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Liu X, Liu R, Sun YX, Wang HL, Wang H, Wang T, Ma YN, Li XX, Wang Q, Su YA, Li JT, Si TM. Dorsal CA3 overactivation mediates witnessing stress-induced recognition memory deficits in adolescent male mice. Neuropsychopharmacology 2024; 49:1666-1677. [PMID: 38504012 PMCID: PMC11399124 DOI: 10.1038/s41386-024-01848-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/18/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
Witnessing violent or traumatic events is common during childhood and adolescence and could cause detrimental effects such as increased risks of psychiatric disorders. This stressor could be modeled in adolescent laboratory animals using the chronic witnessing social defeat (CWSD) paradigm, but the behavioral consequences of CWSD in adolescent animals remain to be validated for cognitive, anxiety-like, and depression-like behaviors and, more importantly, the underlying neural mechanisms remain to be uncovered. In this study, we first established the CWSD model in adolescent male mice and found that CWSD impaired cognitive function and increased anxiety levels and that these behavioral deficits persisted into adulthood. Based on the dorsal-ventral functional division in hippocampus, we employed immediate early gene c-fos immunostaining after behavioral tasks and found that CWSD-induced cognition deficits were associated with dorsal CA3 overactivation and anxiety-like behaviors were associated with ventral CA3 activity reduction. Indeed, chemogenetic activation and inhibition of dorsal CA3 neurons mimicked and reversed CWSD-induced recognition memory deficits (not anxiety-like behaviors), respectively, whereas both inhibition and activation of ventral CA3 neurons increased anxiety-like behaviors in adolescent mice. Finally, chronic administration of vortioxetine (a novel multimodal antidepressant) successfully restored the overactivation of dorsal CA3 neurons and the cognitive deficits in CWSD mice. Together, our findings suggest that dorsal CA3 overactivation mediates CWSD-induced recognition memory deficits in adolescent male mice, shedding light on the pathophysiology of adolescent CWSD-induced adverse effects and providing preclinical evidence for early treatment of stress-induced cognitive deficits.
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Affiliation(s)
- Xiao Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Rui Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Ya-Xin Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Hong-Li Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Han Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Ting Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Yu-Nu Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Xue-Xin Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Qi Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Yun-Ai Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Ji-Tao Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
| | - Tian-Mei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
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Iktilat K, Isacson M, Tzemah-Shahar R, Agmon M. The link between exposure to violence and psychological distress among middle-aged Muslims in Israel: the role of gender. Front Public Health 2024; 12:1382053. [PMID: 38903569 PMCID: PMC11188443 DOI: 10.3389/fpubh.2024.1382053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 05/20/2024] [Indexed: 06/22/2024] Open
Abstract
Introduction To date, it is still unclear if exposure to violence affects psychological distress in middle-aged adults and if the effects are gender specific. This age group is of special interest as it is at the onset of the aging process and is often overlooked or understudied in scholarly research. Specifically, targeted research on middle-aged Muslims living in Israel, a unique population exposed to increasing violence, is lacking. Methods We examined the relationship between exposure to violence and psychological distress in a cohort of 363 middle-aged adults (223 women) from three Muslim villages in northern Israel, collecting data on violence exposure (Screen for Adolescent Violence Exposure (SAVE) questionnaire), psychological distress (Kessler 6 Psychological Distress questionnaire), and other demographic characteristics including education level and socioeconomic status. We used this data to answer two questions: (1) is exposure to violence a predictor of psychological distress in middle-aged Muslims, and (2) does the relationship between exposure and distress differ between men and women? Results We revealed a positive link between exposure to violence and psychological distress (β = 0.145, p = 0.017) when controlling for gender, age, education level, and socioeconomic level. Discussion Despite previous evidence of gender-based differences in this interplay in younger cohorts, we did not find a significant interaction between gender and the violence exposure-psychological distress interplay. Our findings are some of the first to focus on middle-aged individuals and show that both men and women exhibit connections between exposure to violence and psychological distress when considering covariates. This research provides insights that can be used when planning community-wide interventions and treatment schemes to support healthy aging.
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Affiliation(s)
- Khalil Iktilat
- Department of Gerontology, Faculty of Health and Social Welfare, University of Haifa, Haifa, Israel
- Ramat Gan Academic College, Ramat Gan, Israel
| | | | - Roy Tzemah-Shahar
- The Cheryl Spencer Institute for Nursing Research, Faculty of Health and Social Welfare, University of Haifa, Haifa, Israel
| | - Maayan Agmon
- The Cheryl Spencer Institute for Nursing Research, Faculty of Health and Social Welfare, University of Haifa, Haifa, Israel
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Dincel M, Karayagmurlu A. An Investigation of Dissociative Symptoms and Related Factors in Autistic Adolescents. J Autism Dev Disord 2024:10.1007/s10803-024-06374-7. [PMID: 38743151 DOI: 10.1007/s10803-024-06374-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2024] [Indexed: 05/16/2024]
Abstract
Despite exposure to trauma and adverse life events being frequently reported in Autism Spectrum Disorder (ASD), few studies have examined the relationship between these factors and dissociative symptoms in the autistic population. The aim of the study is to investigate symptoms of dissociation in autistic adolescents, and to explore factors that could be associated with dissociative symptoms in ASD. This cross-sectional study involved 59 autistic adolescents between 12 and 18 years old, with the mean age of 14.3 ± 1.8. Dissociation, autism characteristics, childhood traumas, peer bullying, and Post-Traumatic Stress Disorder (PTSD) symptoms were assessed using the Adolescent Dissociative Experiences Scale (ADES), the Childhood Autism Rating Scale (CARS), the Childhood Trauma Questionnaire (CTQ), the Nine-Item Child-Adolescent Bullying Screen (CABS-9), and the Child Posttraumatic Stress Reaction Index (CPTS-RI), respectively. Results from the ADES revealed that 12.5% of the participants scored above the threshold for dissociative disorders. In the linear regression model constructed to evaluate factors associated with dissociative symptoms, an increase in dissociative symptoms was statistically significantly associated with an increase in the total CTQ score (p = 0.002) and age (p = 0.006). The findings of the study indicate that dissociative symptoms may occur in autistic adolescents. It is suggested that dissociative symptoms observed in autistic adolescents may particularly be associated with childhood traumas and increasing age. Further research into dissociative symptoms in ASD is warranted, requiring larger sample sizes, specialized measurement scales, and structured interviews.
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Affiliation(s)
- Melodi Dincel
- Department of Child and Adolescent Psychiatry, Midyat State Hospital, Midyat, Mardin, Turkey.
| | - Ali Karayagmurlu
- Department of Child and Adolescent Psychiatry, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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Wente VM, Retz-Junginger P, Crombach A, Retz W, Barra S. The Suitability of the Childhood Trauma Questionnaire in Criminal Offender Samples. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5195. [PMID: 36982104 PMCID: PMC10048956 DOI: 10.3390/ijerph20065195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/14/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
Adverse childhood experiences (ACEs) are common in community samples and are associated with various dysfunctional physical, psychological, and behavioral consequences. In this regard, criminal offenders are at specific risk, considering their elevated ACE rates compared with community samples and the associations of ACEs with criminal behaviors. However, assessing ACEs in offender samples by self-reports has been criticized with regard to their validity and reliability. We examined the suitability of ACE-self-reports using the Childhood Trauma Questionnaire (CTQ) in a sample of 231 male offenders involved in the German criminal justice system by comparing self-reported to externally rated ACEs to externally rated ACEs based on the information from the offenders' criminal and health-related files and on interviews conducted by forensically trained psychological/psychiatric experts. The accordance between self-ratings and expert ratings was examined considering mean differences, correlations, inter-rater agreement measures, and regression analyses. Offenders themselves reported a higher ACE burden than the one that was rated externally, but there was a strong relationship between CTQ self-assessments and external assessments. However, associations were stronger in offenders seen for risk assessment than in those evaluated for criminal responsibility. Overall, the CTQ seems suitable for use in forensic samples. However, reporting bias in self-reports of ACEs should be expected. Therefore, the combination of self-assessments and external assessments seems appropriate.
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Affiliation(s)
- Vera Maria Wente
- Institute for Forensic Psychology and Psychiatry, Saarland University Hospital, 66421 Homburg, Germany (W.R.)
| | - Petra Retz-Junginger
- Institute for Forensic Psychology and Psychiatry, Saarland University Hospital, 66421 Homburg, Germany (W.R.)
| | - Anselm Crombach
- Department of Psychology, Saarland University, 66123 Saarbruecken, Germany
| | - Wolfgang Retz
- Institute for Forensic Psychology and Psychiatry, Saarland University Hospital, 66421 Homburg, Germany (W.R.)
- Department of Psychiatry and Psychotherapy, University Medical Center, Johannes Gutenberg-University, 55131 Mainz, Germany
| | - Steffen Barra
- Institute for Forensic Psychology and Psychiatry, Saarland University Hospital, 66421 Homburg, Germany (W.R.)
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Strenth CR, Mo A, Kale NJ, Day PG, Gonzalez L, Green R, Cruz II, Schneider FD. Adverse Childhood Experiences and Diabetes: Testing Violence and Distress Mediational Pathways in Family Medicine Patients. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP23035-NP23056. [PMID: 35225043 DOI: 10.1177/08862605221076536] [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: 02/05/2023]
Abstract
Type 2 diabetes mellitus (diabetes) is increasing in frequency and creating a significant burden on the United States healthcare system. Adverse childhood experiences (ACE) and interpersonal violence (IV) have been shown to have detrimental effects on mental and physical health. How ACE can influence IV as an adult and how this can influence the management of diabetes is not known. The purpose of the current study is to understand the relationship between violence and social determinants of health (SDoH), and its effect on patients with type 2 diabetes mellitus. A practiced-based research network (PBRN) of family medicine residency programs was utilized to collect cross-sectional data from seven family medicine residency program primary care clinics. In total, 581 participants with type 2 diabetes were recruited. A serial/parallel mediation model were analyzed. The majority of participants (58.3%) had a Hemoglobin A1c (HbA1c) that was not controlled. ACE was associated with an increase in Hurt-Insult-Threaten-Scream (HITS) scores, which in turn was positively associated with an increase in emotional burden, and finally, emotional burden decreased the likelihood that one's HbA1c was controlled (Effect = -.054, SE = .026 CI [-.115, -.013]). This indirect pathway remained significant even after controlling for several SDoH and gender. The impact of ACE persists into adulthood by altering behaviors that make adults more prone to experiencing family/partner violence. This in turn makes one more emotionally distressed about their diabetes, which influences how people manage their chronic condition. Family physicians should consider screening for both ACE and family/partner violence in those patients with poorly controlled diabetes.
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Affiliation(s)
| | - Albert Mo
- 23458Memorial Hermann Hospital, Houston, TX, USA
| | - Neelima J Kale
- 12252University of Kentucky College of Medicine, Lexington, KY, USA
| | - Philip G Day
- 12262University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | - Ronya Green
- 427554TriStar Southern Hills Medical Center, Nashville, TN, USA
| | - Inez I Cruz
- 14742UT Health San Antonio, San Antonio, TX, USA
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Seitz KI, Gerhardt S, von Schroeder C, Panizza A, Thekkumthala D, Bertsch K, Herpertz SC, Schmahl C, Schalinski I. Measuring types and timing of childhood maltreatment: The psychometric properties of the KERF-40+. PLoS One 2022; 17:e0273931. [PMID: 36074774 PMCID: PMC9455860 DOI: 10.1371/journal.pone.0273931] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/17/2022] [Indexed: 12/03/2022] Open
Abstract
Childhood maltreatment, specifically during sensitive developmental periods, is a major risk factor for poor physical and mental health. Despite its enormous clinical relevance, there is still a lack of scales measuring different types, timing, and duration of childhood maltreatment. The current study sought to validate and determine the psychometric properties of the brief German version of the Maltreatment and Abuse Chronology of Exposure (MACE) scale, the KERF-40. The KERF-40 was administered as an interview (i.e., KERF-40-I) to 287 adult participants with and without mental disorders. Based on item response theory, items of the KERF-40-I were assigned to different types of maltreatment, resulting in a scaled version, the KERF-40+. Test-retest reliability was assessed in a small subsample (n = 14). Convergent and relative predictive validity were measured with correlations of the KERF-40+ and the Childhood Trauma Questionnaire (CTQ) as well as self-report measures of general and trauma-related psychopathology. Rasch analysis and fit statistics yielded a 49-item version, encompassing ten different types of maltreatment. The test-retest reliability of the KERF-40+ was shown to be acceptable to excellent for almost all global and subscale scores (.74 ≤ ρ ≤ 1.00), with the exception of the subscale emotional neglect (ρ = .55). Convergent validity with the CTQ was confirmed for both KERF-40+ global scores (.72 ≤ r ≤ .87) and corresponding subscale scores (.56 ≤ r ≤ .78). Relative predictive validity was reflected by significant small-to-moderate correlations between KERF-40+ global scores and indices of general and trauma-related psychopathology (.24 ≤ r ≤ .45). Taken together, the KERF-40+ appears to be suited for clinicians and researchers interested in retrospectively assessing different types, timing, and duration of childhood maltreatment experiences during sensitive periods in adults.
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Affiliation(s)
- Katja I. Seitz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
- * E-mail:
| | - Sarah Gerhardt
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Claudius von Schroeder
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
| | - Angelika Panizza
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
| | | | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
- Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Sabine C. Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
| | - Inga Schalinski
- Department of Psychology, University of Konstanz, Konstanz, Germany
- Psychologische Hochschule Berlin, Berlin, Germany
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The Chinese version of the Maltreatment and Abuse Chronology of Exposure (MACE) scale: Psychometric properties in a sample of young adults. PLoS One 2022; 17:e0270709. [PMID: 35771860 PMCID: PMC9246159 DOI: 10.1371/journal.pone.0270709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/15/2022] [Indexed: 11/19/2022] Open
Abstract
There are several effective self-report instruments used by Chinese researchers to retrospectively assess exposure to childhood maltreatment. However, these measures do not assess the timing of exposure, restricting efforts to identify periods of development when childhood maltreatment maximally increases vulnerability to psychopathology and health outcomes. In the current study we created a Chinese version of the Maltreatment and Abuse Chronology of Exposure (MACE) scale, which assesses multiplicity (number of types of maltreatment experienced) and severity of maltreatment as well as when it occurred during childhood and adolescence. Rasch modeling was used for scale development in a sample of 812 undergraduate students. Item reduction analysis of the original 75 items produced a 58-item Chinese version with ten subdimensions. The new scale showed good three-week test-retest reliability, and good convergent validity with the Childhood Trauma Questionnaire (CTQ) and the revised Adverse Childhood Experiences Questionnaire (ACEQ-R). Variance decomposition analyses found that compared to the CTQ and ACE, the MACE Severity and Multiplicity scores explained higher variance in self-reported depression and anxiety symptom ratings on the Depression Anxiety Stress Scales (DASS). The results of the present study confirmed that the Chinese version of the MACE has sound psychometric properties in the Chinese cultural context. This new instrument will be a valuable tool for Chinese researchers, psychiatrists and psychologists to ascertain the type and timing of exposure to maltreatment.
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McElvaney R, McDonnell Murray R, Dunne S. Siblings' Perspectives of the Impact of Child Sexual Abuse Disclosure on Sibling and Family Relationships. FAMILY PROCESS 2022; 61:858-872. [PMID: 34060077 DOI: 10.1111/famp.12681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Child sexual abuse (CSA) may have significant consequences for siblings; however, limited research has been conducted on the impact of the abuse on sibling and family relationships following the disclosure of CSA. This study sought to investigate sibling responses to disclosures of CSA among a group of adult siblings in Ireland, and the impact on sibling and family relationships through an online survey. A thematic analysis was conducted on a sub-set of participants who responded to open-ended questions (n = 45). Three main themes were identified as follows: (a) intense emotional reactions, (b) relationship support and strain, and (c) managing family dynamics. CSA disclosure may have a substantial impact on sibling and family relationships. Supporting siblings in the aftermath of CSA disclosure is essential, both for the well-being of the individual who was sexually abused and for the wider family.
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Tucker CJ, Finkelhor D, Turner H. Exposure to parent assault on a sibling as a childhood adversity. CHILD ABUSE & NEGLECT 2021; 122:105310. [PMID: 34509926 DOI: 10.1016/j.chiabu.2021.105310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/24/2021] [Accepted: 08/31/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Children's exposure to parental violence against another parent has been widely studied as an adverse childhood experience and source of childhood trauma. Exposure to parental violence against a sibling could be equally as traumatizing, but the literature on this exposure is sparse, by comparison. We examined the frequency of exposure to parental assault on a sibling (EPAS) and its demographic distributions. We also investigated the links between EPAS and symptoms of distress. METHOD From three combined surveys of the National Survey on Children's Exposure to Violence, based on telephone interviews with parents, and in the case of those 10-17 years old, adolescents, we examined children living with a juvenile sibling (N = 7, 029; 49% female). RESULTS Lifetime EPAS was 3.7%, and sibling assault was more common by fathers (70%) than by mothers (30%). Exposure was greatest for boys and adolescents, highest for those whose parents had some college education, and for those living with other non-parental adults, single parents, and stepfamilies. Rates did not differ by ethnicity. Most exposed youth felt afraid (83%), and fear was greater when witnessing fathers than mothers assaulting a sibling. Controlling for child maltreatment and exposure to interparental violence, those exposed to EPAS showed higher current levels of mental distress (anger, depression, and anxiety; F (10, 6146) = 140.44, p = .001; R2 = 0.19). CONCLUSIONS Clinical work and parent education programs should address the occurrence of EPAS and the adverse association between EPAS and mental health to reduce its potential negative impact.
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Affiliation(s)
- Corinna Jenkins Tucker
- Human Development and Family Studies Department, University of New Hampshire, United States of America.
| | - David Finkelhor
- Crimes Against Children Research Center, University of New Hampshire, United States of America
| | - Heather Turner
- Crimes Against Children Research Center, University of New Hampshire, United States of America
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Katz C, Tener D. "It burns her more than it burns for me": The sibling subsystem in the context of child physical abuse as portrayed by children during forensic interviews. CHILD ABUSE & NEGLECT 2021; 120:105251. [PMID: 34392024 DOI: 10.1016/j.chiabu.2021.105251] [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: 11/30/2020] [Revised: 06/20/2021] [Accepted: 07/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The sibling subsystem is a central and potentially protective factor for children. Nevertheless, in the context of child abuse, it remains surprisingly understudied. OBJECTIVE The current study was designed to examine how children referred to a forensic interview following suspected physical abuse experienced and perceived the sibling subsystem. PARTICIPANTS AND SETTING The sample included 60 forensic interviews with children, aged 4 to 14. Each child had at least one sibling and referred to this sibling in the context of the abuse they experienced. METHODS Thematic analysis was carried out on the narratives provided by the children. Several steps were taken to ensure the trustworthiness of the study, with four criteria: credibility, transferability, dependability, and confirmability. RESULTS The main theme identified was physical abuse as a familial routine. This abusive routine was sometimes perceived as normal and sometimes traumatic, with descriptions of fear and physical pain. The children addressed the various figures in this abusive routine. When these horrific daily experiences were elaborated on, the children often captured the sibling subsystem as a source of security, comfort and protection. Moreover, the children's language often communicated the siblings' bond, referring to "we" and "us." Within a few narratives, a split between the siblings was identified, which appeared to be a strategy of self-protection by going against their siblings. CONCLUSION The current findings join the recent accumulating evidence with respect to the centrality of the sibling subsystem in the experiences and consequences of child abuse. It is imperative to advance practitioners' knowledge and interventions to better adapt to the central role of the sibling subsystem in the context of child abuse.
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Affiliation(s)
- Carmit Katz
- Bob Shapell School of Social Work, Tel-Aviv University, Israel.
| | - Dafna Tener
- Bob Shapell School of Social Work, Tel-Aviv University, Israel
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Benasi G, Fava GA, Rafanelli C. Kellner's Symptom Questionnaire, a Highly Sensitive Patient-Reported Outcome Measure: Systematic Review of Clinimetric Properties. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 89:74-89. [PMID: 32050199 DOI: 10.1159/000506110] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/23/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Patient-reported outcomes (PROs) are of increasing importance in clinical medicine. However, their evaluation by classic psychometric methods carries considerable limitations. The clinimetric approach provides a viable framework for their assessment. OBJECTIVE The aim of this paper was to provide a systematic review of clinimetric properties of the Symptom Questionnaire (SQ), a simple, self-rated instrument for the assessment of psychological symptoms (depression, anxiety, hostility, and somatization) and well-being (contentment, relaxation, friendliness, and physical well-being). METHODS The PRISMA guidelines were used. Electronic databases were searched from inception up to March 2019. Only original research articles, published in English, reporting data about the clinimetric properties of the SQ, were included. RESULTS A total of 284 studies was selected. The SQ has been used in populations of adults, adolescents, and older individuals. The scale significantly discriminated between subgroups of subjects in both clinical and nonclinical settings, and differentiated medical and psychiatric patients from healthy controls. In longitudinal studies and in controlled pharmacological and psychotherapy trials, it was highly sensitive to symptoms and well-being changes and discriminated between the effects of psychotropic drugs and placebo. CONCLUSIONS The SQ is a highly sensitive clinimetric index. It may yield clinical information that similar scales would fail to provide and has a unique position among the PROs that are available. Its use in clinical trials is strongly recommended.
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Affiliation(s)
- Giada Benasi
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Giovanni A Fava
- Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Chiara Rafanelli
- Department of Psychology, University of Bologna, Bologna, Italy,
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Brassard MR, Hart SN, Glaser D. Psychological maltreatment: An international challenge to children's safety and well being. CHILD ABUSE & NEGLECT 2020; 110:104611. [PMID: 32660756 DOI: 10.1016/j.chiabu.2020.104611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Child psychological maltreatment (PM), also known as emotional abuse and neglect, mental violence, and emotional maltreatment, is the least recognized and addressed of the four major forms of child maltreatment. OBJECTIVES This article provides an 1) the history of PM and its relationship to children's rights, 2) an overview of the current state of knowledge, 3) implications of diversity for the topic of PM, 4) an example of a topic-relevant intervention, and 5) a vision for further progress in addressing this form of child maltreatment. PARTICIPANTS AND SETTINGS NA. METHOD Literature review, intervention description of fabricated or induced illness, and expert opinion. RESULTS PM is directly implicated in seven of the articles of the Convention. PM is common, reliable definitions of PM exist and need to be applied to practice and public health surveillance, harmfulness has been empirically established but is not fully appreciated, and countries vary dramatically in terms of incidence. CONCLUSIONS PM is a human rights issue that must be addressed through child protection and promotion of child wellbeing. Adoption of reliable definitions of the different aspects of PM for Child Protective Service practice is a top policy goal. The development of empirically supported curricula on PM for training professionals and parents and culturally sensitive interventions to change social norms on the use of psychologically aggressive disciplinary practices and other forms of PM are critical research needs. Well-validated interventions to support quality parent-child relationships and support families exist and need to be widely adopted. Individual child protective measures should be confined to cases of ongoing serious PM when interventions have failed to reduce harm to the child.
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Affiliation(s)
| | - Stuart N Hart
- Indiana University Purdue University at Indianapolis, USA
| | - Danya Glaser
- Great Ormond Street Hospital for Children and University College, London, UK
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Riedl D, Lampe A, Exenberger S, Nolte T, Trawöger I, Beck T. Prevalence of adverse childhood experiences (ACEs) and associated physical and mental health problems amongst hospital patients: Results from a cross-sectional study. Gen Hosp Psychiatry 2020; 64:80-86. [PMID: 32304934 DOI: 10.1016/j.genhosppsych.2020.03.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 03/11/2020] [Accepted: 03/12/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) can have severe detrimental effects on physical and mental health. This study aimed to present prevalence rates of ACEs amongst a mixed sample of hospital patients. METHODS In- and outpatients at seven departments of the University Hospital of Innsbruck (Austria) participated in the study. They completed questionnaires regarding retrospective assessments of ACEs, physical and mental health and experience of domestic violence. The impact of ACEs on patients' health was evaluated by calculation of odds ratios (OR) in binary logistic regressions. RESULTS A total of n = 2392 (74.3% of all approached patients) were included in the analyses. The results showed that 36.1% of them reported at least one form of ACEs, and 6.3% were polyvictimized (i.e. they reported ≥4 forms of ACEs). Most frequent forms of ACE were emotional abuse (18.3%), peer abuse (14.2%), and neglect (12.3%). ACEs were significantly associated with increased ORs for various physical diseases, mental health problems and domestic violence. CONCLUSION Retrospectively assessed ACEs are highly prevalent amongst hospital patients and exposure to high numbers of ACEs is associated with decreased physical and mental health. The identification of patients with symptoms following ACEs and referral to appropriate treatment is a crucial challenge for health-care professionals.
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Affiliation(s)
- David Riedl
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Astrid Lampe
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria.
| | - Silvia Exenberger
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Tobias Nolte
- Wellcome Department of Imaging Neuroscience, University College London, London, United Kingdom; Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Iris Trawöger
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Beck
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
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14
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Effect of anapanasati meditation on anxiety: a randomized control trial. Ann Neurosci 2020; 26:32-36. [PMID: 31896910 PMCID: PMC6894628 DOI: 10.5214/ans.0972.7531.260107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/19/2018] [Accepted: 11/19/2018] [Indexed: 12/02/2022] Open
Abstract
Background Meditation has shown positive results in improving the psychological
disorders such as anxiety. There is a need to study the therapeutic benefits
of Anapanasati meditation, a mindfulness meditation technique. Purpose The study aims at investigating the effect of Anapanasati meditation on
individuals with moderate anxiety. Methods A total of 112 participants who were willing to participate in the study were
recruited for the study. Anapanasati meditation was used as an intervention.
The participants were divided into two groups experiment and control groups.
Experiment group had 56 persons performing Anapanasati meditation and
Control group had 56 persons not performing any type of meditation. The
experiment group practiced one hour of Anapanasati meditation daily under
the supervision of experts for six months and continued their daily routine
and control group was not given any intervention, but they continued their
daily routine. State Trait Anxiety Inventory (STAI) is used to assess the
anxiety level. Results The STAI score before and after Anapanasati meditation was analysed for both
experiment and control groups using Paired Samples T test. The experiment
group has shown significant reduction in the STAI (P < 0.05) score after
the intervention whereas in the control group the reduction in STAI score
was not significant. Conclusion This study has shown that after six months of intervention, the subjects with
moderate anxiety who practiced Anapanasati meditation had a significant
decrease in their STAI score and the control group has not shown significant
change in the STAI score.
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15
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Augsburger M, Basler K, Maercker A. Is there a female cycle of violence after exposure to childhood maltreatment? A meta-analysis. Psychol Med 2019; 49:1776-1786. [PMID: 30994081 DOI: 10.1017/s0033291719000680] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Several studies have demonstrated a vicious cycle of violence, in which experiences of childhood maltreatment (CM) transition into later perpetration of aggressive acts. But evidence for the presence of this cycle in adult women is mixed. The aim of this meta-analysis is to investigate the strength of associations and the mechanisms underlying a cycle of violence in women. Databases were searched for terms related to female aggression, violence, delinquency, antisocial behavior, or offending in addition to exposure to traumatic experiences, abuse, or maltreatment during childhood. Only peer-reviewed studies were included that investigated associations between any type of CM and different acts of aggression. Multi-level meta-analyses were applied, as well as meta-regressions, all based on Cohen's d. K = 34 studies were identified. The overall association between exposure to CM was in the positive but small range (Cohen's d = 0.30). There was no significant difference between specific types of abuse and/or neglect. However, associations were smaller for the perpetration of sexual aggression and violent crime compared with other acts of aggression. These findings underline the long-lasting and devastating impact of CM, including types of maltreatment that were long assumed to be less severe. Due to the limited number of available studies, interactions between types of CM and aggression could not be modeled, thus compromising their probable interacting contribution to the cycle of violence. Early interventions targeting families and women at risk are critical in order to prevent ongoing cycles of violence.
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Affiliation(s)
| | - Kayley Basler
- Department of Psychology,University of Zurich,Switzerland
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16
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Norton-Baker M, Wolff JM, Kolander TW, Evans M, King AR. Childhood Sexual Abuse and Lifetime Aggression. JOURNAL OF CHILD SEXUAL ABUSE 2019; 28:690-707. [PMID: 31180815 DOI: 10.1080/10538712.2019.1607963] [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: 01/19/2019] [Revised: 03/28/2019] [Accepted: 04/02/2019] [Indexed: 06/09/2023]
Abstract
This study of college undergraduates (N = 873) examined three hypotheses regarding associations between childhood sexual abuse and lifetime aggression: 1) childhood sexual abuse was expected to account for unshared variance in the lifetime aggression indicators after controlling for the potential effects of parental physical abuse, sibling physical abuse, exposure to intimate partner violence, peer bullying, and respondent age; 2) childhood sexual abuse associations were expected to be relatively stronger among the women than the men; 3) childhood sexual abuse links to lifetime aggression were expected to vary as a function of age of victimization (adolescent < childhood < dual-age victims). Aggression histories varied widely with over 20% reporting prior injuries inflicted on others (3.2% > five injuries). Sexual abuse links to aggression tended to be stronger (p < .001) for the women than the men, and rates of aggression were higher when sexual abuse recurred across both childhood and adolescence. Partial support was found for all three hypotheses.
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Affiliation(s)
- Mara Norton-Baker
- a Psychology Department, University of North Dakota , Grand Forks , ND , USA
| | - Jenna M Wolff
- a Psychology Department, University of North Dakota , Grand Forks , ND , USA
| | - Tyler W Kolander
- a Psychology Department, University of North Dakota , Grand Forks , ND , USA
| | - Matthew Evans
- a Psychology Department, University of North Dakota , Grand Forks , ND , USA
| | - Alan R King
- a Psychology Department, University of North Dakota , Grand Forks , ND , USA
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17
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Susceptibility or Resilience to Maltreatment Can Be Explained by Specific Differences in Brain Network Architecture. Biol Psychiatry 2019; 85:690-702. [PMID: 30528381 PMCID: PMC6440838 DOI: 10.1016/j.biopsych.2018.10.016] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 10/15/2018] [Accepted: 10/26/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Childhood maltreatment is a major risk factor for psychopathology. However, some maltreated individuals appear remarkably resilient to the psychiatric effects while manifesting the same array of brain abnormalities as maltreated individuals with psychopathology. Hence, a critical aim is to identify compensatory brain alterations that enable resilient individuals to maintain mental well-being despite alterations in stress-susceptible regions. METHODS Network models were constructed from diffusion tensor imaging and tractography in physically healthy unmedicated 18- to 25-year-old participants (N = 342, n = 192 maltreated) to develop network-based explanatory models. RESULTS First, we determined that susceptible and resilient individuals had the same alterations in global fiber stream network architecture using two different definitions of resilience: 1) no lifetime history of Axis I or II disorders, and 2) no clinically significant symptoms of anxiety, depression, anger-hostility, or somatization. Second, we confirmed an a priori hypothesis that right amygdala nodal efficiency was lower in asymptomatic resilient than in susceptible participants or control subjects. Third, we identified eight other nodes with reduced nodal efficiency in resilient individuals and showed that nodal efficiency moderated the relationship between maltreatment and psychopathology. Fourth, we found that models based on global network architecture and nodal efficiency could delineate group membership (control, susceptible, resilient) with 75%, 82%, and 80% cross-validated accuracy. CONCLUSIONS Together these findings suggest that sparse fiber networks with increased small-worldness following maltreatment render individuals vulnerable to psychopathology if abnormalities occur in specific nodes, but that decreased ability of certain nodes to propagate information throughout the network mitigates the effects and leads to resilience.
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18
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Lev-Wiesel R, Eisikovits Z, First M, Gottfried R, Mehlhausen D. Prevalence of Child Maltreatment in Israel: A National Epidemiological Study. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2018; 11:141-150. [PMID: 32318144 PMCID: PMC7163892 DOI: 10.1007/s40653-016-0118-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The current study is based on data collected from Jewish and Arab 6th, 8th and 10th grade students (age range 12-17) within the Israeli national school system (N = 12,035). Data collection for the study utilized two complementary instruments: the Childhood Trauma Questionnaire (CTQ) and the Juvenile Victimization Questionnaire (JVQ). Study results revealed that the lifetime prevalence of child maltreatment in contemporary Israeli society is within the range of estimates from other countries. However, contrary to others, Israeli boys reported higher rates of abuse, including sexual abuse, compared to girls. Additionally, Arab compared to Jewish children and youth reported higher rates of all types of abuse. The need for widely accepted, uniform definitions of the various child maltreatment types, a standardized methodology of data collection, and regularly updated national and international data bases is discussed.
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Affiliation(s)
- Rachel Lev-Wiesel
- The Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
| | - Zvi Eisikovits
- The Center for the Study of Society, University of Haifa, Haifa, Israel
| | - Maya First
- The Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
| | - Ruth Gottfried
- The Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
- The Haruv Institute, Jerusalem, Israel
- School of Social Work, Georgia State University, Atlanta, USA
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19
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Childhood maltreatment is associated with alteration in global network fiber-tract architecture independent of history of depression and anxiety. Neuroimage 2017; 150:50-59. [PMID: 28213111 DOI: 10.1016/j.neuroimage.2017.02.037] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 12/31/2016] [Accepted: 02/13/2017] [Indexed: 11/21/2022] Open
Abstract
Childhood maltreatment is a major risk factor for psychopathology. It is also associated with alterations in the network architecture of the brain, which we hypothesized may play a significant role in the development of psychopathology. In this study, we analyzed the global network architecture of physically healthy unmedicated 18-25 year old subjects (n=262) using diffusion tensor imaging (DTI) MRI and tractography. Anatomical networks were constructed from fiber streams interconnecting 90 cortical or subcortical regions for subjects with no-to-low (n=122) versus moderate-to-high (n=140) exposure to maltreatment. Graph theory analysis revealed lower degree, strength, global efficiency, and maximum Laplacian spectra, higher pathlength, small-worldness and Laplacian skewness, and less deviation from artificial networks in subjects with moderate-to-high exposure to maltreatment. On balance, local clustering was similar in both groups, but the different clusters were more strongly interconnected in the no-to-low exposure group. History of major depression, anxiety and attention deficit hyperactivity disorder did not have a significant impact on global network measures over and above the effect of maltreatment. Maltreatment is an important factor that needs to be taken into account in studies examining the relationship between network differences and psychopathology.
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20
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Rehkopf DH, Headen I, Hubbard A, Deardorff J, Kesavan Y, Cohen AK, Patil D, Ritchie LD, Abrams B. Adverse childhood experiences and later life adult obesity and smoking in the United States. Ann Epidemiol 2016; 26:488-492.e5. [PMID: 27449570 PMCID: PMC4966898 DOI: 10.1016/j.annepidem.2016.06.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 05/27/2016] [Accepted: 06/02/2016] [Indexed: 11/22/2022]
Abstract
PURPOSE Prior work demonstrates associations between physical abuse, household alcohol abuse, and household mental illness early in life with obesity and smoking. Studies, however, have not generally been in nationally representative samples and have not conducted analyses to account for bias in the exposure. METHODS We used data from the 1979 U.S. National Longitudinal Survey of Youth to test associations between measures of adverse childhood experiences with obesity and smoking and used an instrumental variables approach to address potential measurement error of the exposure. RESULTS Models demonstrated associations between childhood physical abuse and obesity at age 40 years (odds ratio [OR] 1.23; 95% confidence interval [CI], 1.00-1.52) and ever smoking (OR 1.83; 95% CI, 1.56-2.16), as well as associations between household alcohol abuse (OR 1.53; 95% CI, 1.31-1.79) and household mental illness (OR 1.29; 95% CI, 1.04-1.60) with ever smoking. We find no evidence of association modification by gender, socioeconomic position, or race and/or ethnicity. Instrumental variables analysis using a sibling's report of adverse childhood experiences demonstrated a relationship between household alcohol abuse and smoking, with a population attributable fraction of 17% (95% CI, 2.0%-37%) for ever smoking and 6.7% (95% CI, 1.6%-12%) for currently smoking. CONCLUSIONS Findings suggest long-term impacts of childhood exposure to physical abuse, household alcohol abuse, and parental mental illness on obesity and smoking and that the association between household alcohol abuse and smoking is not solely due to measurement error.
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Affiliation(s)
- David H Rehkopf
- Department of Medicine, Stanford University School of Medicine, Stanford, CA.
| | - Irene Headen
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley
| | - Alan Hubbard
- Division of Biostatistics, School of Public Health, University of California, Berkeley, Berkeley
| | - Julianna Deardorff
- Division of Maternal and Child Health, School of Public Health, University of California, Berkeley, Berkeley
| | - Yamini Kesavan
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley
| | - Alison K Cohen
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley
| | - Divya Patil
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley
| | - Lorrene D Ritchie
- Division of Agriculture and Natural Resources, Nutrition Policy Institute, University of California, Oakland
| | - Barbara Abrams
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley
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21
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Teicher MH, Samson JA. Annual Research Review: Enduring neurobiological effects of childhood abuse and neglect. J Child Psychol Psychiatry 2016; 57:241-66. [PMID: 26831814 PMCID: PMC4760853 DOI: 10.1111/jcpp.12507] [Citation(s) in RCA: 645] [Impact Index Per Article: 80.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Childhood maltreatment is the most important preventable cause of psychopathology accounting for about 45% of the population attributable risk for childhood onset psychiatric disorders. A key breakthrough has been the discovery that maltreatment alters trajectories of brain development. METHODS This review aims to synthesize neuroimaging findings in children who experienced caregiver neglect as well as from studies in children, adolescents and adults who experienced physical, sexual and emotional abuse. In doing so, we provide preliminary answers to questions regarding the importance of type and timing of exposure, gender differences, reversibility and the relationship between brain changes and psychopathology. We also discuss whether these changes represent adaptive modifications or stress-induced damage. RESULTS Parental verbal abuse, witnessing domestic violence and sexual abuse appear to specifically target brain regions (auditory, visual and somatosensory cortex) and pathways that process and convey the aversive experience. Maltreatment is associated with reliable morphological alterations in anterior cingulate, dorsal lateral prefrontal and orbitofrontal cortex, corpus callosum and adult hippocampus, and with enhanced amygdala response to emotional faces and diminished striatal response to anticipated rewards. Evidence is emerging that these regions and interconnecting pathways have sensitive exposure periods when they are most vulnerable. CONCLUSIONS Early deprivation and later abuse may have opposite effects on amygdala volume. Structural and functional abnormalities initially attributed to psychiatric illness may be a more direct consequence of abuse. Childhood maltreatment exerts a prepotent influence on brain development and has been an unrecognized confound in almost all psychiatric neuroimaging studies. These brain changes may be best understood as adaptive responses to facilitate survival and reproduction in the face of adversity. Their relationship to psychopathology is complex as they are discernible in both susceptible and resilient individuals with maltreatment histories. Mechanisms fostering resilience will need to be a primary focus of future studies.
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Affiliation(s)
- Martin H. Teicher
- Department of Psychiatry, Harvard Medical School, Boston, MA,Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| | - Jacqueline A. Samson
- Department of Psychiatry, Harvard Medical School, Boston, MA,Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
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Mood dysregulation and affective instability in emerging adults with childhood maltreatment: An ecological momentary assessment study. J Psychiatr Res 2015; 70:1-8. [PMID: 26424417 PMCID: PMC4684950 DOI: 10.1016/j.jpsychires.2015.08.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/29/2015] [Accepted: 08/13/2015] [Indexed: 12/31/2022]
Abstract
Childhood maltreatment increases risk for mood, anxiety, substance use and personality disorders and is associated with alterations in structure, function and connectivity of brain regions involved in emotional regulation. We sought to assess whether maltreatment was specifically associated with disturbances in positive or negative mood regulation. Ecological momentary ratings were collected with a wristwatch-like device with joy-stick (Seiko ecolog) approximately six times per day over a week in 60 unmedicated participants (22 control, 38 maltreated, 18-25 years old). Forty-five percent of maltreated subjects had a history of major depression but all were currently euthymic. Principal component analysis with varimax rotation was used to provide orthogonal measures of positive and negative valence, which were analyzed for indices of variability, circadian rhythmicity and persistence, using linear and non-linear hierarchical modeling and Hurst analysis. Groups did not differ in mean levels of positive or negative affect. Maltreated subjects had increased variability and circadian and hemicircadian abnormalities in ratings of positive but not negative affect. Conversely, they had higher estimated Hurst exponents for negative but not positive affect ratings indicating a greater degree of persistence. Abnormalities in variability, rhythmicity and persistence were present in both maltreated subjects with and without histories of major depression. These findings suggest that both positive and negative valence systems may be dysregulated in individuals with childhood maltreatment. However the nature of the dysregulation appears to differ fundamentally in these domains, as positive mood ratings were more variable and negative ratings more persistent.
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Frewen P, Brown M, DePierro J, D'Andrea W, Schore A. Assessing the family dynamics of childhood maltreatment history with the Childhood Attachment and Relational Trauma Screen (CARTS). Eur J Psychotraumatol 2015; 6:27792. [PMID: 26243548 PMCID: PMC4524890 DOI: 10.3402/ejpt.v6.27792] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 06/22/2015] [Accepted: 06/25/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Existing survey measures of childhood trauma history generally fail to take into account the relational-socioecological environment in which childhood maltreatment occurs. Variables such as the relationship between the perpetrator and the victim, the emotional availability of caregivers, witnessing the abuse of others, and the respondent's own thoughts, feelings, and actions in response to maltreatment are rarely assessed by current measures. METHODS To address these concerns, the current study further investigated the family dynamics of childhood maltreatment using the Childhood Attachment and Relational Trauma Screen (CARTS) in 1,782 persons assessed online. RESULTS Paired differences in means between item-rated descriptiveness of self, mothers, and fathers suggested that respondents' relationship with their biological fathers was less positive and secure than their relationship with their biological mothers, and that biological fathers were more often the perpetrator of emotional, physical, and sexual abuse than biological mothers. However, results further suggested that ratings between self, mothers, and fathers were positively correlated such that, for example, reports of a mother's or a respondent's own abusive behavior were more likely in the presence of reports of a father's abusive behavior. In addition, analyses evaluating witnessing violence demonstrated that fathers were rated as more often violent toward mothers than the reverse, although intimate partner violence was also frequently bidirectional. Analyses of sibling ratings further demonstrated that older brothers were either as or more frequently abusive when compared with parents. Finally, results suggested that childhood emotional, physical, and sexual abuse were much more often perpetrated by family members than extra-familial and non-family members. CONCLUSIONS In so far as these findings are consistent with the prior childhood trauma and attachment literature, the current study further supports the utility of the CARTS as a means of assessing the family dynamics of childhood attachment and maltreatment within a relational-socioecological framework.
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Affiliation(s)
- Paul Frewen
- Departments of Psychiatry, Psychology, and Graduate Program in Neuroscience, Western University Canada, London, Ontario, Canada;
| | - Matthew Brown
- Department of Psychology, Western University, London, Ontario, Canada
| | - Jonathan DePierro
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Wendy D'Andrea
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Allan Schore
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Type and timing of childhood maltreatment and severity of shutdown dissociation in patients with schizophrenia spectrum disorder. PLoS One 2015; 10:e0127151. [PMID: 25992568 PMCID: PMC4438058 DOI: 10.1371/journal.pone.0127151] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 04/13/2015] [Indexed: 11/19/2022] Open
Abstract
Dissociation, particularly the shutting down of sensory, motor and speech systems, has been proposed to emerge in susceptible individuals as a defensive response to traumatic stress. In contrast, other individuals show signs of hyperarousal to acute threat. A key question is whether exposure to particular types of stressful events during specific stages of development can program an individual to have a strong dissociative response to subsequent stressors. Vulnerability to ongoing shutdown dissociation was assessed in 75 inpatients (46M/29F, M = 31±10 years old) with schizophrenia spectrum disorder and related to number of traumatic events experienced or witnessed during childhood or adulthood. The Maltreatment and Abuse Chronology of Exposure (MACE) scale was used to collect retrospective recall of exposure to ten types of maltreatment during each year of childhood. Severity of shutdown dissociation was related to number of childhood but not adult traumatic events. Random forest regression with conditional trees indicated that type and timing of childhood maltreatment could predictably account for 31% of the variance (p < 0.003) in shutdown dissociation, with peak vulnerability occurring at 13-14 years of age and with exposure to emotional neglect followed by various forms of emotional abuse. These findings suggest that there may be windows of vulnerability to the development of shutdown dissociation. Results support the hypothesis that experienced events are more important than witnessed events, but challenge the hypothesis that “life-threatening” events are a critical determinant.
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25
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Khan A, McCormack HC, Bolger EA, McGreenery CE, Vitaliano G, Polcari A, Teicher MH. Childhood Maltreatment, Depression, and Suicidal Ideation: Critical Importance of Parental and Peer Emotional Abuse during Developmental Sensitive Periods in Males and Females. Front Psychiatry 2015; 6:42. [PMID: 25870565 PMCID: PMC4378368 DOI: 10.3389/fpsyt.2015.00042] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 03/09/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The adverse childhood experience (ACE) study found that risk for depression increased as a function of number of types of childhood maltreatment, and interpret this as a result of cumulative stress. An alternative hypothesis is that risk depends on type and timing of maltreatment. This will also present as a linear increase, since exposure to more types of abuse increases likelihood of experiencing a critical type of abuse at a critical age. METHODS 560 (223M/337F) young adults (18-25 years) were recruited from the community without regard to diagnosis and balanced to have equal exposure to 0-4 plus types of maltreatment. The Maltreatment and Abuse Chronology of Exposure Scale assessed severity of exposure to 10 types of maltreatment across each year of childhood. Major depressive disorder (MDD) and current symptoms were evaluated by SCID, interview, and self-report. Predictive analytics assessed importance of exposure at each age and evaluated whether exposure at one or two ages was a more important predictor than number, severity, or duration of maltreatment across childhood. RESULTS The most important predictors of lifetime history of MDD were non-verbal emotional abuse in males and peer emotional abuse (EA) in females at 14 years of age, and these were more important predictors across models than number of types of maltreatment (males: t 9 = 16.39, p < 10(-7); females t 9 = 5.78, p < 10(-4)). Suicidal ideation was predicted, in part, by NVEA and peer EA at age 14, but most importantly by parental verbal abuse at age 5 in males and sexual abuse at age 18 in females. CONCLUSION This study provides evidence for sensitive exposure periods when maltreatment maximally impacts risk for depression, and provides an alternative interpretation of the ACE study results. These findings fit with emerging neuroimaging evidence for regional sensitivity periods. The presence of sensitive exposure periods has important implications for prevention, preemption, and treatment of MDD.
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Affiliation(s)
- Alaptagin Khan
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Hannah C. McCormack
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| | - Elizabeth A. Bolger
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| | | | - Gordana Vitaliano
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Ann Polcari
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
- School of Nursing, Northeastern University, Belmont, MA, USA
| | - Martin H. Teicher
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
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26
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Teicher MH, Parigger A. The 'Maltreatment and Abuse Chronology of Exposure' (MACE) scale for the retrospective assessment of abuse and neglect during development. PLoS One 2015; 10:e0117423. [PMID: 25714856 PMCID: PMC4340880 DOI: 10.1371/journal.pone.0117423] [Citation(s) in RCA: 213] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 12/22/2014] [Indexed: 01/06/2023] Open
Abstract
There is increasing interest in childhood maltreatment as a potent stimulus that may alter trajectories of brain development, induce epigenetic modifications and enhance risk for medical and psychiatric disorders. Although a number of useful scales exist for retrospective assessment of abuse and neglect they have significant limitations. Moreover, they fail to provide detailed information on timing of exposure, which is critical for delineation of sensitive periods. The Maltreatment and Abuse Chronology of Exposure (MACE) scale was developed in a sample of 1051 participants using item response theory to gauge severity of exposure to ten types of maltreatment (emotional neglect, non-verbal emotional abuse, parental physical maltreatment, parental verbal abuse, peer emotional abuse, peer physical bullying, physical neglect, sexual abuse, witnessing interparental violence and witnessing violence to siblings) during each year of childhood. Items included in the subscales had acceptable psychometric properties based on infit and outfit mean square statistics, and each subscale passed Andersen's Likelihood ratio test. The MACE provides an overall severity score and multiplicity score (number of types of maltreatment experienced) with excellent test-retest reliability. Each type of maltreatment showed good reliability as did severity of exposure across each year of childhood. MACE Severity correlated 0.738 with Childhood Trauma Questionnaire (CTQ) score and MACE Multiplicity correlated 0.698 with the Adverse Childhood Experiences scale (ACE). However, MACE accounted for 2.00- and 2.07-fold more of the variance, on average, in psychiatric symptom ratings than CTQ or ACE, respectively, based on variance decomposition. Different types of maltreatment had distinct and often unique developmental patterns. The 52-item MACE, a simpler Maltreatment Abuse and Exposure Scale (MAES) that only assesses overall exposure and the original test instrument (MACE-X) with several additional items plus spreadsheets and R code for scoring are provided to facilitate use and to spur further development.
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Affiliation(s)
- Martin H. Teicher
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, United States of America
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, Massachusetts, United States of America
- * E-mail:
| | - Angelika Parigger
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, Massachusetts, United States of America
- Department of Psychology, University of Konstanz, Konstanz, Germany
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Isele D, Teicher MH, Ruf-Leuschner M, Elbert T, Kolassa IT, Schury K, Schauer M. KERF–Ein Instrument zur umfassenden Ermittlung belastender Kindheitserfahrungen. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2014. [DOI: 10.1026/1616-3443/a000257] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Hintergrund: Belastende Kindheitserfahrungen steigern das Risiko für Psychopathologie und beeinflussen die Erkrankungsschwere und den Behandlungserfolg. Validierte Instrumente zur umfangreichen Erfassung von Kindheitsbelastungen sind für die klinisch-psychologische Arbeit unabdingbar jedoch nur bedingt vorhanden. Fragestellung: Diese Arbeit stellt die Konstruktion und psychometrische Prüfung der Skala „Belastende Kindheitserfahrungen” (KERF), einem Instrument zur umfangreichen Erfassung von Kindheitsbelastungen vor. Die KERF beruht auf einer modifizierten Version des US-amerikanischen „Adversive Childhood Experiences” Index. Methode: Basierend auf den Daten von 165 Probandinnen wurden mit Rasch-Modellen zehn Subskalen modelliert. Korrelationen mit dem CTQ (Childhood Trauma Questionnaire) und Psychopathologie wurden bestimmt. Ergebnisse: Unterstützt durch konzeptuelle Überlegungen konnten zehn Subskalen gebildet werden. Wir fanden zufriedenstellende Assoziationen mit dem CTQ und Psychopathologie. Schlussfolgerungen: KERF ermöglicht eine detaillierte valide Erfassung belastender Kindheitserfahrungen.
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Polcari A, Rabi K, Bolger E, Teicher MH. Parental verbal affection and verbal aggression in childhood differentially influence psychiatric symptoms and wellbeing in young adulthood. CHILD ABUSE & NEGLECT 2014; 38:91-102. [PMID: 24268711 PMCID: PMC3946237 DOI: 10.1016/j.chiabu.2013.10.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 09/19/2013] [Accepted: 10/03/2013] [Indexed: 05/18/2023]
Abstract
Previous research has shown that exposure to parental verbal aggression is common and associated with increased levels of depression, anxiety, dissociation, and drug use. A key question that has not been addressed is whether verbal affection from the same or opposite parent can attenuate the effects of verbal aggression. This cross-sectional study examined the effects of parental verbal aggression and affection during childhood on measures of psychopathology and wellbeing in a community sample of 2,518 individuals (18-25 years). Data were analyzed for moderating influences using mixed effect models and for direct and indirect effects using structural equation models. The moderation analysis suggested that high levels of exposure to verbal affection did not mitigate the effects of verbal aggression from the same parent, and high levels of verbal affection from another parent did not generally result in a significant attenuation of the effects of verbal aggression. Structural equation models showed that verbal aggression was predominantly associated with effects on psychiatric symptoms scores, whereas verbal affection was primarily associated with effects on measures of wellbeing. These findings highlight the relatively independent effects of verbal aggression and verbal affection and suggest that the latter may be particularly important in establishing a foundation for emotional and physical wellbeing. These findings also suggest that ridicule, disdain, and humiliation cannot be easily counteracted by praise and warmth from the same or another parent.
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Affiliation(s)
- Ann Polcari
- Northeastern University, Bouvé College of Health Sciences, School of Nursing, 360 Huntington Avenue, Boston, MA 02115
- Developmental Biopsychiatry Research Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478
- Department of Psychiatry, Harvard Medical School
| | - Keren Rabi
- Developmental Biopsychiatry Research Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478
| | - Elizabeth Bolger
- Developmental Biopsychiatry Research Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478
| | - Martin H. Teicher
- Developmental Biopsychiatry Research Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478
- Department of Psychiatry, Harvard Medical School
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Tomoda A, Nishitani S, Matsuura N, Fujisawa TX, Kawatani J, Toyohisa D, Ono M, Shinohara K. No interaction between serotonin transporter gene (5-HTTLPR) polymorphism and adversity on depression among Japanese children and adolescents. BMC Psychiatry 2013; 13:134. [PMID: 23663729 PMCID: PMC3653806 DOI: 10.1186/1471-244x-13-134] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 04/16/2013] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Identification of gene × environment interactions (G × E) for depression is a crucial step in ascertaining the mechanisms underpinning the disorder. Earlier studies have indicated strong genetic influences and numerous environmental risk factors. In relation to childhood and adolescent depression, evidence is accumulating that the quality of the parental environment is associated with serotonin biology in children. We hypothesized that maternal depression is a crucial environmental risk factor associated with serotonin-regulating genes. METHODS This study was designed to ascertain the G × E interaction for diagnosis of depression in a Japanese pediatric sample. DNA samples from 55 pediatric patients with depression and 58 healthy schoolchildren were genotyped for the 5-HTT (2 short (S) alleles at the 5-HTT locus) promoter serotonin-transporter-linked polymorphic region (5-HTTLPR) polymorphism. We examined whether an adverse parental environment, operationalized as the mother's history of recurrent major depressive disorder, interacts with 5-HTTLPR polymorphism to predict patients' depression symptoms. RESULTS Binary logistic regression analyses revealed that maternal depression (adversity), gender, and FSIQ significantly affect the diagnosis of depression among children and adolescents. However, no main effect was found for adversity or genotype. Results of multivariable logistic regression analyses using stepwise procedure have elicited some models with a good fit index, which also suggests no interaction between 5-HTTLPR and adversity on depression. CONCLUSIONS To assess G × E interaction, data obtained from children and adolescents who had been carefully diagnosed categorically and data from age-matched controls were analyzed using logistic regression. Despite an equivocal interaction effect, adversity and gender showed significant main effects.
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Affiliation(s)
- Akemi Tomoda
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan.
| | - Shota Nishitani
- Department of Neurobiology& Behavior Unit of Basic Medical Sciences Course of Medical & Dental Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naomi Matsuura
- School of Education, Tokyo University and Graduate School of Social Welfare, Tokyo, Japan
| | - Takashi X Fujisawa
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan,Department of Neurobiology& Behavior Unit of Basic Medical Sciences Course of Medical & Dental Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Junko Kawatani
- Department of Child Development, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Daiki Toyohisa
- Department of Child Development, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Mai Ono
- Department of Child Development, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kazuyuki Shinohara
- Department of Neurobiology& Behavior Unit of Basic Medical Sciences Course of Medical & Dental Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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