The invisible scars of emotional abuse: a common and highly harmful form of childhood maltreatment

Dimensions of Child Maltreatment in Australians With a History of Out-of-Home Care

Research suggests that the dimensions of childhood maltreatment (type, age of onset, duration, frequency and perpetrator) play an important role in determining health and wellbeing outcomes, though little information is available on these dimensions for any care experienced cohorts. This study aimed to determine if any variation in maltreatment dimensions were experienced between two subsets of the nationally representative Australian Child Maltreatment Study, both of which reported childhood maltreatment histories: care-experienced (n = 358) and non-care-experienced (n = 4922). Using a series of independent t-tests and chi-square tests, we compared the two groups on seven dimensions (number of maltreatment types, range of maltreatment items, age of onset, duration, frequency, perpetrator number, and perpetrator type) for the five child maltreatment types (physical, emotional, sexual abuse, neglect, and exposure to domestic violence). Results showed that the care-experienced group reported a higher intensity of maltreatment, being younger when maltreatment first started, experiencing greater variety of maltreatment types, for longer periods, more times and by more perpetrators than maltreated people with no care experience. We conclude that children and young people in out-of-home care experience maltreatment at a higher intensity than the rest of the population, which has implications for effective treatment.

Child maltreatment elevated the risk of late-life chronic pain: a biopsychosocial framework from the UK Biobank cohort

ABSTRACT

Understanding the development of chronic pain (CP) is challenging due to its multifactorial etiology. Child maltreatment (CM), encompassing various types of neglect and abuse affecting more than one-third of the population, is a critical aspect of early-life adversity with long-lasting impacts. It is increasingly recognized for its role in altering biopsychosocial processes, potentially increasing vulnerability to CP. However, the exact path connecting CM to CP is not fully elucidated, primarily attributable to limitations in prior research, including insufficient sample sizes, inadequate consideration of comprehensive mediative variables, and a lack of longitudinal data. To address these gaps, our study utilizes a large-scale dataset (n = 150,989) comprising both cross-sectional and longitudinal data, along with an extensive range of biopsychosocial variables. Our findings reveal that all types of CMs, except physical neglect, significantly increase the risk of CP, and all types of CPs, except headache, were affected by CM. Furthermore, we demonstrate that individuals with CM histories are more predisposed to comorbid CP conditions. Importantly, biopsychosocial factors are found to explain over 60% of the association between CM and CP, with psychological factors playing a key role. This study not only characterizes the relationship between CM and CP but also underscores the influence of psychosocial elements in this dynamic interplay. These findings offer important insights into the long-term impacts of CM and provide a foundation for developing targeted therapeutic and preventive strategies for CP.

Impact of adverse childhood experiences on risk for internalizing psychiatric disorders in youth at clinical high-risk for psychosis

INTRODUCTION

Research has established that adverse childhood experiences (ACEs) confer risk for psychiatric diagnoses, and that protective factors moderate this association. Investigation into the effect of protective factors in the relationship between ACEs and internalizing disorders (e.g., depression, anxiety) is limited in high-risk groups. The present study investigated the relationship between ACEs and risk for internalizing disorders in youth at clinical high risk for psychosis (CHR-P) and tests the hypothesis that protective factors moderate this relationship.

METHODS

688 participants aged 12-30 (M = 18; SD = 4.05) meeting criteria for CHR-P were administered measures of child adversity, protective factors (SAVRY), and diagnostic assessment (SCID- 5). Logistic regression tested whether ACEs predicted internalizing disorders. Moderation regression analyses determined whether these associations were weaker in the presence of protective factors.

RESULTS & CONCLUSIONS

Higher levels of ACEs predicted history of depressive disorder (β = 0.26(1.30), p < .001), self-harm/suicide attempts (β = 0.34(1.40), p < .001), and substance use (β = 0.14(1.15), p = .04). Childhood sexual abuse (β = 0.77(2.15), p = .001), emotional neglect (β = 0.38(1.46), p = .05), and psychological abuse (β = 0.42(1.52), p = .04), predicted self- harm/suicide attempts. Sexual abuse (β = 1.00 (2.72), p = .001), and emotional neglect (β = 0.53(1.71), p = .011), were also linked to depressive disorder. There was no association between ACEs and anxiety disorder, and no moderation effect of protective factors in the relationship between ACEs and psychiatric outcomes. These findings add nuance to a growing literature linking ACEs to psychopathology and highlight the importance of investigation into the mechanisms that may buffer this relationship.

Role of stress and early-life stress in the pathogeny of inflammatory bowel disease

Numerous preclinical and clinical studies have shown that stress is one of the main environmental factor playing a significant role in the pathogeny and life-course of bowel diseases. However, stressful events that occur early in life, even during the fetal life, leave different traces within the central nervous system, in area involved in stress response and autonomic network but also in emotion, cognition and memory regulation. Early-life stress can disrupt the prefrontal-amygdala circuit thus favoring an imbalance of the autonomic nervous system and the hypothalamic-pituitary adrenal axis, resulting in anxiety-like behaviors. The down regulation of vagus nerve and cholinergic anti-inflammatory pathway favors pro-inflammatory conditions. Recent data suggest that emotional abuse at early life are aggravating risk factors in inflammatory bowel disease. This review aims to unravel the mechanisms that explain the consequences of early life events and stress in the pathophysiology of inflammatory bowel disease and their mental co-morbidities. A review of therapeutic potential will also be covered.

Associations Between PTSD and Depressive Symptoms and Victimization Among Female College Students: A Latent Class Analysis

Research on subgroups of female college students who share similar experiences of childhood maltreatment (CM) and intimate partner violence (IPV) victimization is sparse. The primary aims of the current study are: (a) to identify subgroups of victims related to experience of psychological, physical, and sexual CM and IPV and (b) to test the association between subgroups and depressive and post-traumatic stress disorder (PTSD) symptom severity. Survey data was collected from 327 female students at a public university in the Northeast. Three distinct subgroups, that is, victimization classes, were found using Latent Class Analysis: A lifetime victimization class, comprised of females reporting high rates of CM and IPV across types (19.0% of the sample), a childhood victimization class (26.9%); and a low victimization class (54.1%). Depressive symptom severity was positively associated with lifetime and childhood, relative to low, victimization class membership. PTSD symptom severity was associated with the childhood victimization class relative to both lifetime and low victimization class. Subgroups of institutions of higher education (IHE) females who share CM and IPV victimization experiences are discernable. The co-occurrence of IPV and CM in female college students is not uncommon. PTSD symptom severity may be more related to CM than IPV in IHE female students.

The Bridge Between Childhood Trauma and Alexithymia Among Adolescents with Depressive and Bipolar Disorders: A Network Bridge Analysis

Childhood trauma and alexithymia are significant risk factors for adolescent mental health issues. Prior research has linked these factors to psychopathology, but the complexities of their interrelation remain underexplored. This study aims to elucidate the relationship between various forms of childhood trauma and alexithymia in adolescents with depressive and bipolar disorders. Structural Equation Modeling (SEM) and network analysis were utilized on data from 2343 Chinese adolescents (aged 12-18 years, 77.93% female) diagnosed with depression or bipolar disorder. Measures included the Childhood Trauma Questionnaire (CTQ) and the Toronto Alexithymia Scale (TAS-20). SEM demonstrated a significant correlation between childhood trauma and alexithymia. Network analysis identified emotional abuse and difficulty identifying feelings as central nodes. Emotional abuse emerged as a key factor for difficulty in emotional identification among adolescents. This study highlights the need for early intervention and the importance of emotional nurturing in childhood to prevent long-term socioemotional difficulties.

The association between emotional abuse in childhood and healthcare utilization in adulthood among sami and non-sami: the SAMINOR 2 questionnaire survey

BACKGROUND

Emotional abuse in childhood is the most common type of childhood abuse worldwide and is associated with a variety of somatic and mental health issues. However, globally and in indigenous contexts, research on the associations between emotional abuse in childhood and somatic and mental specialist healthcare utilization in adulthood is sparse.

AIM

The main aim of this study was to investigate the association between emotional abuse in childhood and somatic and mental specialist healthcare utilization in adulthood in Sami and non-Sami populations, and to examine whether this association differs between the two ethnic groups.

METHOD

This study used cross-sectional data from the SAMINOR 2 Questionnaire Survey - a population-based study on health and living conditions in areas with Sami and non-Sami populations in Middle and Northern Norway. In total, 11 600 individuals participated in SAMINOR 2. Logistic regression was used to present the association between emotional abuse in childhood and somatic and mental specialist healthcare utilization.

RESULTS

Emotional abuse in childhood was significantly associated with somatic specialist healthcare utilization in adulthood (fully adjusted odds ratio [OR] 1.31, 95% confidence interval [CI] 1.15-1.49), with no differences observed between ethnic groups. Emotional abuse in childhood was also associated with mental specialist healthcare utilization (fully adjusted OR 3.99, 95% CI 3.09-5.14), however this association was weaker among Sami (crude OR 2.38, 95% CI 1.37-4.13) compared with non-Sami (crude OR 5.40, 95% Cl 4.07-7.15) participants.

CONCLUSIONS

Emotional abuse in childhood is associated with somatic and mental specialist healthcare utilization in adulthood, with a stronger association to mental healthcare utilization. The association between emotional abuse in childhood and mental specialist healthcare utilization was weaker among Sami than non-Sami participants. Future studies should investigate the reason for this ethnic difference. Our results highlight the need to strengthen efforts to prevent childhood abuse and develop strategies to reduce its societal and personal burden.

Emotional abuse mediated by negative automatic thoughts impacts functional connectivity during adolescence

Background

Emotional abuse during childhood and adolescence is thought to be associated with the brain; however, the neural mechanism underlying the cognitive process remains unknown. Therefore, we aimed to investigate the mediating effect of negative automatic thoughts on the relationship between emotional abuse and resting-state functional connectivity (rsFC) during adolescence.

Method

Our community sample included 54 adolescents aged 13-17 years in the statistical analysis. Resting-state functional and structural magnetic resonance imaging (MRI) was performed, while emotional abuse and negative automatic thoughts were assessed using self-reported scales. A mediation analysis was used to assess the contributions of early traumatic events and negative automatic thoughts to resting functional connectivity.

Result

Higher negative automatic thoughts were associated with lower connectivity in the context of greater emotional abuse (i.e., suppression effect). Thus, the relationships between emotional abuse and connectivity in the precuneus (pCun)-medial prefrontal cortex, parahippocampal cortex-extrastriate cortex, and temporal cortex-temporal pole were decreased by negative automatic thoughts. In contrast, functional connections in the pCun-pCun, pCun-precuneus/posterior cingulate cortex, and nucleus accumbens-somatomotor areas were strongly mediated when emotionally abused adolescents reported a high tendency for negative automatic thoughts.

Conclusion

Negative automatic thoughts strengthened the relationship between emotional abuse and rsFC. These findings highlight the underlying cognitive processing of the traumatic event-neural system, supporting the use of cognitive therapy for post-traumatic symptoms.

Childhood trauma moderates schizotypy-related brain morphology: analyses of 1182 healthy individuals from the ENIGMA schizotypy working group

BACKGROUND

Schizotypy represents an index of psychosis-proneness in the general population, often associated with childhood trauma exposure. Both schizotypy and childhood trauma are linked to structural brain alterations, and it is possible that trauma exposure moderates the extent of brain morphological differences associated with schizotypy.

METHODS

We addressed this question using data from a total of 1182 healthy adults (age range: 18-65 years old, 647 females/535 males), pooled from nine sites worldwide, contributing to the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Schizotypy working group. All participants completed both the Schizotypal Personality Questionnaire Brief version (SPQ-B), and the Childhood Trauma Questionnaire (CTQ), and underwent a 3D T1-weighted brain MRI scan from which regional indices of subcortical gray matter volume and cortical thickness were determined.

RESULTS

A series of multiple linear regressions revealed that differences in cortical thickness in four regions-of-interest were significantly associated with interactions between schizotypy and trauma; subsequent moderation analyses indicated that increasing levels of schizotypy were associated with thicker left caudal anterior cingulate gyrus, right middle temporal gyrus and insula, and thinner left caudal middle frontal gyrus, in people exposed to higher (but not low or average) levels of childhood trauma. This was found in the context of morphological changes directly associated with increasing levels of schizotypy or increasing levels of childhood trauma exposure.

CONCLUSIONS

These results suggest that alterations in brain regions critical for higher cognitive and integrative processes that are associated with schizotypy may be enhanced in individuals exposed to high levels of trauma.

The effect of complex posttraumatic stress and poverty on quality of life among adult survivors of childhood institutional maltreatment: evidence from survivors of the 'Hyeongje Welfare Institution' in South Korea

Background: Childhood institutional maltreatment (IM) is associated with both complex posttraumatic stress disorder (CTPSD) and poverty in adulthood life, each of which may impact an individual's quality of life (QoL). To find implications for clinical practice and policy making for adult survivors with childhood IM experiences, it is necessary to conduct research examining their current QoL and identifying related factors.Objective: By applying the model of the conservation of resources theory, we focused on how adulthood QoL can be indicated by childhood IM as well as the life outcomes of IM such as additional lifetime trauma, CPTSD, and poverty.Methods: In a cross-sectional study, self-report data were collected from 127 adults who were survivors of the 'Hyeongje' childhood IM in South Korea. We conducted regression analyses of childhood IM experiences, trauma experiences after escape from the institution, current CPTSD symptoms, and current poverty experiences on current QoL.Results: The duration of placement at the 'Hyeongje' (β = .24, p = .009) was associated with trauma experiences after escape from the institution. Trauma experiences after escape from the institution (β = .25, p = .007) were associated with CPTSD symptoms. CPTSD symptoms (β = .26, p = .005) were associated with poverty, and both CPTSD symptoms (β = -.52, p < .001) and poverty (β = -.26, p = .003) were negatively associated with current QoL.Conclusions: Prolonged childhood IM brings about loss spirals by increasing an individual's exposure to experiences of further cumulative trauma, CPTSD, and poverty. There is a need for due diligence-based policy making and public support from the government to help create upward spirals for QoL. This may include the imminent detection and rescue of children as well as providing a safe environment, offering multidisciplinary interventions including evidence-based treatment for CPTSD, and considering economic support including collective reparations.

Prevalence and factors associated with risky sexual behavior among Brazilian school adolescents

This article evaluated the prevalence and factors associated with risky sexual behavior (RSB) among Brazilian school adolescents. This is a cross-sectional study with data collected from the National Survey of School Health, 2019 edition, with a representative sample of 7th grade of elementary school to 3rd year of high school Brazilian school adolescents. This work evaluated sociodemographic, behavioral, sexual and reproductive health, mental health, sociability characteristics, medical advice received at school, and body image. RSB was characterized as the non-use of a condom during sexual intercourse. The data were analyzed using hierarchical Poisson regression modeling. The prevalence of RSB was of 40.3%, with the lowest proportion appearing in the North region (37.4%). The highest prevalence of RSB was found among female adolescents, whose first sexual intercourse occurred at 13 years of age or under, who were victims of sexual violence, who practiced bullying, and who used illicit drugs, cigarettes, and alcohol. Those who used a condom during their first sexual intercourse showed the lowest prevalence of RSB. The high prevalence of RSB among Brazilian school adolescents, together with the knowledge of the associated factors, serves to define strategies to favor improvements in the sexual and reproductive health of these young people.

Emerging adult college students' descriptions of exposure to childhood emotional abuse and associated factors: A qualitative exploration

BACKGROUND

Growing evidence on the long-term deleterious impacts of emotional abuse highlights the need to further understand childhood emotional abuse and its context to strengthen prevention efforts.

OBJECTIVE

To describe emerging adults' experiences of emotional abuse in their childhoods and the household context surrounding that abuse.

PARTICIPANTS AND SETTING

Fifty-eight interviews were conducted with emerging adults, ages 18-25, recruited from four 2- and 4-year institutions of higher education.

METHODS

Thematic analysis was conducted to identify and describe patterns in the data. A cyclical approach to codebook development and data analysis was followed by a team of four coders.

RESULTS

Themes related to participants' experiences of emotional abuse included: inability to meet parent expectations; parent attacks on the child's character; parent negative comparisons to siblings and others; parent invalidation of the child's emotions and mental health needs; and evolution over time in the parent-child relationship. Aspects of childhood family environments contemporaneous with the childhood emotional abuse included: financial stress; parent mental illness; parent divorce, separation, or volatile relationship; parent adversity or trauma; physical abuse; and young parent age. Many participants identified these aspects of their family environment, most of which could potentially be improved with sufficient support, as playing causal roles in the emotional abuse they experienced.

CONCLUSION

This descriptive qualitative study provides additional insight into child emotional abuse and its associated factors, providing invaluable insights that can enhance current measurement and intervention approaches.

Childhood maltreatment and suicide risk: The mediating role of self-compassion, mentalization, depression

BACKGROUND

Childhood maltreatment (CM) is a well-established risk factor for depression and increased suicide risk. This study aimed to investigate the distinctive mechanisms of individual types of CM on young adult suicide risk, by exploring the potential mediating role of mentalization, self-compassion, and depression.

METHODS

A total of 4873 adults completed a survey screening for experiences of CM, self-compassion, mentalization, depression, and suicide risk.

RESULTS

The path analysis revealed significant direct effects of mentalization, self-compassion, and depression on suicide risk. Moreover, mentalization, self-compassion, and depression mediated the relationship between emotional abuse/neglect and suicide risk, whereas physical neglect contributed to suicide risk only through mentalization and depression. Furthermore, sexual abuse had a significant direct effect on suicide risk, whereas physical abuse did not show any direct or indirect effects.

LIMITATIONS

The cross-sectional design of the study limits its ability to establish causality, and the risk of recall bias in reporting physical or sexual abuse cannot be ignored.

CONCLUSIONS

This study represents the first identification of disturbances in self-compassion, mentalization, and depression that mediate the relationship between various types of CM and suicide risk in young adults. Our findings suggest substantive differences in the impact of emotional CM compared to other forms of CM. Enhancing self-compassion and mentalization abilities could be valuable intervention strategies for individuals with a history of emotional CM. Addressing factors that hinder the recall of relevant subjective experiences of physical and sexual abuse is also critical.

The burden of early life stress in chronic inflammatory bowel diseases

The aim of this study was to evaluate the prevalence of early life stress (ELS) in a population with inflammatory bowel diseases (IBD) and to estimate its burden on mental, physical, and digestive health. Ninety-three participants with IBD were asked to anonymously complete questionnaires (Childhood Trauma Questionnaire-Short Form, Early Life Event Scale, Perceived Stress Scale, Hospital Anxiety and Depression Scale, Ways of Coping Checklist, Gastro-Intestinal Quality of Life Index questionnaire, and ad hoc questions about symptoms). The prevalence of patients with IBD who were exposed to at least one childhood abuse was 53%. Mental health and quality of life were significantly poorer in patients with IBD who were exposed to early abuse than in those who were not. Patients exposed to ELS had also more digestive perturbations and fatigue. These results suggest that early abuse should be considered a component of IBD care.

Association between adverse childhood experiences and suicidal behavior in schizophrenia spectrum disorders: A systematic review and meta-analysis

Assessing and managing suicide behaviors is highly relevant to individuals with schizophrenia spectrum disorders. Our study aims to assess the association between adverse childhood experiences and suicidal behaviors in individuals with schizophrenia spectrum disorders. We included observational studies comparing the probability of suicide behaviors in adults with schizophrenia spectrum disorders exposed and unexposed to adverse childhood experiences. Odds ratio estimates were obtained by pooling data using a random-effects pairwise meta-analysis. Standardized criteria were used to assess the strength of the association of the pooled estimate. We found 21 eligible studies reporting outcomes for 6257 individuals from 11 countries. The primary outcome revealed an association between any suicidal behavior and adverse childhood experiences, which resulted "highly suggestive" according to validated Umbrella Criteria. Similarly, a positive association was confirmed for suicidal ideation and suicide attempt and for any subtype of adverse childhood experience. This meta-analysis showed that exposure to adverse childhood experiences strongly increases the probability of suicide behaviors in people with schizophrenia spectrum disorders.

Childhood maltreatment and adulthood victimization: An evidence-based model

There is ample evidence showing that childhood maltreatment increases two to three fold the risk of victimization in adulthood. Various risk factors, including posttraumatic stress disorder (PTSD) symptoms, dissociation, self-blame, and alcohol abuse are related to revictimization. Although previous research examined associations between risk factors for revictimization, the evidence is limited and the proposed models mostly include a handful of risk factors. Therefore, it is critical to investigate a more comprehensive model explaining the link between childhood maltreatment and adulthood (re)victimization. Accordingly, this study tested a data-driven theoretical path model consisting of 33 variables (and their associations) that could potentially enhance understanding of factors explaining revictimization. Cross-sectional data derived from a multi-wave study were used for this investigation. Participants (N = 2156, age mean = 19.94, SD = 2.89) were first-year female psychology students in the Netherlands and New Zealand, who responded to a battery of questionnaires and performed two computer tasks. The path model created by structural equation modelling using modification indices showed that peritraumatic dissociation, PTSD symptoms, trauma load, loneliness, and drug use were important mediators. Attachment styles, maladaptive schemas, meaning in life, and sex motives connected childhood maltreatment to adulthood victimization via other factors (i.e., PTSD symptoms, risky sex behavior, loneliness, emotion dysregulation, and sex motives). The model indicated that childhood maltreatment was associated with cognitive patterns (e.g., anxious attachment style), which in turn were associated with emotional factors (e.g., emotion dysregulation), and then with behavioral factors (e.g., risky sex behavior) resulting in revictimization. The findings of the study should be interpreted in the light of the limitations. In particular, the cross-sectional design of the study hinders us from ascertaining that the mediators preceded the outcome variable.

Trauma-Informed Care: A Missing Link in Addressing Burnout

The Covid-19 pandemic and national movements for health equity have highlighted the impact of trauma on public health as well as on health worker well-being. As burnout rates across healthcare climb, we seek creative and effective solutions. Current anti-burnout strategies focus on much needed systems solutions for employee success; however, they often lack a trauma-informed approach. Trauma is highly prevalent in society at large, and health workers are further exposed to trauma in the course of their professional studies and duties. Common symptoms of burnout may actually be manifestations of traumatic stress. Trauma-informed care (TIC) is a strategic framework and growing social movement for providing quality care to survivors of individual, interpersonal, collective, and structural trauma. Importantly, TIC has practical applications to address our healthcare burnout epidemic. In this perspective piece, an expert describes a trauma-informed lens through which to view burnout solutions using SAMHSA's 4 Rs of a trauma-informed approach: 1) Realize the widespread impact of trauma, 2) Recognize the signs and symptoms in patients and staff, 3) Respond by integrating knowledge about trauma into practice, and actively 4) Resist re-traumatization. Moving forward, key stakeholders must collaborate to build and refurbish efficient systems alongside a trauma-informed organizational model. TIC can transform the healthcare experience for patients and employees alike by fostering community, empowerment, and healing.

Trauma in childhood is associated with greater pain catastrophizing but not anxiety sensitivity: a cross-sectional study

Introduction

Adverse life experiences have been identified as a possible vulnerability factor for chronic pain. This association could result from the effect of trauma on the psychological state of individuals. Previous studies found childhood trauma to be associated with pain catastrophizing and anxiety sensitivity, both of which have been associated with an increased risk of chronic pain. However, it is unknown whether trauma in adulthood affects these variables and whether the effect on pain catastrophizing is independent of confounds such as depression and anxiety.

Objectives

To test the effect of childhood and adulthood trauma on pain catastrophizing and anxiety sensitivity whilst controlling for depression and anxiety.

Methods

In the current study, we conducted an online survey in the United Kingdom in a chronic pain sample (N = 138; 123 women; age range 19-78). We analysed whether there is an association between different types of trauma (both in childhood and through the lifespan), pain catastrophizing, and anxiety sensitivity while controlling for anxiety and depression.

Results

We found that childhood trauma (particularly emotional abuse) significantly predicts pain catastrophizing, even when controlling for depression and anxiety, whereas it did not have a significant effect on anxiety sensitivity. Trauma through the lifespan (not childhood) did not have a significant effect on anxiety sensitivity nor did it have a significant effect on pain catastrophizing.

Conclusions

Our results show that the life stage in which trauma occurs is key in its psychological effects on patients with chronic pain. Furthermore, it shows that trauma affects some psychological variables but not others.

Childhood trauma and its relationship with suicide probability and Self-Esteem: A case study in a university in Turkey

PURPOSE

The aim of this study is to investigate to what extent childhood trauma affects suicide probability and self-esteem of university students.

DESIGN AND METHODS

In this descriptive study, 3602 university students continuing their education in the 2019-2020 academic year were selected into the sample. The data in the study were collected using a personal information form, "Childhood Trauma Questionnaire (CTQ)", "Suicide Probability Scale (SPS)" and Rosenberg Self-Esteem Scale (RSES). The data were evaluated using appropriate statistical methods, and p < 0.05 value was considered statistically significant.

FINDINGS

In the study, students' mean scale scores of CTQ and SPS were found high (38.1 ± 13.7; 87.7 ± 10.7, respectively), and the RSES total mean scale score was found average (1.7 ± 1.4). CTQ total mean score was found to show a positive correlation between SPS and RSES total mean scores. It has been established that the past traumatic experiences of university students decrease self-esteem and are associated with suicide probability.

PRACTICE IMPLICATIONS

Risk management programs for university students should be organized by determining the risk groups exposed to Childhood Trauma by psychiatric and child nurses.

Early life adverse experiences and loneliness among young adults: The mediating role of social processes

Loneliness has been described as endemic among young people. Such feelings of social isolation 'even in a crowd' are likely linked to adverse early life experiences that serve to diminish perceptions of social support and intensify negative social interactions. It was suggested in the present series of survey studies that childhood abuse, which compromises a child's sense of safety in relationships, may affect social processes that contribute to loneliness in young adulthood. Study 1 assessed different adverse childhood and adult experiences in relation to loneliness among young adults (N = 171). Linear regression analyses indicated that childhood abuse was uniquely associated with greater loneliness, and this relationship was partially mediated by the perceived availability of social support. Study 2 (N = 289) assessed different forms of childhood abuse and demonstrated that early life emotional abuse was a unique predictor of loneliness, and this relationship was fully mediated by lower perceived support or value in social connections (social connectedness) and more frequent unsupportive interactions with friends. Study 3 evaluated the implications of the age of occurrence of abuse (N = 566). Both emotional and sexual abuse predicted young adult loneliness regardless of age; abuse that was recalled to have occurred at very early ages (0-5 years) was not predictive of loneliness over and above consideration of events that happened in older childhood. These relationships were at least partially mediated by perceived social support, social connectedness, and in the case of emotional abuse, unsupportive interactions with friends. Our results add to mounting evidence pointing to the prevalence of loneliness among young adults and the links to adverse early life experiences that may serve to shape appraisals of safety, value, and personal worth in social relationships.

Childhood Trauma and Suicide: The Mediating Effect of Stress and Sleep

This study aimed to investigate the relationship between suicide risk, perceived stress, and sleep quality through a structural equation modeling approach. This study used convenience sampling to survey 780 undergraduate and graduate students aged 18–30 years. Students were invited to participate in the online questionnaires, which included the Beck Scale for Suicide Ideation, the Suicidal Behaviors Questionnaire-Revised, the Perceived Stress Scale, the Childhood Trauma Questionnaire-Short Form, and the Pittsburgh Sleep Quality Index. The results showed that suicide ideation and suicidal behavior were positively correlated with childhood trauma, stress, and sleep. A well-fitted structural equation model (χ2 = 1.52, df = 1, χ2/df = 1.52, RMSEA = 0.03, CFI = 1.00, NFI = 1.00) was constructed in this study. The hierarchical regression test showed significance in all the path coefficients of the model. The total effect of emotional abuse on suicide behaviors was 49.5%. The mediating effects accounted for 73.7% of the total effects of emotional abuse on suicidal behaviors. The results demonstrate efforts targeting stress and poor sleep might mitigate the risk of suicidal behaviors among individuals with early emotional abuse experiences.

Intergenerational trauma: Parental PTSD and parent-reported child abuse subtypes differentially relate to admission characteristics in the autism inpatient collection

Autistic youth experience high rates of maltreatment. Little research has considered how distinct abuse dimensions differentially relate to meaningful outcomes, nor taken an intergenerational approach to consider how caregiver trauma and child maltreatment are related. This study sought to identify how parent-reported child abuse subtypes and parent posttraumatic stress disorder (PTSD) relate to each other and to admission characteristics upon inpatient service entry. Autistic youth (N = 527; 79% White, 21.3% girls, mean age = 12.94 years) participated in the autism inpatient collection. Parents reported on child abuse subtypes (physical, sexual, emotional) and their own PTSD, child behavior and emergency services, and parenting stress. Youth of parents with PTSD were nearly three times more likely to have parent-reported physical and emotional abuse. Autistic girls were more likely to experience parent-reported sexual abuse and a higher number of subtypes. Lower income related to higher rates of parent-reported child emotional abuse and parent PTSD. Emotional abuse associated with child behavior whereas both child physical and emotional abuse related to emergency services. Reported parent PTSD associated with child behavior and parental distress. When considered jointly, parent PTSD and number of parent-reported child abuse subtypes differentially related to child behavior and interacted to predict psychiatric hospitalizations. Intergenerational continuity of trauma is important to consider among autistic youth, and both parent-reported child abuse and parent PTSD relate to admission characteristics. Critical limitations include reliance on binary parent reports of child abuse and parent PTSD and the low representation of youth of minoritized identities. Implications for trauma-informed care are discussed.

Childhood Emotional Abuse Is Associated With the Desire to Get Married and Have Children in Korean Young Adults

OBJECTIVE

Young adults putting off marriage and having less children have become recent trends in many modern societies. Yet less is known about the psychological factors underlying the drastically low marriage and fertility rates. We hypothesized that childhood maltreatment experience may have a negative association with one's marriage and childbearing intention.

METHODS

A total of 1,004 college students (mean age of 20.8±2.3 years, 56.1% female) completed self-questionnaires including sociodemographic information, marriage and childbearing intention, Patient Health Questionnaire 9 (PHQ-9), and Childhood Trauma Questionnaire (CTQ). Multivariable logistic regression analyses were conducted to evaluate the effect of childhood trauma on marriage and childbearing intentions after controlling for sociodemographic variables and depression.

RESULTS

29.7% had no intention to get married and 40.4% had no intention to have children in the future. The prevalence of physical, sexual, and emotional abuse was 33.1%, 18.5%, and 22.3%, respectively. Multivariable logistic regression analyses revealed that female (p<0.001), poor health status (p=0.001), and childhood emotional abuse (p=0.01) were independent predictors of no desire to get married. Female (p<0.001), poor health status (p<0.001), and childhood emotional abuse (p=0.038) were also predictors of no desire to have children.

CONCLUSION

Childhood emotional abuse may be the most damaging form among other types of childhood maltreatment because it can occur more pervasively and persist for a longer period, causing extensive damage to a child's emotional, social and cognitive development. Raising awareness regarding the life-long consequences of childhood emotional abuse and the need to prevent and detect childhood emotional abuse should be emphasized.

Tonic Immobility is Associated with PTSD Symptoms in Traumatized Adolescents

Purpose

Growing evidence suggests that peritraumatic tonic immobility, an involuntary defensive response that involves extreme physical immobility and the perceived inability to escape, is a significant predictor of post-traumatic stress disorder (PTSD) symptomatology. However, this issue has not been specifically addressed in adolescents. Here, we investigated whether tonic immobility response experienced during the worst childhood or adolescent trauma is associated with PTSD symptom severity in a non-clinical student sample.

Methods

The sample was composed of students in 9th grade who were attending public and private schools. Symptoms of post-traumatic stress and tonic immobility were assessed using questionnaires. We performed bivariate and multivariate negative binomial regressions to examine whether tonic immobility was associated with PTSD symptomatology after controlling for confounders (peritraumatic dissociation, peritraumatic panic reactions, gender, age and time since trauma).

Results

We found an association between tonic immobility and PTSD symptom severity, even after controlling for confounders. Therefore, tonic immobility is associated with PTSD symptoms in trauma-exposed adolescents.

Conclusion

These findings highlight tonic immobility as a possible risk factor that could be used to provide direction for more targeted trauma interventions for individuals, particularly those at risk for developing PTSD. Therefore, it contributes to preventing and reducing the psychiatric burden in adolescence and later in life.