisms involved in this association.
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Affiliation(s)
- Elisa Teixeira Bernardes
- Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP, Brazil.
| | - Alicia Matijasevich Manitto
- Departamento de Medicina Preventiva, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Arnaldo, 455, Sao Paulo, SP, Brazil
- Programa de pos-graduacao em Epidemiologia, Universidade Federal de Pelotas, R. Mal. Deodoro, 1160, Pelotas, RS, Brazil
| | - Eurípedes Constantino Miguel
- Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INCT-INPD), R. Dr Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil
| | - Pedro Mario Pan
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INCT-INPD), R. Dr Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil
- Labortatorio Interdisciplinar de Neuroimagem e Cognicao (LiNC), Universidade Federal de Sao Paulo (UNIFESP), R. Pedro de Toledo, 669, Sao Paulo, SP, Brazil
| | - Marcelo Camargo Batistuzzo
- Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INCT-INPD), R. Dr Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil
| | - Luis Augusto Rohde
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INCT-INPD), R. Dr Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil
- Departmento de Psiquiatria, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil
| | - Guilherme V Polanczyk
- Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INCT-INPD), R. Dr Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil
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Spira N. Why Can’t We See It? PSYCHOANALYTIC STUDY OF THE CHILD 2020. [DOI: 10.1080/00797308.2020.1690872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Neal Spira
- Chicago Psychoanalytic Institute, Northwestern University
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Palines PA, Rabbitt AL, Pan AY, Nugent ML, Ehrman WG. Comparing mental health disorders among sex trafficked children and three groups of youth at high-risk for trafficking: A dual retrospective cohort and scoping review. CHILD ABUSE & NEGLECT 2020; 100:104196. [PMID: 31575432 DOI: 10.1016/j.chiabu.2019.104196] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 09/04/2019] [Accepted: 09/16/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Individuals at high-risk for trafficking are often subject to preexisting complex trauma that only intensifies during the trafficking experience. This greatly increases their risk of mental illness, although the actual prevalence of mental health disorders in children who are sex trafficked remains unclear. OBJECTIVE To examine the prevalence of mental health diagnoses among a sample of youth identified as being sex trafficked, and to discuss these rates in relation to other high-risk groups reported in the literature. PARTICIPANTS AND SETTING 143 female and male child trafficking victims in Wisconsin. METHODS We retrospectively reviewed individual medical records, identifying mental health diagnoses and behaviors. The results were compared to summarized prevalence data for mental health disorders in sex trafficked, runaway children, juvenile offenders, and foster care children identified via a scoping review. RESULTS We observed significantly higher rates of ADHD (52.4%, p < 0.0001), bipolar disorder (26.6%, p < 0.0001), and PTSD (19.6%, p < 0.05 to p < 0.0001) in our sample of trafficked youth compared to all high-risk groups, as well as for depression (45.5%), anxiety (19.6%), conduct disorder (19.6%), ODD (25.9%), and psychosis (14.0%) relative to multiple groups individually. CONCLUSIONS The complex trauma suffered by child survivors of sex trafficking can impart numerous effects with overlapping symptomatology of many mental health disorders. Survivors' adaptive responses to complex trauma may lead to improper diagnosis and treatment of mental health disorders at the expense of prompt access to trauma-focused therapies. Alternative diagnoses and treatments of this complex dysfunction are discussed.
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Affiliation(s)
- Patrick A Palines
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, 53213, USA
| | - Angela L Rabbitt
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, 53213, USA.
| | - Amy Y Pan
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, 53213, USA
| | - Melodee L Nugent
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, 53213, USA
| | - Wendi G Ehrman
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, 53213, USA
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Cook-Cottone C. Childhood Posttraumatic Stress Disorder: Diagnosis, Treatment, and School Reintegration. SCHOOL PSYCHOLOGY REVIEW 2019. [DOI: 10.1080/02796015.2004.12086237] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Musicaro RM, Ford J, Suvak MK, Sposato A, Andersen S. Sluggish cognitive tempo and exposure to interpersonal trauma in children. ANXIETY STRESS AND COPING 2019; 33:100-114. [PMID: 31818141 DOI: 10.1080/10615806.2019.1695124] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: Childhood adversity has been suggested, but not yet empirically examined, as a factor in sluggish cognitive tempo (SCT) in childhood.Objective: This study was an examination of SCT in relation to childhood adversity, and its association with exposure to non-interpersonal and interpersonal trauma.Method: Caregivers (N = 161) and a sub-sample of children, 8-17 years old, were recruited from mental health and pediatric practices/programs and interviewed.Results: SCT was positively associated with interpersonal trauma but not non-interpersonal trauma. Two hierarchical regression analyses revealed that interpersonal trauma exposure was associated with SCT score over and above symptoms of other psychopathologies.Conclusion: Results suggest that SCT is associated with interpersonal trauma exposure in children. Further research is needed to examine the association between SCT and interpersonal trauma exposure, and trauma-related biopsychosocial impairments.
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Affiliation(s)
- Regina Marie Musicaro
- Suffolk University Clinical Psychology Doctoral Program, Boston, USA.,Trauma Center at Justice Resource Institute
| | - Julian Ford
- University of Connecticut Health Center, Farmington, USA
| | - Michael K Suvak
- Suffolk University Clinical Psychology Doctoral Program, Boston, USA.,Trauma Center at Justice Resource Institute
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Boyd M, Kisely S, Najman J, Mills R. Child maltreatment and attentional problems: A longitudinal birth cohort study. CHILD ABUSE & NEGLECT 2019; 98:104170. [PMID: 31525706 DOI: 10.1016/j.chiabu.2019.104170] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 08/11/2019] [Accepted: 08/30/2019] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To examine whether child maltreatment is associated with attentional problems in adolescence (14 years) and young adulthood (21 years), and whether outcomes depend on the type of maltreatment (sexual vs non-sexual). METHODS Data from a population based cohort study involving 3778 mother-child pairs were linked with data from the state child protection agency to examine associations between child abuse and neglect and attention problems, measured using the Achenbach Child Behaviour Checklist (CBCL) and the Achenbach Young Adult Self Report (YASR). RESULTS 245 (6.5%) participants had been the subject of notification for non-sexual maltreatment (one or more of neglect, emotional or physical abuse) compared with only 54 (1.4%) who had been subject of notification for suspected sexual abuse. After adjusting for potential confounding variables including maternal, participant and sociodemographic factors, we found those exposed to non sexual maltreatment were likely to experience attentional problems at 14 years (p < .001) and 21 years of age (p = .044), compared with those participants who had not experienced non sexual maltreatment. By contrast, at age 14 years, sexual abuse was associated with attentional problems only as reported by the participant, not their carer. Results at 21 years of age for those exposed to sexual child maltreatment (p=.655) were again in contrast to the observed association between attentional problems and non sexual child maltreatment (p = .035). CONCLUSION In this study, non-sexual maltreatment in childhood is associated with attentional problems at both 14 years and 21 years of age. These findings highlight the need for targeted research to better understand the longer term mental health outcomes for children exposed to non-sexual maltreatment. Potential implications for mental health services include the need for broader screening at presentation and importantly, greater collaboration with schools, general practitioners and paediatricians, given the greatest impact would arguably be within these settings.
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Affiliation(s)
- Melinda Boyd
- Psychiatry Registrar, C/- Metro South Addiction and Mental Health Service, Building 19, Princess Alexandra Hospital, Woolloongabba, Queensland, 4102, Australia.
| | - Steve Kisely
- School of Medicine, University of Queensland, Princess Alexandra Hospital, Woolloongabba, 4102, Queensland, Australia
| | - Jake Najman
- School of Public Health, University of Queensland, Herston, Queensland 4006, Australia
| | - Ryan Mills
- School of Medicine, University of Queensland, c/-Deparment of Paediatrics, Logan Hospital, Logan, Queensland, 4129, Australia
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Weiss NH, Risi MM, Sullivan TP, Armeli S, Tennen H. Post-traumatic stress disorder symptom severity attenuates bi-directional associations between negative affect and avoidant coping: A daily diary study. J Affect Disord 2019; 259:73-81. [PMID: 31442882 PMCID: PMC6791769 DOI: 10.1016/j.jad.2019.08.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 08/01/2019] [Accepted: 08/12/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Avoidant coping plays an important role in the maintenance of post-traumatic stress disorder (PTSD). However, existing investigations have been limited in their assessment of coping as a static process - despite evidence that the coping strategies individuals use to manage stressors vary across time and contexts. Further, research has relied on cross-sectional designs, precluding determination of the directionality of the negative affect-avoidant coping association. The current study addresses these limitations by using a daily diary method to examine the moderating role of PTSD symptom severity on reciprocal relations between negative affect and avoidant coping. METHODS Participants were 1,188 trauma-exposed adults (M age = 19.2, 56% female, 79% White) who provided daily diary data for 30 days via online surveys. Multi-level models were tested to evaluate the moderating role of PTSD symptom severity in the daily relations between negative affect and avoidant coping during the 30-day period. RESULTS Levels of daytime negative affect were assoicated with use of evening avoidant coping. Use of evening avoidant coping were associated with levels of next-day daytime negative affect. PTSD symptom severity moderated these relations. For individuals with more (vs. less) severe PTSD symptoms, the association of negative affect to avoidant coping was weaker and the association of avoidant coping to negative affect was stronger. LIMITATIONS Findings must be interpreted in light of limitations, including self-report measures and assessment of a alcohol using sample of college students. DISCUSSION These findings advance our understanding of the negative affect-avoidant coping association among trauma-exposed individuals.
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Affiliation(s)
- Nicole H. Weiss
- University of Rhode Island, 142 Flagg Rd., Kingston, RI, 02881
| | - Megan M. Risi
- University of Rhode Island, 142 Flagg Rd., Kingston, RI, 02881
| | - Tami P. Sullivan
- Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT 06511
| | - Stephen Armeli
- Fairleigh Dickinson University, 1000 River Road, Teaneck, NJ, 07666, USA.
| | - Howard Tennen
- University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA.
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42
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The Association Between Child Abuse and Emotional and Behavioral Problems in Chinese School-Aged Boys With Attention Deficit Hyperactivity Disorder. J Nerv Ment Dis 2019; 207:869-874. [PMID: 31306291 DOI: 10.1097/nmd.0000000000001041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The aim of our study was to investigate the relationship between child abuse and emotional and behavioral problems in Chinese school-aged boys with attention deficit hyperactivity disorder (ADHD). Forty-eight school-aged boys with ADHD and 77 male healthy controls completed the final assessments that included the Child Behavior Checklist, the Barratt Impulsiveness Scale Version 11, the Screen for Child Anxiety Related Disorders, the Depression Self-Rating Scale for Children, and the Childhood Trauma Questionnaire, Short Form. Our findings showed that child abuse could associate with the behavioral problems in ADHD. Regression analysis further showed that child abuse (especially emotional abuse and physical abuse), adverse living conditions, and school anxiety significantly could be contributors to behavioral problems in boys with ADHD. Our study indicated that child abuse may be associated with the behavioral problems in Chinese school-aged boys with ADHD.
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43
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González RA, Vélez-Pastrana MC, McCrory E, Kallis C, Aguila J, Canino G, Bird H. Evidence of concurrent and prospective associations between early maltreatment and ADHD through childhood and adolescence. Soc Psychiatry Psychiatr Epidemiol 2019; 54:671-682. [PMID: 30903235 DOI: 10.1007/s00127-019-01659-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 01/17/2019] [Indexed: 01/04/2023]
Abstract
PURPOSE An emerging body of work suggests a link between childhood maltreatment and attention-deficit hyperactivity disorder (ADHD). However, research examining the role of maltreatment in the early course of the disorder lacks robust evidence from longitudinal studies. Our aim was to examine concurrent and prospective associations between maltreatment experiences and ADHD diagnosis and sex differences, and to estimate the association between repetitive maltreatment exposure and ADHD through childhood and adolescence. METHODS Data were obtained from the Boricua Youth Study, a longitudinal study of 2480 children and adolescents of Puerto Rican background. Neglect, physical, emotional and sexual abuse, and foster placement were regressed on ADHD diagnosis measured at each of three waves using the Diagnostic Interview Schedule for Children-IV. Multilevel regressions estimated the effects of exposure on ADHD, adjusted by age, sex, income, household education, parental psychopathology, comorbidity and ADHD medication status. RESULTS Emotional abuse and foster placement had robust associations with ADHD diagnosis. For girls, physical abuse had a threefold increase in the odds of having ADHD diagnosis; for boys, associations were observed only for emotional abuse. Prospective models examining the risk of ADHD following maltreatment provided initial evidence for the effects of physical abuse on ADHD, and a linear trend for repetitive exposure suggested increased probability for disorder persistence. CONCLUSIONS Associations between early maltreatment and ADHD were robust. Different categories of maltreatment increase the likelihood of ADHD for girls and boys. Increased exposure to maltreatment may predict symptom persistence. Interventions addressing ADHD must consider the effects of both sex and family environment.
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Affiliation(s)
- Rafael A González
- Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, 7th floor Commonwealth Building, Du Cane Road, London, W12 0NN, UK. .,Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, PR, USA.
| | - María C Vélez-Pastrana
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, PR, USA.,Ph.D. Program in Clinical Psychology, Carlos Albizu University, San Juan, PR, USA
| | - Eamon McCrory
- Division of Psychology and Language Sciences, University College London, London, UK
| | | | - Jivelisse Aguila
- Ph.D. Program in Clinical Psychology, Carlos Albizu University, San Juan, PR, USA
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico School of Medicine, San Juan, PR, USA
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Derella OJ, Burke JD, Stepp SD, Hipwell AE. Reciprocity in Undesirable Parent-Child Behavior? Verbal Aggression, Corporal Punishment, and Girls' Oppositional Defiant Symptoms. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 49:420-433. [PMID: 31059308 DOI: 10.1080/15374416.2019.1603109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Parental verbal aggression and corporal punishment are associated with children's conduct problems and oppositional defiant disorder (ODD). The strength of bidirectional relationships among specific disruptive behaviors has been inconsistent across gender, and the direction of influence between parental aggression and girls' ODD symptoms is particularly understudied. This study tested reciprocal effects between aggressive parent behaviors and girls' ODD dimensions of oppositionality, antagonism, and irritability. Data from the Pittsburgh Girls Study (N = 2,450) were used, including annual child and parent-reported aggressive discipline and girls' parent-reported ODD symptoms between ages 5 and 16. Separate clustered Poisson regression models examined change in parent or child behavior outcomes using predictors lagged by one time point. After controlling for demographic factors, behavior stability, and other disruptive behaviors, parent-reported corporal punishment predicted girls' increasing antagonism and irritability, whereas child-reported corporal punishment was unrelated to ODD symptom change. Both parent- and child-reported verbal aggression predicted increases across ODD dimensions. Girls' oppositionality and antagonism predicted increasing parent-reported verbal aggression over time, but only oppositionality was significantly related to child-reported verbal aggression. Although ODD symptoms were unrelated to change in corporal punishment, attention deficit/hyperactivity disorder (ADHD) predicted increasing parental aggression of both types. Bidirectional associations emerged such that parental verbal aggression escalates reciprocally with girls' behavioral ODD symptoms. Verbal aggression contributed to increasing irritability, but irritability did not influence parenting behavior. "Child effects" may be most salient for behavioral ODD symptoms in transaction with verbal aggression and for ADHD symptoms in predicting worsening corporal punishment and verbal aggression.
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Affiliation(s)
| | - Jeffrey D Burke
- Department of Psychological Sciences, University of Connecticut
| | | | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh Medical Center
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Choi KR, McCreary M, Ford JD, Rahmanian Koushkaki S, Kenan KN, Zima BT. Validation of the Traumatic Events Screening Inventory for ACEs. Pediatrics 2019; 143:peds.2018-2546. [PMID: 30837293 DOI: 10.1542/peds.2018-2546] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/28/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Our purpose in this study was to adapt and validate the Traumatic Events Screening Inventory (TESI) as a primary-care childhood adversity screening tool for children living in vulnerable neighborhoods using a community-partnered approach. METHODS In this cross-sectional, descriptive study, we used a sample of 261 children (3-16 years old) who were seeking services at a Federally Qualified Health Center with colocated behavioral health services in Chicago and had a positive Pediatric Symptom Checklist screen result or received a referral for behavioral health evaluation. The TESI was adapted as a screening tool to be sensitive to adverse childhood experiences (ACEs) unique to the clinic communities. ACEs were mapped by zip code with objective neighborhood crime data, and latent class analysis was performed to identify ACE subgroups. RESULTS The mapping validation suggested face validity for geographic overlap between participant ACEs and objective violent-crime occurrence. With latent class analysis, we identified 3 ACE subgroups: (1) high ACE (18.0% of the sample; polyvictimization and/or maltreatment), (2) moderate ACE (52.1%; violent environments), and (3) low ACE (29.9%; few adverse experiences). Membership in the high-ACE subgroup was associated with higher odds of a clinically significant Pediatric Symptom Checklist score (odds ratio = 3.83) and clinical-level attention problems (odds ratio = 3.58) even after accounting for child resilience and parent depression. CONCLUSIONS ACEs play a significant role in predicting a need for behavioral health services among children seeking primary-care services. The community-adapted TESI is a valid ACE screening tool.
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Affiliation(s)
- Kristen R Choi
- Division of General Internal Medicine and Health Services Research, National Clinician Scholars Program and
| | - Michael McCreary
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Julian D Ford
- Department of Psychiatry, University of Connecticut, Mansfield, Connecticut; and
| | - Sara Rahmanian Koushkaki
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Kristen N Kenan
- Department of Pediatrics, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
| | - Bonnie T Zima
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
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46
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Gul H, Gurkan CK. Child Maltreatment and Associated Parental Factors Among Children With ADHD: A Comparative Study. J Atten Disord 2018; 22:1278-1288. [PMID: 27401238 DOI: 10.1177/1087054716658123] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study investigated the role of child and parental factors in maltreatment of children with ADHD compared with a healthy control group. METHOD We examined the rates and correlations of child maltreatment by parents in a sample of children with ADHD ( n = 100) and a matched comparison sample of children without ADHD ( n = 100), all aged 6 to 11 years. Parent and child ratings evaluated demographic characteristics, severity of ADHD symptoms, and childhood trauma exposure. RESULTS According to regression analysis, maternal hyperactivity/impulsivity and male gender of the child increase the emotional abuse; whereas maternal history of emotional abuse and physical neglect and paternal attention deficit increase sexual abuse, and higher maternal hyperactivity/impulsivity increases emotional neglect of ADHD children. CONCLUSION The study's findings provide strong evidence that the maltreatment of children with ADHD is more associated with parental factors than with the symptoms of ADHD in children.
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Affiliation(s)
- Hesna Gul
- 1 Ankara University, School of Medicine, Turkey.,2 Necip Fazil State Hospital, Kahramanmaras, Turkey
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47
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Spinazzola J, van der Kolk B, Ford JD. When Nowhere Is Safe: Interpersonal Trauma and Attachment Adversity as Antecedents of Posttraumatic Stress Disorder and Developmental Trauma Disorder. J Trauma Stress 2018; 31:631-642. [PMID: 30338544 PMCID: PMC6221128 DOI: 10.1002/jts.22320] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 05/17/2018] [Accepted: 05/18/2018] [Indexed: 02/06/2023]
Abstract
Developmental trauma disorder (DTD) has been proposed as clinical framework for the sequelae of complex trauma exposure in children. In this study, we investigated whether DTD is associated with different traumatic antecedents than posttraumatic stress disorder (PTSD). In a multisite sample of 236 children referred from pediatric or mental health treatment, DTD was assessed using the DTD Structured Interview. Trauma history was assessed using the Traumatic Events Screening Instrument (TESI). On an unadjusted basis, both DTD, odds ratios (ORs) = 2.0-3.8, 95% CI [1.17, 7.19]; and PTSD, ORs = 1.8-3.0, 95% CI [1.04, 6.27], were associated with past physical assault and/or abuse, family violence, emotional abuse, neglect, and impaired caregivers; and DTD was associated community violence, OR = 2.7, 95% CI [1.35, 5.43]. On a multivariate basis after controlling for the effects of PTSD, DTD was associated with family and community violence and impaired caregivers, ORs = 2.0-2.5, 95% CI [1.09, 5.97], whereas PTSD was only associated with physical assault and/or abuse after controlling for the effects of DTD, OR = 2.4, 95% CI [1.07, 4.99]. Exposure to both interpersonal trauma and attachment adversity was associated with the highest DTD symptom count, controlling for the PTSD symptom count. Although childhood PTSD and DTD share several traumatic antecedents, DTD may be uniquely associated with pervasive exposure to violent environments and impaired caregiving. Therefore, DTD warrants further investigation as a framework for the assessment and treatment of children with histories of interpersonal victimization and attachment adversity.
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Affiliation(s)
| | - Bessel van der Kolk
- The Trauma CenterBrooklineMassachusetts,Department of PsychiatryBoston University School of MedicineBostonMassachusettsUSA
| | - Julian D. Ford
- Department of PsychiatryUniversity of Connecticut School of MedicineFarmingtonConnecticutUSA
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Olafson E, Boat BW, Putnam KT, Thieken L, Marrow MT, Putnam FW. Implementing Trauma and Grief Component Therapy for Adolescents and Think Trauma for Traumatized Youth in Secure Juvenile Justice Settings. JOURNAL OF INTERPERSONAL VIOLENCE 2018; 33:2537-2557. [PMID: 26872505 DOI: 10.1177/0886260516628287] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We describe a multiyear pilot dissemination of a trauma-focused group treatment, Trauma and Grief Component Therapy for Adolescents, coupled with a trauma-informed staff training, Think Trauma, to six residential juvenile justice (JJ) facilities. All staff members were trained in Think Trauma. Seventy-seven youth from four facilities completed the treatment groups and 69 completed all pre- and postgroup assessment measures. The aims of this study were to determine whether trauma-focused interventions (a) could be implemented in complex JJ systems, (b) would be associated with a decrease in posttraumatic symptoms and reactions in youth, and (c) might contribute to reduced Incident Reports in facilities. A related question was whether we would receive feedback that youth who participated in the trauma and/or grief narrative components of the intervention were adversely affected. Pre- and postgroup assessments indicated significant reductions in symptoms of posttraumatic stress, depression, and anger, but not in anxiety or sexual concerns. There were significantly greater reductions in posttraumatic stress disorder (PTSD) among incarcerated youth who completed all modules of the group treatment intervention relative to incarcerated youth who received an abbreviated version. Two of the facilities tracked their Incident Reports and reported reductions. No Incident Reports or therapist feedback documented that the trauma/grief processing components of the intervention were destabilizing to the youth.
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Affiliation(s)
- Erna Olafson
- 1 Cincinnati Children's Hospital Medical Center, OH, USA
- 2 University of Cincinnati, OH, USA
| | - Barbara W Boat
- 1 Cincinnati Children's Hospital Medical Center, OH, USA
- 2 University of Cincinnati, OH, USA
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49
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Kim S, Kim JS, Shim M, Im CH, Lee SH. Altered cortical functional network during behavioral inhibition in individuals with childhood trauma. Sci Rep 2018; 8:10123. [PMID: 29973600 PMCID: PMC6031680 DOI: 10.1038/s41598-018-28329-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 06/18/2018] [Indexed: 11/08/2022] Open
Abstract
Individuals who have prior history of childhood traumatic experiences are at a high risk for a variety of psychological and behavioral problems throughout their lifetime. This study aimed to investigate whether such individuals exhibit altered cortical functional networks during a behavioral inhibition task. One hundred fifty-three non-clinical individuals were recruited and instructed to perform a Go/NoGo task during an electroencephalograph. Source-level weighted functional networks based on the graph theory were analyzed for NoGo-P3 processing. Based on their total scores on the childhood trauma questionnaire (CTQ) participants were divided into three groups: low CTQ, middle CTQ, and high CTQ. Results at the global level indicated decreased strength, clustering coefficient, and efficiency for the low and gamma bands in the high CTQ group. In addition, the path length of the low beta band was observed to be longer in the high CTQ group than the low CTQ group. At the nodal level, the nodal clustering coefficient of high CTQ group was decreased in left primary somatosensory cortex and middle occipital gyrus for the low beta band, and in left superior temporal gyrus for the gamma band. The nodal clustering coefficient of the left primary somatosensory cortex showed a significant negative correlation with the total CTQ score for the low beta band. In addition, the nodal clustering coefficient of the left middle occipital gyrus for the low beta band and superior temporal gyrus for the gamma band showed significant negative correlations with the emotional neglect score. Our results demonstrate an altered cortical functional network in individuals who experienced childhood trauma. In particular, the left primary somatosensory cortex, middle occipital gyrus, and superior temporal gyrus were found to be vulnerable in individuals who experienced childhood trauma, especially emotional neglect.
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Affiliation(s)
- Sungkean Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Ji Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Miseon Shim
- Department of Psychiatry, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Chang-Hwan Im
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea.
- Department of Psychiatry, Inje University, Ilsan-Paik Hospital, Goyang, Republic of Korea.
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50
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Whitt-Woosley A, Sprang G, Royse DG. Identifying the trauma recovery needs of maltreated children: An examination of child welfare workers' effectiveness in screening for traumatic stress. CHILD ABUSE & NEGLECT 2018; 81:296-307. [PMID: 29778039 DOI: 10.1016/j.chiabu.2018.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 04/30/2018] [Accepted: 05/08/2018] [Indexed: 06/08/2023]
Abstract
Children in the child welfare system comprise a group characterized by exposure to trauma via experiences of maltreatment, under circumstances presenting multiple risk factors for traumatic stress. High rates of posttraumatic stress have been observed in this population. However, there is currently no standard for the universal screening of children in child welfare for trauma exposure and traumatic stress. This study examined the trauma experiences of a sample of maltreated children and whether their child welfare workers were effective screeners of traumatic stress symptoms. Descriptive and correlational analyses were conducted regarding a sample of children (N = 131) with trauma screenings completed by their child welfare workers and clinical measures of traumatic stress symptoms. Four hierarchical regression models were also examined to determine whether workers' screening information regarding child age, trauma exposure history and symptoms of traumatic stress were predictive of outcomes on clinical measures. The analyses revealed complex trauma exposure histories and high rates of traumatic stress symptoms among this generally younger sample of maltreated children. Additionally, the models supported workers' efficacy in screening for symptoms of total posttraumatic stress and specific trauma symptoms of intrusion and avoidance. Workers were less effective in screening for the symptoms of arousal. These findings support the importance of identifying the trauma recovery needs of maltreated children and the utility of child protection workers in assisting with the trauma screening process. Implications are provided for related practice, policy and training efforts in child welfare.
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Affiliation(s)
| | - Ginny Sprang
- University of Kentucky, College of Medicine- Department of Psychiatry, United States
| | - David G Royse
- University of Kentucky, College of Social Work, United States
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