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Schalkwijk F, Van Someren EJW, Nicolai NJ, Uijttewaal JL, Wassing R. From childhood trauma to hyperarousal in adults: The mediating effect of maladaptive shame coping and insomnia. Front Hum Neurosci 2023; 17:990581. [PMID: 36875235 PMCID: PMC9978488 DOI: 10.3389/fnhum.2023.990581] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 01/26/2023] [Indexed: 02/18/2023] Open
Abstract
Introduction A new line of insomnia research focuses on the developmental trajectories from early live stress to insomnia in adulthood. Adverse childhood experiences (ACE's) might create a vulnerability for later maladaptive coping with distress, as seen in chronic hyperarousal or insomnia. In an functional magnetic resonance imaging (fMRI) study, failure to dissociate the neurobiological components of shame from autobiographical shameful memories in insomnia was reflected by continued activation of the dorsal anterior cingulate cortex (dACC), which may be a result of maladaptive coping in the wake of ACE's. Following up on that study, the current pilot study explores the relation between ACE's, shame coping-styles, adult insomnia, hyperarousal, and neurobiology of autobiographical memory. Methods We used existing data (N = 57) from individuals with insomnia (N = 27) and controls (N = 30), and asked these participants to complete the childhood trauma questionnaire (CTQ). Two structural equation models were used to test the hypotheses that shame-coping styles and insomnia symptom severity mediate the association between ACE's and (1) self-rated hyperarousal symptoms and (2) dACC activation to recall of autobiographical memories. Results For the association between ACE's and hyperarousal, there was a significant mediation of shame-coping style (p < 0.05). This model also indicated worse shame coping with more ACE's (p < 0.05) and worse insomnia symptoms with more ACES's (p < 0.05), but no association between shame coping and insomnia symptoms (p = 0.154). In contrast, dACC activation to recall of autobiographical memories could only be explained by its direct association with ACE's (p < 0.05), albeit that in this model more ACE's were also associated with worse insomnia symptoms. Discussion These findings could have an implication for the approach of treatment for insomnia. It could be focused more on trauma and emotional processing instead of conventional sleep interventions. Future studies are recommended to investigate the relationship mechanism between childhood trauma and insomnia, with additional factors of attachment styles, personality, and temperament.
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Affiliation(s)
- Frans Schalkwijk
- Department of Forensic Special Education, University of Amsterdam, Amsterdam, Netherlands
| | - Eus J W Van Someren
- Netherlands Institute for Neuroscience, Amsterdam, Netherlands.,Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Julia L Uijttewaal
- Department of Forensic Special Education, University of Amsterdam, Amsterdam, Netherlands
| | - Rick Wassing
- Netherlands Institute for Neuroscience, Amsterdam, Netherlands.,Woolcock Institute of Medical Research, Sydney, NSW, Australia
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Ling H, Meng F, Yan Y, Feng H, Zhang J, Zhang L, Yuan S. Why Is Maternal Control Harmful? The Relation between Maternal Control, Insecure Attachment and Antisocial Personality Disorder Features in Chinese College Students: A Sequential Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10900. [PMID: 36078615 PMCID: PMC9518312 DOI: 10.3390/ijerph191710900] [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] [Received: 04/12/2022] [Revised: 05/23/2022] [Accepted: 05/28/2022] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous work has indicated that a negative parenting style is associated with antisocial personality disorder features in Chinese college students, yet few studies have explored the unique role of negative mothering in children's antisocial personality disorder. METHODS The current study mainly examined the sequential mediation effect of parental antipathy and neglect (PAN) and mother negative loving (a form of insecure attachment) in the association between mother control and adulthood antisocial personality disorder features (ASPD features) in the framework of attachment theory and cognitive-behavioral theory. A community sample of 1547 Chinese college students filled in the Parental Bonding Instrument, the Childhood Experience of Care and Abuse Questionnaire, the Adult Attachment Questionnaire and the Personality Diagnostic Questionnaire-4+. RESULTS A sequential mediation model analysis showed that maternal control significantly predicted PAN, mother negative loving, as well as ASPD features. CONCLUSIONS Mother control and mother negative loving appear to advance on the development and exacerbation of ASPD features in college students.
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Affiliation(s)
- Hui Ling
- Department of Psychology, Hunan Normal University, Changsha 410081, China
| | - Fanfei Meng
- School of Preschool Education, Changsha Normal University, Changsha 410100, China
| | - Yaqin Yan
- Department of Psychology, Hunan Normal University, Changsha 410081, China
- Department of Student Affairs, Hunan First Normal University, Changsha 410205, China
| | - Hong Feng
- Hunan Wenjin Research Institute of Education, Changsha 410013, China
| | - Jianren Zhang
- Department of Psychology, Hunan Normal University, Changsha 410081, China
- Cognition & Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha 410081, China
| | - Linrui Zhang
- Department of Psychology, University of Toronto Scarborough, Toronto, ON M4Y 1M7, Canada
| | - Siyang Yuan
- School of Dentistry, University of Dundee, Dundee DD1 4HN, UK
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Abstract
PURPOSE OF REVIEW Loneliness is a common experience in patients with personality disorders (PDs) that are characterized by impairment in self (identity, self-direction) and interpersonal functioning (empathy, intimacy). Here, we review studies assessing the association of loneliness with PD or PD traits including DSM-5's Alternative Model of PD (AMPD). RECENT FINDINGS The number of loneliness studies varied greatly among different PDs with most studies conducted in borderline PD. Across PDs, loneliness was associated with the severity of psychopathological symptoms and with several AMPD trait domains. Consequently, loneliness may contribute to PD severity and further impair personality functioning. Loneliness and PD share intra- and interpersonal factors (i.e., increased rejection sensitivity, information processing biases, social withdrawal) and common origins in childhood maltreatment that may explain their close association. Future research needs to investigate mechanisms on how loneliness and core characteristics of PD mutually reinforce each other in order to therapeutically address loneliness in PD.
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Affiliation(s)
- Matthias A. Reinhard
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Tabea Nenov-Matt
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Nussbaumstr. 7, 80336 Munich, Germany
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Kavanagh BE, Gwini SM, Pasco JA, Stuart AL, Quirk SE, Gaston J, Holloway-Kew KL, Turner A, Berk M, Dean OM, Chanen AM, Koivumaa-Honkanen H, Moran P, Borschmann R, Williams LJ. The Added Burden of Personality Disorder on Subsidized Australian Health Service Utilization Among Women With Mental State Disorder. Front Glob Womens Health 2021; 2:615057. [PMID: 34816186 PMCID: PMC8593946 DOI: 10.3389/fgwh.2021.615057] [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: 10/08/2020] [Accepted: 02/23/2021] [Indexed: 11/25/2022] Open
Abstract
This study aimed to investigate health service utilization among women with mental state disorder only (MSD-PD), mental state disorder plus personality disorder (MSD+PD), and controls in a population-based sample. Women (n = 635) from the Geelong Osteoporosis Study completed mental health assessments and were categorized into groups (MSD-PD, MSD+PD, controls). General practitioner (mental and non-mental health encounters) and specialized mental health service utilization was ascertained from data linkage to the Medicare Benefits Schedule, Australia (01/09/2008-31/12/2012). Negative binomial and binary logistic regression models were employed to assess health service utilization differences between groups. Results indicated that women with MSD+PD had more encounters of non-mental health service utilization than women with MSD-PD and controls. Age significantly modified these relationships: women with MSD+PD and MSD-PD had more encounters of health service utilization at midlife and in the seventh decade of life. No significant differences were found in the frequency of general practitioner mental health service utilization or specialized mental health service utilization between groups. These data suggest that the presence of co-occurring PD is associated with increased health service utilization among women with other common mental health problems. Healthcare providers should be vigilant to the presence of PD when establishing management plans with patients presenting with common mental health problems.
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Affiliation(s)
- Bianca E Kavanagh
- School of Medicine, Institute for Physical and Mental Health and Clinical Translation, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Stella M Gwini
- School of Medicine, Institute for Physical and Mental Health and Clinical Translation, Barwon Health, Deakin University, Geelong, VIC, Australia.,University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
| | - Julie A Pasco
- School of Medicine, Institute for Physical and Mental Health and Clinical Translation, Barwon Health, Deakin University, Geelong, VIC, Australia.,University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Medicine-Western Health, University of Melbourne, St. Albans, VIC, Australia
| | - Amanda L Stuart
- School of Medicine, Institute for Physical and Mental Health and Clinical Translation, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Shae E Quirk
- School of Medicine, Institute for Physical and Mental Health and Clinical Translation, Barwon Health, Deakin University, Geelong, VIC, Australia.,Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland.,Institute of Clinical Medicine, Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, Kuopio, Finland
| | - James Gaston
- School of Medicine, Institute for Physical and Mental Health and Clinical Translation, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Kara L Holloway-Kew
- School of Medicine, Institute for Physical and Mental Health and Clinical Translation, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Alyna Turner
- School of Medicine, Institute for Physical and Mental Health and Clinical Translation, Barwon Health, Deakin University, Geelong, VIC, Australia.,Faculty of Health and Medicine, School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Michael Berk
- School of Medicine, Institute for Physical and Mental Health and Clinical Translation, Barwon Health, Deakin University, Geelong, VIC, Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.,Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia.,Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Olivia M Dean
- School of Medicine, Institute for Physical and Mental Health and Clinical Translation, Barwon Health, Deakin University, Geelong, VIC, Australia.,University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Andrew M Chanen
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Heli Koivumaa-Honkanen
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland.,Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Paul Moran
- Population Health Sciences Department, Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Rohan Borschmann
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Lana J Williams
- School of Medicine, Institute for Physical and Mental Health and Clinical Translation, Barwon Health, Deakin University, Geelong, VIC, Australia
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Erkoreka L, Zamalloa I, Rodriguez S, Muñoz P, Mendizabal I, Zamalloa MI, Arrue A, Zumarraga M, Gonzalez-Torres MA. Attachment anxiety as mediator of the relationship between childhood trauma and personality dysfunction in borderline personality disorder. Clin Psychol Psychother 2021; 29:501-511. [PMID: 34228846 DOI: 10.1002/cpp.2640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/11/2022]
Abstract
Insecure attachment has been described as mediating the relationship between childhood trauma and dysfunctional personality traits in different mental disorders. Despite the role insecure attachment and childhood trauma have independently demonstrated to play as determinants of borderline personality disorder, less is known about the mediating mechanisms explaining these associations. For the first time, we assessed adult attachment, childhood trauma and dimensional personality pathology in a sample of outpatients with borderline personality disorder and tested whether the association between childhood trauma and personality dysfunction was at least partially attributable to insecure attachment. The results showed that attachment anxiety fully mediated the relationship between specific types of trauma (emotional abuse and physical neglect) and emotional dysregulation. Further, emotional abuse was both directly associated with dissocial behaviour and indirectly via attachment anxiety (partial mediation). Emotional abuse has been described as an essential environmental factor for the development of borderline personality disorder and emotional dysregulation, on its part, as the core feature of the condition. Our results indicate that attachment anxiety explains the link between these central aspects of borderline personality disorder. Our findings are consistent with previous research and current etiological understanding of the condition and provide support for recommending a careful assessment of childhood traumatic experiences and adult attachment style to gain a more comprehensive insight into the symptoms and its heterogeneity. As a secondary aim, we assessed the effect parental mental illness may have in these mediation models, but no significant influence on childhood trauma, attachment or personality was found.
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Affiliation(s)
- Leire Erkoreka
- Department of Psychiatry, Galdakao-Usansolo Hospital, Osakidetza Basque Health Service, Galdakao, Spain.,Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Iker Zamalloa
- Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain
| | | | - Pedro Muñoz
- Eating Disorders Unit, Bizkaia Mental Health Network, Osakidetza Basque Health Service, Barakaldo, Spain
| | - Imanol Mendizabal
- Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain
| | - M Isabel Zamalloa
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Neurochemical Research, Bizkaia Mental Health Network, Osakidetza Basque Health Service, Barakaldo, Spain
| | - Aurora Arrue
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Neurochemical Research, Bizkaia Mental Health Network, Osakidetza Basque Health Service, Barakaldo, Spain
| | - Mercedes Zumarraga
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Neurochemical Research, Bizkaia Mental Health Network, Osakidetza Basque Health Service, Barakaldo, Spain
| | - Miguel Angel Gonzalez-Torres
- Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Psychiatry, Basurto University Hospital, Osakidetza Basque Health Service, Bilbao, Spain
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