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Vidal AC, Sosnowski DW, Marchesoni J, Grenier C, Thorp J, Murphy SK, Johnson SB, Schlief W, Hoyo C. Maternal adverse childhood experiences (ACEs) and offspring imprinted gene DMR methylation at birth. Epigenetics 2024; 19:2293412. [PMID: 38100614 PMCID: PMC10730185 DOI: 10.1080/15592294.2023.2293412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023] Open
Abstract
Adverse childhood experiences (ACEs) contribute to numerous negative health outcomes across the life course and across generations. Here, we extend prior work by examining the association of maternal ACEs, and their interaction with financial stress and discrimination, with methylation status within eight differentially methylated regions (DMRs) in imprinted domains in newborns. ACEs, financial stress during pregnancy, and experience of discrimination were self-reported among 232 pregnant women. DNA methylation was assessed at PEG10/SGCE, NNAT, IGF2, H19, PLAGL1, PEG3, MEG3-IG, and DLK1/MEG3 regulatory sequences using pyrosequencing. Using multivariable linear regression models, we found evidence to suggest that financial stress was associated with hypermethylation of MEG3-IG in non-Hispanic White newborns; discrimination was associated with hypermethylation of IGF2 and NNAT in Hispanic newborns, and with hypomethylation of PEG3 in non-Hispanic Black newborns. We also found evidence that maternal ACEs interacted with discrimination to predict offspring PLAGL1 altered DMR methylation, in addition to interactions between maternal ACEs score and discrimination predicting H19 and SGCE/PEG10 altered methylation in non-Hispanic White newborns. However, these interactions were not statistically significant after multiple testing corrections. Findings from this study suggest that maternal ACEs, discrimination, and financial stress are associated with newborn aberrant methylation in imprinted gene regions.
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Affiliation(s)
- Adriana C. Vidal
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - David W. Sosnowski
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joddy Marchesoni
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Carole Grenier
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - John Thorp
- Department of Obstetrics and Gynecology, Maternal and Child Health, UNC Gillings School of Public Health, UNC, Chapel Hill, NC, USA
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Sara B. Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - William Schlief
- Johns Hopkins All Children’s Pediatric Biorepository, Johns Hopkins All Children’s Hospital, St. Petersburg, FL, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
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Guastaferro K, Melchior MS, Heng S, Trudeau J, Holloway JL. Maximizing the reach of universal child sexual abuse prevention: Protocol for an equivalence trial. Contemp Clin Trials Commun 2024; 41:101345. [PMID: 39188413 PMCID: PMC11345503 DOI: 10.1016/j.conctc.2024.101345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/19/2024] [Accepted: 07/27/2024] [Indexed: 08/28/2024] Open
Abstract
Background Child sexual abuse (CSA) affects 1 in 5 girls and 1 in 12 boys before age 18. Universal school-based prevention programs are an effective and cost-efficient method of teaching students an array of personal safety skills. However, the programmatic reach of universal school-based programs is limited by the inherent reliance on the school infrastructure and a dearth of available alternative delivery modalities. Methods The design for this study will use a rigorous cluster randomized design (N = 180 classrooms) to determine the equivalence of two delivery modalities of Safe Touches: as usual vs. modified. The as usual workshop will be delivered by two facilitators with live puppet skits (n = 90). Whereas, the modified workshop will be delivered by one facilitator using prerecorded skit videos (n = 90). We will determine the equivalence by measuring concept learning acquisition preworkshop to immediate postworkshop (Aim 1) and retention at 3-months postworkshop (Aim 2) among students in classrooms that receive the as usual or modified workshops. To conclude equivalence, it is imperative to also examine factors that may impact future dissemination and implementation, specifically program adoption among school personnel and implementation fidelity between the two modalities (Aim 3). Conclusion Study findings will inform the ongoing development of effective CSA prevention programs and policy decisions regarding the sustainable integration of such programs within schools. Clinical trial registration NCT06195852.
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Affiliation(s)
- Kate Guastaferro
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, 708 Broadway, 6th Floor Room 636, New York, NY, 10003, USA
| | - Mia S. Melchior
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, 708 Broadway, 6th Floor Room 636, New York, NY, 10003, USA
| | - Siyu Heng
- Department of Biostatistics, School of Global Public Health, New York University, 708 Broadway, 7th Floor Room 743, New York, NY, 10003, USA
| | - Jessica Trudeau
- New York Society for the Prevention of Cruelty to Children, 520 8 Avenue Suite 1401, New York, NY, 10018, USA
| | - Jacqueline L. Holloway
- New York Society for the Prevention of Cruelty to Children, 520 8 Avenue Suite 1401, New York, NY, 10018, USA
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Luciani KR, Johal PK, Chao T, Thiessen KA, Schütz CG. Adult self-reported childhood maltreatment types are associated with treatment satisfaction and alcohol relapse in patients with comorbid substance use and mental health disorders. Am J Addict 2024; 33:516-524. [PMID: 38504581 DOI: 10.1111/ajad.13535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/25/2024] [Accepted: 02/29/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Individuals with comorbid substance use and mental health disorders (concurrent disorders; CD) report poor treatment outcomes, high prevalence of childhood maltreatment, and mostly negative experiences with treatment. No studies to date have examined childhood maltreatment and treatment outcomes in CD. This study investigated self-reported childhood maltreatment as it relates to treatment satisfaction and substance use relapse among CD patients. METHODS The 258 CD inpatients completed a self-report questionnaire package, comprising the Childhood Trauma Questionnaire and the Inpatient Consumer Survey (ICS). Childhood maltreatment was assessed according to five subtypes and self-perceived treatment satisfaction was rated across six ICS domains. Psychiatric diagnoses, substance use status and relapse data were retrieved via patient medical charts. RESULTS Emotional neglect was associated with lower ratings across all ICS domains and physical neglect was associated with a lower rating for 'outcome of care'. Childhood sexual abuse was associated with a greater likelihood of alcohol relapse. No other relationships were statistically significant. DISCUSSION AND CONCLUSIONS The presence of childhood neglect (but not abuse) was more associated with overall treatment dissatisfaction, and sexual abuse alone increased the likelihood of alcohol relapse. These findings suggest some early adverse experiences in CD patients may increase negative experiences in treatment while others contribute to the risk of substance use. Broader longitudinal research is needed to examine the trajectory leading to negative outcomes. SCIENTIFIC SIGNIFICANCE This is the first study to report differential patterns of association by type of childhood maltreatment on negative outcomes in treatment among CD patients.
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Affiliation(s)
- Karling R Luciani
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Priya K Johal
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Thomas Chao
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Karina A Thiessen
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christian G Schütz
- Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- BC Mental Health & Substance Use Services Research Institute, PHSA, Vancouver, British Columbia, Canada
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Blankenship P, Hogge I. Self-Compassion and Psychological Well-Being of Childhood Sexual Abuse Survivors: Emotional Dysregulation and Trauma-Related Shame as Mediators. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241268781. [PMID: 39183692 DOI: 10.1177/08862605241268781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
In this study, we explored explanations for the link between self-compassion and psychological well-being among a sample of adult childhood sexual abuse (CSA) survivors in the United States (n = 335). Informed by Neff's self-compassion theory, we hypothesized that the relationship between self-compassion and psychological well-being would be partially explained by a reduction in emotional dysregulation and trauma-related shame. We tested a parallel multiple mediation model with (a) emotion dysregulation and (b) trauma-related shame as the mediators. As hypothesized, we found a significant positive relationship between self-compassion and psychological well-being among the sample of CSA survivors. Emotional dysregulation and trauma-related shame were both significant mediators of this relationship. However, self-compassion had a significant direct effect even after accounting for the two mediators, which suggests partial mediation. Our results provide further support for the link between self-compassion and psychological well-being and identify reductions in both emotional dysregulation and trauma-related shame as potential mechanisms for this relationship. This study also has implications for clinical practice and prevention efforts that integrate self-compassion, emotion regulation, and trauma-related shame as salient areas of focus.
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Antunes MJL, Ahlin EM. Should I Stay, or Should I Go Now? Neighborhood, Family, and Youth Predictors of Intracity Mobility. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241271373. [PMID: 39183698 DOI: 10.1177/08862605241271373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
The effects of residential mobility on youth development outcomes related to violence and victimization have traditionally been understood from an outward mobility perspective. Less attention has been paid to predictors of intracity moves, a more common mobility practice. Research, however, should identify factors associated with intracity mobility before scholars can explore and fully understand the impacts of moving within the city on youth development outcomes such as violence and victimization and whether they are akin to those identified for moves beyond city limits. Using data from the Project on Human Development in Chicago Neighborhoods, we apply a multilevel ecological framework to assess neighborhood, family, and youth factors associated with intracity mobility. We employed hierarchical generalized linear modeling to examine within and between-neighborhood models of intracity mobility among youth and their families who moved within Chicago (N = 426) and those who did not (N = 867). Our investigation highlights as important factors family dynamics instability and aggression and violence at the neighborhood level. Findings show that parental divorce/separation, harsh disciplinary practices, negative school experiences such as racial/ethnic conflict, gangs, or heightened security measures, and exposure to violence predict intracity mobility. Critically, negative school experiences proved to be a robust determinant of moving as cross-level interactions suggest neighborhood crime significantly shapes how these experiences inform intracity mobility. This study emphasizes the importance of examining mobility beyond urban city limits, noting distinct predictors of intracity mobility across systemic levels. The findings fill a gap in our understanding of neighborhood turnover and stability, while also providing a foundation for exploring within and between-neighborhood differences in intracity mobility.
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Zheng Q, Feng Y, Li J, Xu S, Ma Z, Wang Y. Distinct characteristics of social anxiety among youths with childhood sexual abuse: A latent profile analysis. CHILD ABUSE & NEGLECT 2024; 155:106967. [PMID: 39173507 DOI: 10.1016/j.chiabu.2024.106967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 07/20/2024] [Accepted: 07/29/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Childhood sexual abuse (CSA) is one type of childhood trauma that has long-term effects on physical and mental health, predisposing to social anxiety. OBJECTIVE This study attempted to investigate the characteristics of different subgroups of social anxiety among youths with CSA experiences. PARTICIPANTS AND SETTING 83,219 participants were recruited in a cross-sectional study from 63 colleges and universities in Jilin Province, China. METHODS The main variables were measured by a series of self-report questionnaires. Latent profile analysis was used to classify different subgroups of social anxiety, and multiple logistic regression was employed to investigate factors influencing transitions between different subgroups. RESULTS 3022 (3.63 %) youths who suffered from CSA (46.8 % were male, Mage = 19.57, SD = 1.76) could be divided into four subgroups of social anxiety: low-risk social anxiety (16.4 %), medium-risk social anxiety with high public speaking anxiety (30.3 %), medium-risk social anxiety with no prominent characteristics (22.9 %), and high-risk social anxiety (30.4 %). Shy bladder and bowel and virtual life orientation increased the level of social anxiety from low to medium and high risk. Smoking and drinking were more prevalent in the low- and medium-risk subgroups than in the high-risk subgroup. CONCLUSIONS There was heterogeneity in different subgroups of social anxiety among youths with CSA experiences. Potential targeted prevention and intervention suggestions could be beneficial in mitigating the risk of social anxiety and further preventing the aggravation of risk between subgroups.
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Affiliation(s)
- Qiaoqing Zheng
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yi Feng
- Mental Health Center, Central University of Finance and Economics, Beijing, China
| | - Jiaqi Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China
| | - Zhihao Ma
- Computational Communication Collaboratory, School of Journalism and Communication, Nanjing University, Nanjing, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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Madzoska M, Lawrence D, Higgins DJ, Haslam DM, Mathews B, Malacova E, Dunne MP, Erskine HE, Pacella R, Meinck F, Thomas HJ, Scott JG. Child Maltreatment, Mental Health Disorders, and Health Risk Behaviors in People With Diverse Gender Identities. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241270077. [PMID: 39152737 DOI: 10.1177/08862605241270077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/19/2024]
Abstract
This study examined rates of mental health disorders and health risk behaviors in people with diverse gender identities and associations with five types of child maltreatment. We used data from the Australian Child Maltreatment Study (ACMS), a nationally representative survey of Australian residents aged 16 years and more, which was designed to understand the experience of child maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, exposure to domestic violence). Mental disorders-major depressive disorder, generalized anxiety disorder (GAD), alcohol use disorder, post-traumatic stress disorder (PTSD), and health risk behaviors-smoking, binge drinking, cannabis dependence, self-harm, and suicide attempt in the past 12 months were assessed. People with diverse gender identities who experienced child maltreatment were significantly more likely to have GAD (43.3%; 95% CI [30.3, 56.2]) than those who had experienced child maltreatment who were either cisgender men (13.8%; [12.0, 15.5]) or cisgender women (17.4%; [15.7, 19.2]). Similarly, higher prevalence was found for PTSD (21.3%; [11.1, 31.5]), self-harm (27.8%; [17.1, 38.5]) and suicide attempt (7.2%; [3.1, 11.3]) for people with diverse gender identities. Trauma-informed approaches, attuned to the high likelihood of any child maltreatment, and the co-occurrence of different kinds may benefit people with diverse gender identities experiencing GAD, PTSD, self-harm, suicidal behaviors, or other health risk behaviors.
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Affiliation(s)
| | | | | | - Divna M Haslam
- The University of Queensland, Brisbane, QLD, Australia
- Queensland Centre for Mental Health Research, Wacol, QLD, Australia
| | - Ben Mathews
- Queensland University of Technology, Brisbane, QLD, Australia
- John Hopkins University, Baltimore, MD, USA
| | - Eva Malacova
- QIMR Berghofer, Medical Research Institute, Brisbane, QLD, Australia
| | - Michael P Dunne
- Curtin University, Perth, WA, Australia
- Australian Catholic University, Melbourne, VIC, Australia
| | - Holly E Erskine
- The University of Queensland, Brisbane, QLD, Australia
- QIMR Berghofer, Medical Research Institute, Brisbane, QLD, Australia
- University of Greenwich, London, UK
| | | | - Franziska Meinck
- University of Edinburgh, Edinburgh, UK
- North-West University, Vanderbijlpark, South Africa
- University of the Witwatersrand, Johannesburg, South Africa
| | - Hannah J Thomas
- The University of Queensland, Brisbane, QLD, Australia
- Queensland Centre for Mental Health Research, Wacol, QLD, Australia
- QIMR Berghofer, Medical Research Institute, Brisbane, QLD, Australia
| | - James G Scott
- The University of Queensland, Brisbane, QLD, Australia
- Queensland Centre for Mental Health Research, Wacol, QLD, Australia
- QIMR Berghofer, Medical Research Institute, Brisbane, QLD, Australia
- Children's Health Queensland, South Brisbane, QLD, Australia
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Jia H, Lubetkin EI. Ranking the Ten Adverse Childhood Experiences: Long-Term Consequences to Health-Related Quality of Life. Am J Prev Med 2024; 67:265-273. [PMID: 38599501 DOI: 10.1016/j.amepre.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION This study compared the long-term harmful consequences of individual adverse childhood experiences (ACEs) to subsequent health-related quality of life (HRQOL) among U.S. adults. METHODS Respondents were from the eleven U.S. states that included the optional ACE module questionnaire in the 2021 Behavioral Risk Factor Surveillance Systems (BRFSS). Relative importance (RI) was estimated for ten ACEs to respondents' self-rated general health (SRGH), physically unhealthy days (PUD), mentally unhealthy days (MUD), and activity limitation days (ALD). A variable's importance was measured as the average gains in R-squared after adding the variable to all sub-models. Statistical analysis was performed in 2023. RESULTS After controlling for demographics, household mental illness was the most important ACE for SRGH, MUD, and ALD, with RIs of 16.4, 28.4 and 23.4, respectively. This ACE was ranked second for PUD (RI=17.8). Sexual abuse was ranked first for PUD (18.7), second for MUD (16.6) and ALD (20.9), and fifth for SRGH (10.4). Parental separation (RI ≤2.4) and incarcerated household member (2.8-5.4) were the least important ACEs for all 4 outcomes. Sexual abuse, parental separation, emotional abuse, and basic needs were not met were considerably more important among females while household mental illness and household substance abuse were more important among males. CONCLUSIONS This study highlight that certain ACEs play a greater role than others for HRQOL with certain ACEs having a greater relative importance according to sex. Additionally, a significant proportion of the long-term impacts of ACE to HRQOL was indirectly through the mediation effect of other explanatory variables.
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Affiliation(s)
- Haomiao Jia
- Department of Biostatistics, Mailman School of Public Health and School of Nursing, Columbia University, New York, New York.
| | - Erica I Lubetkin
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, New York
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Stickley A, Shirama A, Sumiyoshi T. Psychotic-like experiences and problem drinking among adults in Japan. Drug Alcohol Depend 2024; 260:111319. [PMID: 38788533 DOI: 10.1016/j.drugalcdep.2024.111319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/27/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Psychotic-like experiences (PLEs) are common in the general population and have been linked to alcohol misuse and abuse. However, much of this research has been undertaken in Western countries. To address this deficit, the current study examined the association between PLEs and problem drinking in the Japanese general population. METHODS Data were used from 3717 adults (age 18-89) collected in an online survey in 2023. Information was obtained on PLEs with the PRIME Screen-Revised (PS-R), while problem drinking was assessed with the CAGE questionnaire (where a score of ≥ 2 was used to categorize cases). Logistic regression was used to examine the associations. RESULTS Problem drinking was prevalent in the study sample (12.5%). In an analysis that was adjusted for sociodemographic factors, self-rated health, smoking status and depressive symptoms, PLEs were associated with significantly higher odds for problem drinking in the total sample (OR: 1.70, 95%CI: 1.13-2.55). In a sex-stratified analysis PLEs were not linked to problem drinking in men (OR: 1.16, 95%CI 0.68-2.00), whereas women with PLEs had over 2.8 times higher odds for problem drinking (OR: 2.83, 95%CI: 1.54-5.21). CONCLUSION PLEs are associated with problem drinking in the Japanese general population and this association is especially pronounced in women. As problem drinking has been linked to a number of detrimental outcomes, future research should examine the potential effects of problem drinking in individuals with PLEs.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan.
| | - Aya Shirama
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan; Japan Health Research Promotion Bureau, 1-21-1, Toyama, Shinnjiku-ku, Tokyo162-8655, Japan
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Rowland GE, Purcell JB, Lebois LM, Kaufman ML, Harnett NG. Child sexual abuse versus adult sexual assault: A review of psychological and neurobiological sequelae. MENTAL HEALTH SCIENCE 2024; 2:e51. [PMID: 39006552 PMCID: PMC11244653 DOI: 10.1002/mhs2.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/13/2023] [Indexed: 07/16/2024]
Abstract
Sexual trauma (ST) occurs with alarming frequency in the United States (U.S.) in the form of both childhood sexual abuse (CSA) and adulthood sexual assault (ASA). It is well-established that the effects of ST are pervasive, and that ST can be a risk factor for the development of several psychiatric disorders. However, the potential for distinct psychological consequences or neural correlates between CSA and ASA has received little attention. Furthermore, despite the high prevalence of sexual revictimization, the combinatorial effects of CSA and ASA are understudied in comparison to each form of ST on its own. In the current review, we present results from both clinical psychology and neuroscience research on the impacts of CSA and ASA, describing major psychological, biopsychosocial, and neuroimaging findings for each form of ST. We further highlight limitations in the current state of the research and needed areas of future research to better understand the distinct, overlapping, and cumulative effects of ST in both childhood and adulthood. The present study summarizes the state of the literature on this critical form of trauma and provides recommendations for future clinical research practices to mitigate the deleterious outcomes of ST.
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Affiliation(s)
- Grace E Rowland
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA
| | - Juliann B Purcell
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Lauren M Lebois
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Milissa L Kaufman
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Nathaniel G Harnett
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
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da Silva HC, Vilete L, Coutinho ESF, Luz MP, Mendlowicz M, Portela CM, Figueira I, Ventura P, Mari JDJ, Quintana MI, Ribeiro WS, Andreoli SB, Berger W. The role of childhood cumulative trauma in the risk of lifetime PTSD: An epidemiological study. Psychiatry Res 2024; 336:115887. [PMID: 38642421 DOI: 10.1016/j.psychres.2024.115887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/11/2024] [Accepted: 03/29/2024] [Indexed: 04/22/2024]
Abstract
Cumulative trauma is usually devastating and can lead to severe psychological consequences, including posttraumatic stress disorder (PTSD). Exposure to various types of traumas, particularly during childhood, can be even more deleterious than the sheer number of events experienced. This epidemiological study is the first to investigate the impact of discrete childhood traumatic exposure on the risk of developing lifetime PTSD in a representative sample of the general population of the two biggest Brazilian cities. Participants were aged between 15 and 75 years old, living in São Paulo and Rio de Janeiro, Brazil, who had experienced traumatic events (N = 3,231). The PTSD diagnosis was assessed using the DSM-IV criteria through the version 2.1 of Composite International Diagnostic Interview. To operationalize childhood cumulative trauma, we considered the sum of 15 different childhood trauma categories that occurred before PTSD onset. The final multivariate logistic regression model indicated a strong relationship between the number of discrete types of childhood traumas and the likelihood of the lifetime PTSD development. The lifetime PTSD risk increased 28 % with each different type of childhood trauma when adjusted by confounds. Our study strengthens the evidence associating childhood cumulative trauma to increased lifetime PTSD risk.
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Affiliation(s)
- Herika Cristina da Silva
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Liliane Vilete
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Mariana Pires Luz
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mauro Mendlowicz
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Department of Psychiatry and Mental Health, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | - Carla Marques Portela
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ivan Figueira
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paula Ventura
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jair de Jesus Mari
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Health Service and Population Research Department, King's College London, Institute of Psychiatry, London, United Kingdom
| | - Maria Inês Quintana
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Wagner Silva Ribeiro
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | | | - William Berger
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Duffy KA, Sammel MD, Johnson RL, Morrison KE, Bale TL, Epperson CN. Sex Differences in Stress-Induced Cortisol Response Among Infants of Mothers Exposed to Childhood Adversity. Biol Psychiatry 2024:S0006-3223(24)01350-7. [PMID: 38821195 DOI: 10.1016/j.biopsych.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) increase risk for mental illness in women and their children, and dysregulation of the hypothalamic-pituitary-adrenal axis may play a role. The impact of ACEs on the hypothalamic-pituitary-adrenal axis may be strongest when ACEs occur prepubertally and in people who are exposed to abuse ACEs. METHODS To test this, we measured salivary cortisol in 96 mother-infant dyads while mothers were separated from their infants, who were experiencing a laboratory stressor. Mothers completed the Adverse Childhood Experiences Questionnaire; ACEs that occurred prepubertally (pACEs) were measured, and mother-infant dyads were grouped based on maternal pACE history as follows: no pACEs, ≥1 pACEs with abuse, or ≥1 pACEs but no abuse. RESULTS Mothers with ≥1 pACEs exhibited decreases in cortisol (relative to preinfant stressor), which differed significantly from the cortisol increase experienced by mothers with no pACEs, regardless of abuse presence (p = .001) or absence (p = .002). These pACE groups did not differ from one another (p = .929). Significant sex differences in infant cortisol were observed in infants of mothers with ≥1 pACEs (regardless of abuse) but not in infants of mothers with no pACEs. When mothers had experienced ≥1 pACEs, males showed decreases in cortisol in response to a stressor whereas females demonstrated increases, and males and females differed significantly when their mothers had ≥1 pACEs with (p = .025) and without (p = .032) abuse. CONCLUSIONS Regardless of maternal exposure to childhood abuse, in response to a stressor, pACEs were associated with lower cortisol response in mothers and sex differences in 6-month-old infants, with males showing a lower cortisol response than females.
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Affiliation(s)
- Korrina A Duffy
- Department of Psychiatry, University of Colorado School of Medicine Anschutz, Medical Campus, Aurora, Colorado
| | - Mary D Sammel
- Department of Psychiatry, University of Colorado School of Medicine Anschutz, Medical Campus, Aurora, Colorado; Department of Biostatistics and Informatics, University of Colorado School of Public Health, Anschutz Medical Campus, Aurora, Colorado
| | - Rachel L Johnson
- Department of Biostatistics and Informatics, University of Colorado School of Public Health, Anschutz Medical Campus, Aurora, Colorado
| | - Kathleen E Morrison
- Department of Psychology, West Virginia University, Morgantown, West Virginia
| | - Tracy L Bale
- Department of Psychiatry, University of Colorado School of Medicine Anschutz, Medical Campus, Aurora, Colorado
| | - C Neill Epperson
- Department of Psychiatry, University of Colorado School of Medicine Anschutz, Medical Campus, Aurora, Colorado; Department of Family Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado.
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Guastaferro K, Abuchaibe V, McCormick KV, Bhoja A, Abourjaily E, Melchior M, Grayson C, Welikson P, Dan C, Zeleke MB. Adapting a selective parent-focused child sexual abuse prevention curriculum for a universal audience: A pilot study. PLoS One 2024; 19:e0302982. [PMID: 38753647 PMCID: PMC11098426 DOI: 10.1371/journal.pone.0302982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Parents are an obvious, but underutilized player in the prevention of child sexual abuse (CSA). A handful of universal parent-focused prevention programs have emerged, however, the evidence for these programs is mixed and the programs suffer ubiquitously from barriers to implementation (e.g., poor engagement, low participation) thereby limiting public health impact. To combat these barriers and improve evidence, researchers previously developed and tested a selective parent-focused CSA prevention program. While promising, the selective approach still leaves a gap in the prevention landscape-parents from the universal audience. However, there appear to be no standardized methods to inform this type of adaptation-interventions designed as universal or selective have primarily been delivered as such. This study sought to adapt the selective curriculum for a universal audience and examined the acceptability and feasibility of the program for evaluation in a future trial. Using mixed methods, N = 31 parents (i.e., primary caregiver for a child under 13) completed pre- and post-workshop surveys followed by a brief individual interview conducted via Zoom. Interviews, coded using content analysis methods, focused on three themes: parents as agents of prevention (e.g., prior action, confidence), curriculum (e.g., content, design), and engagement (e.g., future marketing and promotion). Overall participants' mean score on CSA-related awareness and intention to use protective behavioral strategies increased. The participants found the curriculum highly acceptable noting strengths in the content and design. All told, the results of this pilot study suggest the acceptability and feasibility of examining the efficacy of the universal parent-focused curriculum in a larger trial. Procedural challenges, such as bots in recruitment, identify areas of caution in design of the larger trial and a roadmap for others seeking to adapt selective programs for universal audiences.
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Affiliation(s)
- Kate Guastaferro
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Vanessa Abuchaibe
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Kaylee V. McCormick
- Mission Kids Child Advocacy Center, East Norriton, Pennsylvania, United States of America
| | - Arushee Bhoja
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Ella Abourjaily
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Mia Melchior
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Corinne Grayson
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Paige Welikson
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Colin Dan
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Meron B. Zeleke
- School of Global Public Health, New York University, New York, New York, United States of America
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14
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Dubowitz H, Finkel M, Feigelman S, Lyon T. Initial Medical Assessment of Possible Child Sexual Abuse: History, History, History. Acad Pediatr 2024; 24:562-569. [PMID: 37972726 PMCID: PMC11056310 DOI: 10.1016/j.acap.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023]
Abstract
Primary care professionals (PCPs) can play a valuable role in the initial assessment of possible child sexual abuse (CSA), an all too prevalent problem. PCPs, however, are often reluctant to conduct these assessments. The goal of this paper is to help PCPs be more competent and comfortable playing a limited but key role. This is much needed as there may be no need for further assessment and also because of a relative paucity of medical experts in this area. While some children present with physical problems, the child's history is generally the critical information. This article therefore focuses on practical guidance regarding history-taking when CSA is suspected, incorporating evidence from research on forensic interviewing. We have been mindful of the practical constraints of a busy practice and the role of the public agencies in fully investigating possible CSA. The approach also enables PCPs to support children and their families.
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Affiliation(s)
- Howard Dubowitz
- Department of Pediatrics (H Dubowitz), Division of Child Protection, University of Maryland School of Medicine, Baltimore, Md.
| | - Martin Finkel
- Child Abuse Research Education Service (CARES) Institute (M Finkel), Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ
| | - Susan Feigelman
- Department of Pediatrics (S Feigelman), Division of General Pediatrics, University of Maryland School of Medicine, Baltimore, Md
| | - Thomas Lyon
- University of Southern California Gould School of Law (T Lyon), Los Angeles
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15
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Ding W, Xu Y, Kondracki AJ, Sun Y. Childhood adversity and accelerated reproductive events: a systematic review and meta-analysis. Am J Obstet Gynecol 2024; 230:315-329.e31. [PMID: 37820985 DOI: 10.1016/j.ajog.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/18/2023] [Accepted: 10/02/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE Accelerated female reproductive events represent the early onset of reproductive events involving puberty, menarche, pregnancy loss, first sexual intercourse, first birth, parity, and menopause. This study aimed to explore the association between childhood adversity and accelerated female reproductive events. DATA SOURCES PubMed, Web of Science, and Embase were systematically searched from September 22, 2022 to September 23, 2022. STUDY ELIGIBILITY CRITERIA Observational cohort, cross-sectional, and case-control studies in human populations were included if they reported the time of reproductive events for female individuals with experience of childhood adversity and were published in English. METHODS Two reviewers independently screened studies, obtained data, and assessed study quality, and conflicts were resolved by a third reviewer. Dichotomous outcomes were evaluated using meta-analysis, and pooled odds ratios and 95% confidence intervals were generated using random-effects models. Moderation analysis and meta-regression were used to investigate heterogeneity. RESULTS In total, 21 cohort studies, 9 cross-sectional studies, and 3 case-control studies were identified. Overall, female individuals with childhood adversity were nearly 2 times more likely to report accelerated reproductive events than those with no adversity exposure (odds ratio, 1.91; 95% confidence interval, 1.33-2.76; I2=99.6%; P<.001). Moderation analysis indicated that effect sizes for the types of childhood adversity ranged from an odds ratio of 1.61 (95% confidence interval, 1.23-2.09) for low socioeconomic status to 2.13 (95% confidence interval, 1.14-3.99) for dysfunctional family dynamics. Among the 7 groups based on different reproductive events, including early onset of puberty, early menarche, early sexual initiation, teenage childbirth, preterm birth, pregnancy loss, and early menopause, early sexual initiation had a nonsignificant correlation with childhood adversity (odds ratio, 2.70; 95% confidence interval, 0.88-8.30; I2=99.9%; P<.001). Considerable heterogeneity (I2>75%) between estimates was observed for over half of the outcomes. Age, study type, and method of data collection could explain 35.9% of the variance. CONCLUSION The literature tentatively corroborates that female individuals who reported adverse events in childhood are more likely to experience accelerated reproductive events. This association is especially strong for exposure to abuse and dysfunctional family dynamics. However, the heterogeneity among studies was high, requiring caution in interpreting the findings and highlighting the need for further evaluation of the types and timing of childhood events that influence accelerated female reproductive events.
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Affiliation(s)
- Wenqin Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Yuxiang Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Anthony J Kondracki
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA
| | - Ying Sun
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.
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16
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Ackers SM, Colbert AM, Fraley HE, Schreiber JB. Exploring Screening Practices for Child Sexual Abuse in School Settings: An Integrative Review. J Sch Nurs 2024; 40:8-25. [PMID: 35833349 DOI: 10.1177/10598405221112662] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Child sexual abuse (CSA) is a pervasive public health problem. If left undetected, CSA can result in immediate and long-term health problems, which can be mitigated through early identification. Schools are an ideal environment to implement screening measures, and school nurses (SN) are uniquely poised to intervene and respond early. The aim of this review was to systematically examine and synthesize the international evidence related to screening for early identification of CSA in schools. Themes emerging from the analysis were SN behaviors relative to screening, potential instruments or approaches for screening, and SN and school professionals' beliefs about CSA screening practices. This review found little evidence that CSA screening is occurring in schools. However, SNs are aware that screening falls within their scope of practice and many SNs feel they should be screening for it. A constant proactive approach by SNs is necessary to improve early identification and subsequent intervention.
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Affiliation(s)
| | | | - Hannah E Fraley
- California State University at Fullerton School of Nursing, Fullerton, CA, USA
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17
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Fine NB, Neuman Fligelman E, Carlton N, Bloch M, Hendler T, Helpman L, Seligman Z, Armon DB. Integration of limbic self-neuromodulation with psychotherapy for complex post-traumatic stress disorder: treatment rationale and case study. Eur J Psychotraumatol 2024; 15:2256206. [PMID: 38166532 PMCID: PMC10769120 DOI: 10.1080/20008066.2023.2256206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/24/2023] [Indexed: 01/04/2024] Open
Abstract
Treatment Rationale: Exposure to repeated sexual trauma, particularly during childhood, often leads to protracted mental health problems. Childhood adversity is specifically associated with complex posttraumatic stress disorder (PTSD) presentation, which is particularly tenacious and treatment refractory, and features severe emotion dysregulation. Augmentation approaches have been suggested to enhance treatment efficacy in PTSD thus integrating first-line psychotherapy with mechanistically informed self-neuromodulation procedures (i.e. neurofeedback) may pave the way to enhanced clinical outcomes. A central neural mechanism of PTSD and emotion dysregulation involves amygdala hyperactivity that can be volitionally regulated by neurofeedback. We outline a treatment rationale that includes a detailed justification for the potential of combining psychotherapy and NF and delineate mechanisms of change. We illustrate key processes of reciprocal interactions between neurofeedback engagement and therapeutic goals.Case Study: We describe a clinical case of a woman with complex PTSD due to early and repetitive childhood sexual abuse using adjunctive neurofeedback as an augmentation to an ongoing, stable, traditional treatment plan. The woman participated in (a) ten sessions of neurofeedback by the use of an fMRI-inspired EEG model of limbic related activity (Amygdala Electrical-Finger-Print; AmygEFP-NF), (b) traditional weekly individual psychotherapy, (c) skills group. Before and after NF training period patient was blindly assessed for PTSD symptoms, followed by a 1, 3- and 6-months self-report follow-up. We demonstrate mechanisms of change as well as the clinical effectiveness of adjunctive treatment as indicated by reduced PTSD symptoms and improved daily functioning within this single case.Conclusions: We outline an integrative neuropsychological framework for understanding the unique mechanisms of change conferring value to conjoining NF applications with trauma-focused psychotherapy in complex PTSD.
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Affiliation(s)
- Naomi B. Fine
- Faculty of Social Sciences, School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Sagol Brain Institute Tel-Aviv, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Ellie Neuman Fligelman
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Sourasky Medical Center, Tel Aviv, Israel
| | - Nora Carlton
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Sourasky Medical Center, Tel Aviv, Israel
| | - Miki Bloch
- Psychiatric Department, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Talma Hendler
- Faculty of Social Sciences, School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Sagol Brain Institute Tel-Aviv, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Liat Helpman
- Psychiatric Department, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Department of Counseling and Human Development, University of Haifa, Haifa, Israel
| | - Zivya Seligman
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Sourasky Medical Center, Tel Aviv, Israel
| | - Daphna Bardin Armon
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Sourasky Medical Center, Tel Aviv, Israel
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18
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Jayakody K, Gunadasa S. Comparison of childhood trauma between depressive disorders and personality disorders. Personal Ment Health 2023; 17:396-407. [PMID: 37452642 DOI: 10.1002/pmh.1589] [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: 12/05/2022] [Revised: 06/17/2023] [Accepted: 06/22/2023] [Indexed: 07/18/2023]
Abstract
The relationship between childhood trauma with major depressive disorder (MDD) and personality disorders is complex. We explored the differences in the subjective reporting of childhood trauma to determine whether there were differences between those with a diagnosis of personality disorder and those with MDD. Adult patients with depressive symptoms were recruited from three adult psychiatry inpatient wards. Sixty inpatients fulfilled the study criteria and were requested to complete the childhood trauma questionnaire (CTQ). At discharge, diagnosis was determined and was allocated mainly to two groups: those with MDD and those with personality disorder. Those with MDD, dysthymia and subsyndromal depressive symptoms were included in the Depression Broad Definition (DBD) group (secondary analysis). Significantly higher subjective reporting of childhood trauma was observed in the personality disorder group compared with MDD in three CTQ domains. Similarly, significantly higher reporting of childhood trauma was observed in all five CTQ domains in those with a personality disorder compared with the DBD group. In conclusion, the presence of personality disorder was associated with greater subjective reporting of childhood trauma compared with those with MDD, and further research is required to explore the differences in objective experience of childhood trauma between the diagnoses using objective measures.
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Affiliation(s)
- Kaushadh Jayakody
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Faculty of Medicine Nursing and Health Sciences, School of Rural Health, Monash University, Bendigo, Victoria, Australia
- Bendigo Health, Bendigo, Victoria, Australia
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19
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Rowland GE, Roeckner A, Ely TD, Lebois LAM, van Rooij SJH, Bruce SE, Jovanovic T, House SL, Beaudoin FL, An X, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Kurz MC, Gentile NT, Hudak LA, Pascual JL, Seamon MJ, Harris E, Pearson C, Merchant RC, Domeier RM, Rathlev NK, Sergot P, Sanchez LD, Miller MW, Pietrzak RH, Joormann J, Pizzagalli DA, Sheridan JF, Smoller JW, Harte SE, Elliott JM, Kessler RC, Koenen KC, McLean SA, Ressler KJ, Stevens JS, Harnett NG. Prior Sexual Trauma Exposure Impacts Posttraumatic Dysfunction and Neural Circuitry Following a Recent Traumatic Event in the AURORA Study. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:705-715. [PMID: 37881578 PMCID: PMC10593890 DOI: 10.1016/j.bpsgos.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023] Open
Abstract
Background Prior sexual trauma (ST) is associated with greater risk for posttraumatic stress disorder after a subsequent traumatic event; however, the underlying neurobiological mechanisms remain opaque. We investigated longitudinal posttraumatic dysfunction and amygdala functional dynamics following admission to an emergency department for new primarily nonsexual trauma in participants with and without previous ST. Methods Participants (N = 2178) were recruited following acute trauma exposure (primarily motor vehicle collision). A subset (n = 242) completed magnetic resonance imaging that included a fearful faces task and a resting-state scan 2 weeks after the trauma. We investigated associations between prior ST and several dimensions of posttraumatic symptoms over 6 months. We further assessed amygdala activation and connectivity differences between groups with or without prior ST. Results Prior ST was associated with greater posttraumatic depression (F1,1120 = 28.35, p = 1.22 × 10-7, ηp2 = 0.06), anxiety (F1,1113 = 17.43, p = 3.21 × 10-5, ηp2 = 0.05), and posttraumatic stress disorder (F1,1027 = 11.34, p = 7.85 × 10-4, ηp2 = 0.04) severity and more maladaptive beliefs about pain (F1,1113 = 8.51, p = .004, ηp2 = 0.02) but was not related to amygdala reactivity to fearful versus neutral faces (all ps > .05). A secondary analysis revealed an interaction between ST and lifetime trauma load on the left amygdala to visual cortex connectivity (peak Z value: -4.41, corrected p < .02). Conclusions Findings suggest that prior ST is associated with heightened posttraumatic dysfunction following a new trauma exposure but not increased amygdala activity. In addition, ST may interact with lifetime trauma load to alter neural circuitry in visual processing regions following acute trauma exposure. Further research should probe the relationship between trauma type and visual circuitry in the acute aftermath of trauma.
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Affiliation(s)
- Grace E Rowland
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
| | - Alyssa Roeckner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Lauren A M Lebois
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, Missouri
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Francesca L Beaudoin
- Department of Epidemiology, Brown University, Providence, Rhode Island
- Department of Emergency Medicine, Brown University, Providence, Rhode Island
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Thomas C Neylan
- Department of Psychiatry, University of California, San Francisco, San Francisco, California
- Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts
- TheMany Brains Project, Belmont, Massachusetts
| | - Scott L Rauch
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, McLean Hospital, Belmont, Massachusetts
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey
| | - Brittany E Punches
- Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, Ohio
- Ohio State University College of Nursing, Columbus, Ohio
| | - Michael C Kurz
- Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, Alabama
- Division of Acute Care Surgery, Department of Surgery, University of Alabama School of Medicine, Birmingham, Alabama
- Center for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama
| | - Nina T Gentile
- Department of Emergency Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Jose L Pascual
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mark J Seamon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Traumatology, Department of Surgery, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Erica Harris
- Einstein Medical Center, Philadelphia, Pennsylvania
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, Michigan
| | - Roland C Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, Michigan
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, Texas
| | - Leon D Sanchez
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Mark W Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
| | - Robert H Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, Connecticut
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
| | - John F Sheridan
- Division of Biosciences, Ohio State University College of Dentistry, Columbus, Ohio
- Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, Ohio
| | - Jordan W Smoller
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, Massachusetts
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, Michigan
| | - James M Elliott
- Kolling Institute, University of Sydney, St. Leonards, New South Wales, Sydney, Australia
- Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, Sydney, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Karestan C Koenen
- Department of Epidemiology, Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Samuel A McLean
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Psychiatry, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Cook JM, Cations M, Simiola V, Ellis AE, Bellamy C, Martino S. Comparisons Between Young, Middle-Aged, and Older Adult Sexual and Gender Minority Male Sexual Assault Survivors. Am J Geriatr Psychiatry 2023; 31:833-843. [PMID: 37217371 DOI: 10.1016/j.jagp.2023.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/24/2023]
Abstract
OBJECTIVE This study compared sexual abuse histories and depressive symptoms between younger, middle-aged, and older sexual and gender minority (SGM) male survivors. DESIGN Participants completed a brief, online screener as part of a large comparative effectiveness psychotherapy trial. SETTING SGM males 18 years or older, residing in the U.S. or Canada, were recruited online. PARTICIPANTS This study included younger (aged 18-39; n = 1,435), middle-aged (aged 40-59; n = 546), and older (aged 60+; n = 40) SGM men who reported a history of sexual abuse/assault. MEASUREMENTS Participants were asked about their sexual abuse history, experience of other traumas, symptoms of depression, and past 60-day mental health treatment engagement. RESULTS Older SGM men reported a lower rate of occurrence of adult sexual assault, exposure to other traumas, and depression. However, older and younger groups did not differ on any childhood sexual assault variable, the frequency of or number of attackers for adult sexual assault, the frequency of accidents and other injury traumas, or the occurrence or frequency of mental health treatment. Trauma load, including childhood and adult sexual assault, were more strongly related to current depressive symptoms than age group. CONCLUSION While there were some age-based or cohort differences in the rates of sexual trauma, the clinical response of both groups was similar. Implications for working clinically with middle-aged and older SGM men with untreated sexual assault-related mental health difficulties are discussed, including outreach and availability of gender- and older-inclusive survivor treatment and resources.
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Affiliation(s)
- Joan M Cook
- Department of Psychiatry (JMC, CB, SM), Yale School of Medicine, New Haven, CT.
| | - Monica Cations
- College of Education (MC), Psychology and Social Work, Flinders University, Adelaide SA, Australia
| | - Vanessa Simiola
- Kaiser Permanente (VS), Center for Integrated Health Care Research, Honolulu, HI
| | - Amy E Ellis
- Nova Southeastern University (AEE), Trauma Resolution & Integration Program, Fort Lauderdale, FL
| | - Chyrell Bellamy
- Department of Psychiatry (JMC, CB, SM), Yale School of Medicine, New Haven, CT
| | - Steve Martino
- Department of Psychiatry (JMC, CB, SM), Yale School of Medicine, New Haven, CT; VA Connecticut Healthcare System, Psychology Service (SM), West Haven, CT
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21
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Koçtürk N. Psychological symptoms of adolescent survivors of sexual abuse and characteristics of survivors displaying suicidal and/or self-harming behaviors. Health Care Women Int 2023; 44:1136-1154. [PMID: 35133950 DOI: 10.1080/07399332.2021.2021204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
We examine the psychological symptoms and suicide attempts and/or self-injury behaviors of survivors of childhood sexual abuse (CSA) according to individual and familial characteristics. The participants of this study included 80 adolescents aged 14-17 years. We show that high psychological symptom scores may indicate that the perpetrator was a family member and that penetration occurred. In addition, most of the participating survivors have experienced numerous problems, largely related to psychological symptoms. Considering the results regarding survivors who had previously attempted suicide, we demonstrate that the perpetrators in these cases were mostly reliable/loved people, while these survivors generally hid the events and were exposed to penetration more often. We conclude that survivors exposed to CSA by a reliable/loved person, blaming themselves, having low social support, and displaying certain symptoms should be followed closely and necessary psychosocial interventions for suicide should be applied.
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Affiliation(s)
- Nilüfer Koçtürk
- Faculty of Education, Department of Psychological Counseling and Guidance, Hacettepe University, Beytepe, Ankara, Turkey
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22
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Abu-Raya NE, Gewirtz-Meydan A. Childhood Sexual Abuse and Relationship Satisfaction: The Moderating Role of PTSD and Sexual-Related Posttraumatic Stress Symptoms. JOURNAL OF SEX & MARITAL THERAPY 2023; 49:996-1012. [PMID: 37497823 DOI: 10.1080/0092623x.2023.2237510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Research on childhood sexual abuse (CSA) has consistently demonstrated the long-term effects of such abuse, not only on survivors' development, but also on the nature and quality of their adult relationships, particularly romantic ones. In this study we examined the moderating role of posttraumatic stress disorder (PTSD) and sexual-related posttraumatic stress symptoms (sexual-related PTSS) between CSA and relationship satisfaction. Survey data from 529 individuals who reported being currently in a romantic relationship were analyzed. In the first set of analyses, results demonstrated that participants with CSA reported significantly lower relationship satisfaction and significantly greater severity of PTSD and sexual-related PTSS than participants without CSA. Sexual-related PTSS but not PTSD moderated the association between CSA and participants' relationship satisfaction, with the model of sexual-related PTSS explaining 20.8% of the variance in relationship satisfaction and the model of PTSD explaining 11.3% of this variance. In the second set of analyses conducted among survivors of CSA only, higher sexual-related PTSS severity was linked with ongoing abuse and with abuse by a non-family member. This study points to the potential contribution made by sexual-related PTSS to relationship satisfaction among survivors of CSA.
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Affiliation(s)
- Narges Evon Abu-Raya
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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23
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Guastaferro K, Shipe SL, Connell CM, Holloway JL, Pulido ML, Noll JG. Knowledge Gains from the Implementation of a Child Sexual Abuse Prevention Program and the Future of School-Based Prevention Education. JOURNAL OF CHILD SEXUAL ABUSE 2023; 32:845-859. [PMID: 37814960 PMCID: PMC10841592 DOI: 10.1080/10538712.2023.2268618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/20/2023] [Indexed: 10/11/2023]
Abstract
School-based child sexual abuse (CSA) programs effectively increase students' CSA-related knowledge. This study focuses on an implementation trial of Safe Touches, an empirically supported, school-based CSA prevention program, that was disrupted by the COVID-19 pandemic. We sought to demonstrate gains in CSA-related knowledge following Safe Touches but were limited to a pre-post design. A total of 2,210 students across five counties in a Mid-Atlantic state received the Safe Touches workshop between September 2019 and March 2020. McNemar's chi-square test was used to assess changes in the proportion of correct responses pre-workshop (Time 1) and one-week post-workshop (Time 2). Students' CSA-related knowledge increased significantly based on changes in mean CSA knowledge scores and the number of correct item-level responses assessed at Time 1 and Time 2 (p < .000). Leveraging the experience of the facilitators' who delivered these workshops prior to the disruption of implementation, we gathered facilitators' perspectives to explore the viability of offering Safe Touches virtually. In July 2020, 16 facilitators completed an electronic survey designed to understand the viability of a virtual Safe Touches workshop. Three themes emerged from facilitator feedback on virtual programming: student engagement concerns, handling disclosures, and technology access to a virtual program. The findings of this study indicate that the Safe Touches workshop significantly increased CSA-related knowledge and, overall, facilitators supported further exploration and development of a virtual Safe Touches workshop. The transition of empirically supported school-based CSA prevention programs to a virtual delivery modality is necessary to maintain an effective means of primary prevention and opportunity for disclosure.
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Affiliation(s)
- Kate Guastaferro
- Department of Human Development and Family Studies, The Pennsylvania State University
- Department of Social and Behavioral Sciences, New York University
| | - Stacey L. Shipe
- Department of Human Development and Family Studies, The Pennsylvania State University
- Department of Social Work, State University of New York, Binghamton
| | - Christian M. Connell
- Department of Human Development and Family Studies, The Pennsylvania State University
| | | | - Mary L. Pulido
- New York Society for the Prevention of Cruelty to Children
| | - Jennie G. Noll
- Department of Human Development and Family Studies, The Pennsylvania State University
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24
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Rosa M, Scassellati C, Cattaneo A. Association of childhood trauma with cognitive domains in adult patients with mental disorders and in non-clinical populations: a systematic review. Front Psychol 2023; 14:1156415. [PMID: 37425159 PMCID: PMC10327487 DOI: 10.3389/fpsyg.2023.1156415] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/01/2023] [Indexed: 07/11/2023] Open
Abstract
Although the association between cognitive performances and the onset of psychiatric disorders has been widely investigated, limited research on the role of childhood trauma or early life stress (CT/ELS), and whether this role differs between clinical and non-clinical cohorts is available. This systematic review aims at filling this gap, testing whether the occurrence of CT/ELS and its subtypes are associated with cognitive domains (general cognitive ability, executive functions, working memory, attention, processing speed, verbal/visual memory) in patients with psychiatric disorders and in non-clinical populations. This study followed the PRISMA 2020 guidelines and the Newcastle-Ottawa scale for quality assessment. The search was performed until May 2022. Seventy-four studies were classified as eligible. The graphical representations of the results reported an association between exposure to CT/ELS and worse general cognitive ability, verbal/visual memory, processing speed and attention in patients affected by anxiety, mood and psychotic disorders, and that specific CT/ELS subtypes (physical neglect, physical/sexual abuse) can differentially influence specific cognitive abilities (executive functions, attention, working memory, verbal/visual memory). In non-clinical cohorts we found associations between CT/ELS exposure and impairments in executive functions, processing speed and working memory, while physical neglect was related to general cognitive ability and working memory. Concerning the emotional abuse/neglect subtypes in both populations, the results indicated their involvement in cognitive functioning; however, the few studies conducted are not enough to reach definitive conclusions. These findings suggest an association of CT/ELS with specific cognitive deficits and psychopathology.
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Affiliation(s)
- Melissa Rosa
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Catia Scassellati
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Annamaria Cattaneo
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
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25
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Husky MM, Sadikova E, Lee S, Alonso J, Auerbach RP, Bantjes J, Bruffaerts R, Cuijpers P, Ebert DD, Garcia RG, Hasking P, Mak A, McLafferty M, Sampson NA, Stein DJ, Kessler RC. Childhood adversities and mental disorders in first-year college students: results from the World Mental Health International College Student Initiative. Psychol Med 2023; 53:2963-2973. [PMID: 37449483 PMCID: PMC10349206 DOI: 10.1017/s0033291721004980] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study investigates associations of several dimensions of childhood adversities (CAs) with lifetime mental disorders, 12-month disorder persistence, and impairment among incoming college students. METHODS Data come from the World Mental Health International College Student Initiative (WMH-ICS). Web-based surveys conducted in nine countries (n = 20 427) assessed lifetime and 12-month mental disorders, 12-month role impairment, and seven types of CAs occurring before the age of 18: parental psychopathology, emotional, physical, and sexual abuse, neglect, bullying victimization, and dating violence. Poisson regressions estimated associations using three dimensions of CA exposure: type, number, and frequency. RESULTS Overall, 75.8% of students reported exposure to at least one CA. In multivariate regression models, lifetime onset and 12-month mood, anxiety, and substance use disorders were all associated with either the type, number, or frequency of CAs. In contrast, none of these associations was significant when predicting disorder persistence. Of the three CA dimensions examined, only frequency was associated with severe role impairment among students with 12-month disorders. Population-attributable risk simulations suggest that 18.7-57.5% of 12-month disorders and 16.3% of severe role impairment among those with disorders were associated with these CAs. CONCLUSION CAs are associated with an elevated risk of onset and impairment among 12-month cases of diverse mental disorders but are not involved in disorder persistence. Future research on the associations of CAs with psychopathology should include fine-grained assessments of CA exposure and attempt to trace out modifiable intervention targets linked to mechanisms of associations with lifetime psychopathology and burden of 12-month mental disorders.
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Affiliation(s)
- Mathilde M. Husky
- Laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | - Ekaterina Sadikova
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, US
| | - Sue Lee
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute; Pompeu Fabra University (UPF); and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, South Africa
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David D. Ebert
- Department for Sport and Health Sciences, Chair for Psychology & Digital Mental Health Care, Technical University Munich, Germany
| | - Raùl Gutiérrez Garcia
- Department of Social Sciences and Humanities, De La Salle Bajio University, Salamanca, Guanajuato, Mexico
| | - Penelope Hasking
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Arthur Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR
| | | | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Dan J. Stein
- Department of Psychiatry & Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, Republic of South Africa
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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26
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Kang W, Kang Y, Kim A, Kim H, Han KM, Ham BJ. Gray and white matter abnormalities in major depressive disorder patients and its associations with childhood adversity. J Affect Disord 2023; 330:16-23. [PMID: 36871915 DOI: 10.1016/j.jad.2023.02.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 02/16/2023] [Accepted: 02/27/2023] [Indexed: 03/07/2023]
Abstract
OBJECTIVE Early life stress of childhood adversity (CA) may result in major depressive disorder (MDD) by sensitizing individuals to proximal stressors in life events. The neurobiological changes that underlie adult depression may result from the absence of proper care and supervision of caregivers. We aimed to find both gray and white matter abnormalities in MDD patients, who reported the experiences of CA. METHODS The present study examined cortical alterations in 54 patients with MDD and 167 healthy controls (HCs) using voxel-based morphology and fractional anisotropy (FA) tract-based spatial statistics (TBSS). Both patients and HCs were administered the self-questionnaire clinical scale (the Korean translation of the Childhood Trauma Questionnaire CTQK). Pearson's correlation analysis was performed to find the associations between FA and CTQK. RESULTS The MDD group showed a significant decrease in gray matter (GM) in the left rectus at both the cluster and peak levels after family-wise error correction. The TBSS results showed significantly reduced FA in widespread regions, including the corpus callosum (CC), superior corona radiata, cingulate gyrus, and superior longitudinal fasciculus. The CA was negatively correlated with the FA in CC and crossing pontine tract. CONCLUSION Our findings demonstrated GM atrophy and white matter (WM) connectivity changes in patients with MDD. The major findings of the widespread FA reduction in WM provided the evidence of brain alterations in MDD. We further propose that the WM would be vulnerable to emotional, physical, and sexual abuse in early childhood during the brain development.
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Affiliation(s)
- Wooyoung Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youbin Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Aram Kim
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyeyoung Kim
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
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27
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Dugan SA, Karavolos K, Zhang Y, Avery E, Janssen I, Farhi M, Harlow SD, Kravitz HM. Childhood Sexual Abuse and Pelvic Floor Dysfunction in Midlife Women in the Study of Women's Health Across the Nation. J Womens Health (Larchmt) 2023; 32:293-299. [PMID: 36735600 PMCID: PMC9993161 DOI: 10.1089/jwh.2022.0211] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Objectives: Research has shown a link between childhood sexual abuse (CSA) and lower urinary tract and sexual disorders in clinical settings. We examined whether CSA was associated with two specific aspects of high tone, elevated resting tension pelvic floor dysfunction (PFD) in community-dwelling women. Materials and Methods: Data were from 2068 participants (25.5% Black, 9.6% Chinese, 10.8% Japanese, 5.0% Hispanic, and 49.1% Non-Hispanic White) in the Study of Women's Health Across the Nation (SWAN), a multirace/multiethnic longitudinal observational study of women's midlife health. At baseline, enrolled women were 42-52 years old and premenopausal or early perimenopausal. Annual or biennial assessments conducted over 20 years (1996 through 2017) included single-item queries about urgency urinary incontinence and pain with sexual activity used to assess PFD outcomes. The 12th follow-up visit conducted in 2009-2011 assessed the primary exposure, history of CSA, using a single-item response. Multivariate logistic regression models tested study objectives. Results: The prevalence of CSA was 15%, self-reported in 313/2068 women. CSA and PFD, both pain with sexual activity (odds ratio [OR] = 1.56 confidence interval [95% CI = 1.12-2.18]) and urgency urinary incontinence (OR = 1.87 [95% CI = 1.29-2.71]), were significantly associated in unadjusted models. The final adjusted model that included sociodemographic variables and physical and behavioral risk factors was significant for pain with sexual activity (OR = 1.48 [95% CI = 1.08-2.02]), but not for urgency urinary incontinence (OR = 1.38 [95% CI = 0.96-1.98]). Conclusions: In midlife women, pain with sex, but not urgency urinary incontinence, was associated with a history of CSA. A multidisciplinary diagnostic and therapeutic approach to PFD is key, inclusive of CSA screening.
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Affiliation(s)
- Sheila A. Dugan
- Department of Physical Medicine & Rehabilitation and Rush University Medical Center, Chicago, Illinois, USA
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Kelly Karavolos
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Yanyu Zhang
- Rush Bioinformatics and Biostatics Core, Rush University Medical Center, Chicago, Illinois, USA
| | - Elizabeth Avery
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Imke Janssen
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Mary Farhi
- Department of Obstetrics and Gynecology, Rush University Medical Center, Chicago, Illinois, USA
| | - Siobán D. Harlow
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Howard M. Kravitz
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
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28
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Ladis I, Abrams D, Calkins C. Differential Associations between Guilt and Shame Proneness and Religious Coping Styles in a Diverse Sample of Young Adults. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP670-NP697. [PMID: 35324358 DOI: 10.1177/08862605221081931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Positive religious coping is linked with better mental health outcomes following physical and sexual abuse while negative religious coping is associated with poorer outcomes. Religious coping styles may be linked with dispositional tendencies to experience guilt or shame. This study compared the associations between guilt and shame proneness and religious coping styles and tested whether abuse history moderated these relationships. We conducted a cross-sectional study with 425 college students (n = 145 with physical and/or sexual abuse history, n = 280 with no abuse history). Participants completed questionnaires assessing positive and negative religious coping style, as well as two dimensions of guilt proneness and shame proneness. Structural equation models were fitted to examine associations between guilt proneness and shame proneness, and positive and negative religious coping, respectively, accounting for abuse history as a binary moderator. Across the full sample, positive religious coping was positively associated with guilt repair (i.e., the tendency to engage in reparative behaviors following one's wrongdoing), guilt negative behavior evaluation (i.e., the tendency to feel bad about how one acted in a given scenario), and shame withdrawal (i.e., the tendency to try and avoid unpleasant situations in which one has done something wrong), and negatively associated with shame negative self-evaluation (i.e., the tendency to make internal, negative self-attributions about one's wrongdoing). Negative religious coping was positively associated with shame withdrawal and, for participants with no abuse history, shame negative self-evaluation. Results suggest that positive religious coping is more closely related to guilt proneness, and negative religious coping to shame proneness. Additional research with longitudinal designs and more defined abuse history subgroups is needed.
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Affiliation(s)
- Ilana Ladis
- Department of Psychology, 2358University of Virginia, Charlottesville, VA, USA
| | - Dylan Abrams
- Department of Psychology, 217454John Jay College of Criminal Justice/City University of New York Graduate Center, New York, NY, USA
| | - Cynthia Calkins
- Department of Psychology, 217454John Jay College of Criminal Justice/City University of New York Graduate Center, New York, NY, USA
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29
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Bikmazer A, Koyuncu Z, Kavruk Erdim N, Kadak MT, Tarakcioglu MC, Gokler E, Gormez V, Ozer OA. Association of Dissociation with Suicide Attempt and Non-Suicidal Self Injury in Adolescents with a History of Sexual Abuse. Psychiatry 2023; 86:17-28. [PMID: 36040868 DOI: 10.1080/00332747.2022.2114268] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Objective: Dissociative symptoms are considered risk factors for suicide and non-suicidal self-injury (NSSI). In this study, the relationship between suicidal behaviors and NSSI with dissociative symptoms in adolescents with a history of Child Sexual Abuse (CSA) was investigated. Methods: A total of 100 adolescents with a history of CSA were evaluated with a detailed forensic psychiatric interview. Dissociative symptoms were measured with the self-report Adolescent Dissociative Experiences Scale (A-DES) and the parent-reported Child Dissociative Checklist (CDC). Results: While dissociative symptoms did not differ between adolescents with and without suicide attempts (CDC; p = .068 and A-DES; p = .060), they were significantly higher in adolescents with non-suicidal self-harming behavior (CDC; p < .001 and A-DES; p = .001). Suicide attempts and NSSI were more common in those who reported genital touching as a type of sexual abuse (respectively, p = .003; p = .048). In regression analysis; history of psychiatric treatment (OR = 9.09 [95% CI = 1.52, 54.29]) and NSSI (OR = 8.18 [95% CI = 2.01, 33.23]) were independently associated with suicide attempts. In addition, parent-reported dissociative symptoms (CDC scores) (OR = 1.27 [95% CI = 1.06, 1.53] and suicide attempt (OR = 8.09 [95%CI = 1.96,33.42] showed independent association with NSSI. Conclusions: Dissociative symptoms may be predictive factors for NSSI and should be considered in risk assessment of adolescents with a history of CSA.
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30
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Neilson EC, Schraufnagel TJ, George WH, Davis KC. The Effects of Childhood Sexual Abuse, Mental Health, and Motives for Sex on Sexual Risk-Taking Among United States Men Who Have Sex with Women. JOURNAL OF CHILD SEXUAL ABUSE 2023; 32:3-21. [PMID: 36515168 PMCID: PMC9911360 DOI: 10.1080/10538712.2022.2155284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/10/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
This study assessed the role of mental health symptoms and motives for sex in the association between childhood sexual abuse (CSA) and sexual risk-taking among men who have sex with women (MSW). The sample consisted of young adult (ages 21 to 30), non-monogamous MSW (N = 532) who reported having condomless sex at least once in the past year. Due to alcohol-related aims from two larger studies from which the data were analyzed, participation was excluded to men who regularly consumed alcohol (3 to 35 weekly drinks) and reported no symptoms of alcohol use disorder. Participants answered background questionnaires in lab and then completed a six-week, follow-up survey assessing the number of sex partners and condom use during the prior six weeks. CSA survivors reported greater mental health symptoms and sex motives related to coping, self-affirmation, and partner approval relative to non-survivors. CSA, sex for partner approval, and sex to enhance motives were positively associated with the number of sex partners. Participants endorsing self-affirmation sex motives reported higher condom use than those who did not. CSA contributes to long-term mental and sexual health outcomes among MSW. Identifying and treating depressive and anxiety symptoms and motives for sex may improve sexual health among CSA survivors.
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Affiliation(s)
- Elizabeth C Neilson
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, United States
| | | | - William H George
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
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31
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Ashaba S, Kakuhikire B, Baguma C, Satinsky EN, Perkins JM, Rasmussen JD, Cooper-Vince CE, Ahereza P, Gumisiriza P, Kananura J, Bangsberg DR, Tsai AC. Adverse childhood experiences, alcohol consumption, and the modifying role of social participation: population-based study of adults in southwestern Uganda. SSM - MENTAL HEALTH 2022; 2:100062. [PMID: 35463801 PMCID: PMC9023342 DOI: 10.1016/j.ssmmh.2022.100062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Adverse childhood experiences (ACEs) include multiple forms of child maltreatment, including abuse and neglect, as well as other forms of household dysfunction. Studies from Uganda have revealed a high prevalence of child abuse, as well as one of the highest levels of alcohol consumption in Africa. Few population-based studies from Africa have estimated associations between ACEs and adult alcohol use, or assessed the potential buffering effects of social participation. Methods This cross-sectional, population-based study was conducted in a rural parish in southwestern Uganda between 2016 and 2018. We assessed self-reported ACEs using a modified version of the Adverse Childhood Experiences - International Questionnaire (ACE-IQ) scale. We measured heavy alcohol consumption using a 3-item scale previously validated in this population. We measured social participation using a 10-item scale eliciting participants' membership and participation in different community groups over the past two months. We fitted multivariable Poisson regression models to estimate the associations between ACEs and heavy alcohol consumption, and to assess for the potential buffering effects of social participation. Results We estimated statistically significant associations between the total ACE score and heavy alcohol consumption (adjusted relative risk [ARR] per ACE=1.17; 95% CI, 1.09-1.25; P ≤0.001). Social participation had a statistically significant moderating effect on the association between total ACE score and heavy alcohol consumption (P=0.047 for interaction): the estimated association between total ACE score and heavy alcohol consumption among study participants who did not participate in a community group was larger, with a narrower confidence interval (ARR=1.21 per ACE; 95% CI, 1.11-1.33; P<0.001), while the estimated association among study participants who did participate in a community group was smaller and less precisely estimated (ARR=1.12 per ACE; 95% CI, 1.02-1.24; P=0.02). Conclusions Our findings demonstrate an association between ACEs and heavy alcohol consumption behavior among adults in rural Uganda. The adverse effects of ACEs were buffered in part by social participation. To prevent or reduce harmful alcohol use behaviors among adults, it is important to address the chronic stress caused by ACEs.
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Affiliation(s)
| | | | - Charles Baguma
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Emily N Satinsky
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | | | | | | | - Phionah Ahereza
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Justus Kananura
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - David R Bangsberg
- Mbarara University of Science and Technology, Mbarara, Uganda
- Oregon Health and Science University - Portland State University School of Public Health, Portland, OR, USA
| | - Alexander C Tsai
- Mbarara University of Science and Technology, Mbarara, Uganda
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
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Foley G, Fowler K, Button P. Positive mental health in Canadian adults who have experienced childhood sexual abuse: exploring the role of social support. BMC Psychiatry 2022; 22:666. [PMID: 36307753 PMCID: PMC9615621 DOI: 10.1186/s12888-022-04279-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/26/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Childhood sexual abuse (CSA) is predictive of poorer mental health, greater psychiatric disorder risk, and lower positive mental health (PMH) during adulthood, outcomes potentially moderated by social support. The current study aimed to explore whether Canadian adults who have experienced CSA differ from those who have not in terms of PMH and social support. Within the CSA sample, it was further investigated whether gender differences exist with respect to PMH and social support, and if particular social support subscales predict PMH. METHOD Using data from the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH), 1,328 adults between 20 and 64 years reporting CSA were profiled and compared in terms of sociodemographic and socioeconomic factors, using an age, sex, and frequency matched sample of non-CSA adults. Social Provisions Scale (SPS), and the Mental Health Continuum - Short Form (MHC-SF) means were subsequently compared between the CSA and non-CSA samples, and Hierarchical regressions were conducted for CSA males and females separately to examine whether SPS subscales predicted PMH after controlling for age and income. RESULTS Canadian adults reporting CSA had significantly lower PMH and social support (overall and for particular subscales). For adult CSA females, guidance, social integration, and reassurance of worth predicted higher PMH, while attachment and reassurance of worth predicted higher PMH scores for CSA males. CONCLUSION Adults who have experienced CSA are at risk for lower PMH and social support. Gender differences are also evident in social support subtypes that predict PMH which have important clinical implications.
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Affiliation(s)
- Gillian Foley
- grid.25055.370000 0000 9130 6822Department of Psychology, Faculty of Science, Memorial University of Newfoundland, St. John’s, NL Canada
| | - Ken Fowler
- Student Wellness and Counselling Centre, Memorial University of Newfoundland, St. John's, NL, Canada.
| | - Pam Button
- grid.25055.370000 0000 9130 6822Student Wellness and Counselling Centre, Memorial University of Newfoundland, St. John’s, NL Canada
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Arbanas G, Marinovic P, Buzina N. Psychiatric and Forensic Characteristics of Sex Offenders With Child and With Adult Victims. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022; 66:1195-1212. [PMID: 32698649 DOI: 10.1177/0306624x20944673] [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: 06/11/2023]
Abstract
This study presents psychiatric and forensic characteristics of people accused of a sexual crime and sent for evaluation. Data were drawn from the only institutional psychiatric forensic assessment center in Croatia, during a 9-year period, from January 1, 2010 to December 31, 2018. There were 72 cases of sex offenses: 37 with child victims and 35 with adult victims. People accused of sex offenses with child victims were more often sexually abused during childhood and treated psychiatrically as inpatients. They used alcohol less often. Sex offenders with child victims were diagnosed with narcissistic and antisocial personality disorder, dementia, and pedophilic disorder. Those with adult victims were diagnosed with antisocial personality disorder, alcohol related disorders and dementia. Due to these differences, the management of these two groups of offenders in both mental health and penal systems should be different.
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Affiliation(s)
- Goran Arbanas
- University Psychiatric Hospital Vrapče, Zagreb, Croatia
- University of Rijeka, Croatia
| | | | - Nadica Buzina
- University Psychiatric Hospital Vrapče, Zagreb, Croatia
- University of Zagreb, Croatia
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Aluh DO, Azeredo-Lopes S, Cardoso G, Pedrosa B, Grigaitė U, Dias M, Xavier M, Caldas-de-Almeida JM. Social anxiety disorder and childhood adversities in Portugal: Findings from the WHO world mental health survey initiative. Psychiatry Res 2022; 315:114734. [PMID: 35872402 DOI: 10.1016/j.psychres.2022.114734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 07/08/2022] [Accepted: 07/16/2022] [Indexed: 11/29/2022]
Abstract
Social anxiety disorder (SAD) is one of the most underrecognized and undertreated common mental disorders. This study aimed to describe its epidemiology and to understand the association between childhood adversities and SAD in the context of Portugal's collectivist culture. Data about SAD, childhood adversities, socio-demographic variables were collected from a nationally representative sample using well-validated scales employed for the World Mental Health Survey. Logistic and linear regression models were carried out to explore the association between childhood adversities and SAD prevalence and age of onset. The estimated lifetime prevalence of SAD was 4.68% and the 12-month prevalence was 3.14%. The mean age of onset was 13.6 ± 8.79. People with a college education had 3.42 higher odds of having SAD compared to people with no education or a primary school education. Most childhood adversities significantly increased the odds of a lifetime prevalence of SAD. Parental Maladjustment increased the odds of SAD when gender, age, and education were adjusted. The study findings show a relatively high prevalence of SAD in Portugal and confirms that females, younger people, students, and single people are more likely to have SAD. The study highlights the need to address experiences of parental maladjustment in interventions for people with SAD in Portugal.
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Affiliation(s)
- Deborah Oyine Aluh
- Lisbon Institute of Global Mental Health, Lisbon, Portugal; Comprehensive Health Research Centre (chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal; Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria Nsukka, Nigeria.
| | - Sofia Azeredo-Lopes
- NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal; Department of Statistics and Operational Research, Faculdade de Ciências, Universidade de Lisboa, Portugal
| | - Graça Cardoso
- Lisbon Institute of Global Mental Health, Lisbon, Portugal; Comprehensive Health Research Centre (chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Barbara Pedrosa
- Lisbon Institute of Global Mental Health, Lisbon, Portugal; Comprehensive Health Research Centre (chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Ugnė Grigaitė
- Lisbon Institute of Global Mental Health, Lisbon, Portugal; Comprehensive Health Research Centre (chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Margarida Dias
- Lisbon Institute of Global Mental Health, Lisbon, Portugal; Comprehensive Health Research Centre (chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Miguel Xavier
- NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - José Miguel Caldas-de-Almeida
- Lisbon Institute of Global Mental Health, Lisbon, Portugal; Comprehensive Health Research Centre (chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
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Distinguishing clinical factors associated with unintentional overdose, suicidal ideation, and attempted suicide among opioid use disorder in-patients. J Psychiatr Res 2022; 153:245-253. [PMID: 35841821 DOI: 10.1016/j.jpsychires.2022.06.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/15/2022] [Accepted: 06/24/2022] [Indexed: 01/11/2023]
Abstract
Opioid and other drug-related overdoses and suicides are leading causes of injury death and represent a significant public health threat in the United States (U.S.). This study examined clinical factors of three patient groups from two inpatient addiction treatment facilities in Appalachian West Virginia (n = 66). Patients were classified as having: 1) unintentional overdose(s) (OD), 2) suicidal ideation or suicide attempt(s) (SI/SA), and 3) suicidal ideation or suicide attempt, and unintentional overdose (SI/SA/OD). Multinomial logistic regression models were used to determine whether adverse childhood experiences, self-injurious behaviors, substance use history, overdose history, and past year stressful life events were differentially associated with history of SI/SA/OD. Participants in the OD group were more likely to have used heroin in the 24-h preceding their most recent overdose compared to either the SI/SA or SI/SA/OD groups. The multivariable model found participants with history of SI/SA had higher adverse childhood experience scores and more participants with history of SI/SA endorsed childhood physical abuse and teen dating violence. Overall, there are characteristics that distinguish unintentional overdose from suicidal ideation and attempt. Patients with SI/SA/OD appear to have greater clinical severity. More thorough evaluation of drugs involved in overdose and history of self-injury may help distinguish future risk and inform treatment planning.
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Timon CE, Dallam SJ, Hamilton MA, Liu E, Kang JS, Ortiz AJ, Gelles RJ. Child Sexual Abuse of Elite Athletes: Prevalence, Perceptions, and Mental Health. JOURNAL OF CHILD SEXUAL ABUSE 2022; 31:672-691. [PMID: 35821644 DOI: 10.1080/10538712.2022.2100026] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 05/25/2022] [Accepted: 06/11/2022] [Indexed: 06/15/2023]
Abstract
Despite a series of high-profile media reports of sexual abuse in sport over the past few years, little research has been done to explore the scope of the problem in the United States. The current article reports on prevalence of child sexual assault in elite athletes in the United States. Using a retrospective web survey, adults answered questions on their experiences in sport. Of the 473 elite athletes surveyed, 3.8% (n = 18) reported being sexual assaulted as a minor in the sporting context. Of those reporting assault, most (61%) reported being abused by an adult authority figure (usually a coach) and 44% reported being assaulted by a peer. Abused athletes were significantly more likely to report having been diagnosed with a mental disorder (Fisher's exact test; p < .001). The findings can be utilized to improve prevention and child protection measures and other safeguarding initiatives in sport.
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Affiliation(s)
| | | | - Marci A Hamilton
- University of Pennsylvania, Fels Institute of Government, Philadelphia, PA, USA
| | - Emily Liu
- University of Pennsylvania, Philadelphia, PA, USA
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A Qualitative Exploration of a Biopsychosocial Profile for Experiencing Sexual Harassment and Abuse in Sports. SOCIAL SCIENCES-BASEL 2022. [DOI: 10.3390/socsci11070309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The purpose of this study was to explore a biopsychosocial profile for experiencing sexual harassment and abuse in sports. A qualitative approach was used; data were collected from semi-structured in-depth interviews covering seven cases of sexual harassment and abuse in sports in the Netherlands. The interview transcripts were analysed and aligned with the biopsychosocial model. The results reveal biological (i.e., aged under 18, sex, and sexual orientation), psychological (i.e., high degree of naivety, altruism and agreeableness, low self-esteem, perfectionism, emotional or disorders) and social factors (i.e., poor or negative relationship with parents, social pressure to perform, incest at home, social isolation, elite sports and too much power of a single trainer/coach) that can contribute to the risk of experiencing sexual harassment and abuse in sports. These findings provide important directions for prevention and recognition in sports practice and future research.
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Pazderka H, Reeson M, Polzin W, Jin J, Hnatko G, Wei Y, Agyapong VIO, Greenshaw AJ, Ohinmaa A, Silverstone PH. Five year cost savings of a multimodal treatment program for child sexual abuse (CSA): a social return on investment study. BMC Health Serv Res 2022; 22:892. [PMID: 35810283 PMCID: PMC9270795 DOI: 10.1186/s12913-022-08267-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Specialized mental health services for the treatment of Child Sexual Abuse (CSA) are generally expensive and labour intensive. They require a trauma-informed approach that may involve multiple services and therapeutic modalities, provided over the course of several months. That said, given the broad-ranging, long term negative sequelae of CSA, an evaluation of the cost-benefit analysis of treatment is clearly justified. METHODS We performed a Social Return on Investment (SROI) analysis of data gathered as part of the treatment program at the Be Brave Ranch in Edmonton, Canada to determine the value-for-money of the services provided. We endeavoured to take a conservative, medium-term (5 year) perspective; this is in contrast to short term (1-2 year) effects, which may rapidly dissipate, or long term (15-20 year) effects, which are likely diffuse and difficult to measure. As such, our analysis was based on an average annual intake of 100 children/adolescents (60:40 split) and their families, followed over a five-year timeframe. Financial proxies were assigned to benefits not easily monetized, and six potential domains of cost savings were identified. RESULTS Our analyses suggest that each dollar spent in treatment results in an average cost savings of $11.60 (sensitivity analysis suggests range of 9.20-12.80). The largest value-for-money was identified as the domain of crisis prevention, via the avoidance of rare but costly events associated with the long term impacts of CSA. Somewhat surprisingly, savings related to the area of criminal justice were minimal, compared to other social domains analysed. Implications are discussed. CONCLUSIONS Our results support the cost effectiveness of the investment associated with specialized, evidence-based early interventions for CSA. These approaches alleviate severe, negative outcomes associated with CSA, resulting in both economic savings and social benefits. These findings rest upon a number of assumptions, and generalizability of these results is therefore limited to similar programs located in comparable areas. However, the SROI ratio achieved in this analysis, in excess of $11:1, supports the idea that, while costly, these services more than pay for themselves over time.
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Affiliation(s)
- Hannah Pazderka
- Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada.,Be Brave Ranch, Centre for Treatment of Child Sexual Abuse, Edmonton, Canada
| | - Matthew Reeson
- Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada
| | - Wanda Polzin
- Be Brave Ranch, Centre for Treatment of Child Sexual Abuse, Edmonton, Canada
| | - Jonathan Jin
- Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada
| | - Gary Hnatko
- CASA Child, Adolescent and Family Mental Health, Edmonton, Canada
| | - Yifeng Wei
- Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Andrew J Greenshaw
- Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Peter H Silverstone
- Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada.
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Differential Effect of Emotional Stimuli on Performance on Verbal and Facial Priming Tasks and Their Relation to PTSD Symptoms in Girls with Intrafamiliar Sexual Abuse. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10313-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Stiernströmer E, Väfors Fritz M, Mellgren C, Khoshnood A. Demographic characteristics of convicted child sexual abusers in South of Sweden, between 2013 and 2018: a pilot study. Forensic Sci Res 2022; 7:393-401. [PMID: 36353331 PMCID: PMC9639549 DOI: 10.1080/20961790.2022.2052590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This study evaluates variables concerning demographic characteristics for all adult male offenders convicted of Child Sexual Abuse (CSA) aged 0–17 in Malmö, Sweden between 2013 and 2018. All convictions (n = 18) based on court documents from the District Court, the Court of Appeals and information from the Swedish Tax Agency were reviewed. A total of 30 victims were identified. Frequency analyses show that the most common features were that of a single offender, averaging 25 years old, with a non-Swedish background and a high school degree. The predominately extrafamilial CSA (i.e. committed by an acquaintance to the family) occurred in a private setting and consisted of penetrative acts. Girls averaging 13 years old were abused multiple times, under fear and pressure. Although assumptions based on these results are preliminary, they provide a clearer image of the typical circumstances under which CSA occurred within this time frame and geographical location. This study is a first attempt to construct an overview of demographic characteristics of CSA. As more data are gathered from this region, more sophisticated analyses can be conducted, providing stronger generalizations. Information of this kind may be important for research, classification of offender profiling and in case linking.
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Affiliation(s)
| | | | | | - Ardavan Khoshnood
- Department of Clinical Sciences Lund, Skane University Hospital, Emergency Medicine, Lund University, Lund, Sweden
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Guastaferro K, Holloway JL, Trudeau J, Lipson LB, Sunshine S, Noll JG, Pulido ML. Virtual Delivery of A School-Based Child Sexual Abuse Prevention Program: A Pilot Study. JOURNAL OF CHILD SEXUAL ABUSE 2022; 31:577-592. [PMID: 35959797 PMCID: PMC9421613 DOI: 10.1080/10538712.2022.2112347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/06/2022] [Accepted: 07/09/2022] [Indexed: 06/15/2023]
Abstract
Universal child sexual abuse (CSA) prevention is a public health priority. The prevailing prevention strategy is school-based CSA prevention programming. School closures during the COVID-19 pandemic highlighted the need for flexible modes of delivery, including virtual programs. This pilot examined the virtual delivery of an evidence-based, school-based CSA prevention program, Safe Touches, designed to teach CSA-related knowledge and concepts. Using mixed methods, the pilot sought to determine the feasibility of the virtually delivered CSA prevention program. One school district that had previously received Safe Touches in-person participated. A total of 176 second grade students participated in the virtual workshop. Post-workshop survey responses from virtual (N = 37) and in-person workshops (N = 60) were compared descriptively. Mean item scores and response patterns from students who received the virtual workshop were nominally comparable to the student scores from the in-person workshop. Following the virtual workshop, one teacher notified the research team of a disclosure of CSA. Qualitative input from the facilitator and school staff was positive, indicating high student engagement. Results suggest the viability and feasibility of virtual school-based CSA preventive programs. Investment in virtual modes of delivery would ensure all students have access to CSA prevention programming in the future.
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Affiliation(s)
- Kate Guastaferro
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | | | - Jessica Trudeau
- The New York Society for the Prevention of Cruelty to Children, New York, NY, USA
| | - Lauren B Lipson
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - S Sunshine
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Jennie G Noll
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Mary L Pulido
- The New York Society for the Prevention of Cruelty to Children, New York, NY, USA
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Letourneau EJ, Assini-Meytin LC, Nair R, Stuart EA, Decker MR, McGinty EB. Health insurance expansion and family violence prevention: A conceptual framework. CHILD ABUSE & NEGLECT 2022; 129:105664. [PMID: 35580400 DOI: 10.1016/j.chiabu.2022.105664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 06/15/2023]
Abstract
Family violence, including child maltreatment (CM) and intimate partner violence (IPV), plagues far too many American families, particularly those in low-income communities. CM and IPV are intertwined and impose a significant emotional, health and financial burden on children and families and an economic burden on our country. Although these and other forms of violence are influenced by shared risk factors across the socioecological spectrum, prevention efforts typically intervene on a single type of violence at a microsystem level via individual or family intervention. Research is needed to identify policies operating at macrosystem levels that reduce, at scale, multiple forms of violence affecting children. In this paper, we propose a three-step theory of change through which health insurance expansions might reduce rates of CM and IPV, using Medicaid expansion as an exemplar. The proposed framework can inform research examining the link between health insurance and the primary prevention of CM and IPV.
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Affiliation(s)
- Elizabeth J Letourneau
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Luciana C Assini-Meytin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Reshmi Nair
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elizabeth A Stuart
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michele R Decker
- Department of Population Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emma Beth McGinty
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Farooqui M, Shoaib S, Afaq H, Quadri S, Zaina F, Baig A, Liaquat A, Sarwar Z, Zafar A, Younus S. Bidirectionality of smoking and depression in adolescents: a systematic review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2022; 45:e20210429. [PMID: 35738567 PMCID: PMC10416256 DOI: 10.47626/2237-6089-2021-0429] [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: 11/30/2021] [Accepted: 06/08/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Recently, evidence has been accumulating that both smoking and mental health disorders are continuously increasing among adolescents. This systematic review elucidates the research into evidence of the direction of the association and risk factors influencing the relationship between smoking and depression. We also highlight recent studies on the effects of electronic cigarettes and developments on the association between depression and smoking. METHODS A literature search was conducted on databases including PubMed, Ovid Medline, EMBASE, and PsycINFO and in relevant neurology and psychiatry journals. Terms used for electronic searches included smoking, tobacco, cigarettes; depression; adolescent, youth; direction. Relevant information was then utilized to synthesize findings on the association between smoking and depression among adolescent population. RESULTS The initial database searches yielded 2,738 related articles. After screening and cross-referencing, duplicate articles, articles published in languages other than English, and studies on animals, social and lifestyle factors, mood disorders, and substance use were excluded. Of these, a total of 122 publications only focusing on smoking and depression in the adolescent population were selected for synthesis in this qualitative systemic review. These include 110 original research articles, eight meta-analyses and reviews, and four reports and websites. CONCLUSION The relationship between smoking and depression in the literature does not reflect the cause-effect relationship. The lack of evidence on the direction of the association may reflect futile study designs, confounding factors and/or use of indirect measures of depression and quantification of smoking. Future prospective randomized studies should target elucidation of the causal association.
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Affiliation(s)
- Mudassir Farooqui
- Department of NeurologyUniversity of IowaHospitals and ClinicsIowa CityIAUSA Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
| | - Samra Shoaib
- Department of PsychiatryNassau UniversityMedical CenterEast MeadowNYUSA Department of Psychiatry, Nassau University Medical Center, East Meadow, NY, USA.
| | - Humera Afaq
- Department of Public HealthNational UniversitySan DiegoCAUSA Department of Public Health, National University, San Diego, CA, USA.
| | - Syed Quadri
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Fatima Zaina
- Department of PulmonologyZiauddin University and HospitalKarachiPakistan Department of Pulmonology, Ziauddin University and Hospital, Karachi, Pakistan.
| | - Aqsa Baig
- Liaquat National HospitalMedical CollegeKarachiPakistan Liaquat National Hospital & Medical College, Karachi, Pakistan.
| | - Ayesha Liaquat
- Karachi Medical and Dental CollegeKarachiPakistan Karachi Medical and Dental College, Karachi, Pakistan.
| | - Zoona Sarwar
- Department of SurgeryUniversity of OklahomaOklahoma CityOKUSA Department of Surgery, University of Oklahoma, Oklahoma City, OK, USA.
| | - Atif Zafar
- Department of NeurologyUniversity of TorontoTorontoONCanada Department of Neurology, University of Toronto, Toronto, ON, Canada.
| | - Sana Younus
- Menninger Department of Psychiatry and Behavioral SciencesBaylor College of MedicineHoustonTXUSA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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44
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Steil R, Schneider A, Schwartzkopff L. How to Treat Childhood Sexual Abuse Related PTSD Accompanied by Risky Sexual Behavior: A Case Study on the Use of Dialectical Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD). JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:471-478. [PMID: 35600534 PMCID: PMC9120332 DOI: 10.1007/s40653-021-00421-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 06/15/2023]
Abstract
Childhood and adolescent sexual abuse (CSA) is a traumatic experience associated with a variety of short- and long-term negative consequences. Theoretical models assume that an abuse related and learned distorted image of sexuality might lead CSA survivors to feel obligated to provide sex or engage in unwanted sexual practices in order to gain affection or prevent abandonment. Dialectical behavioral therapy for posttraumatic stress disorder (DBT-PTSD) is tailored to people with PTSD and comorbid emotion regulation deficits. This case study presents the results of an outpatient DBT-PTSD treatment of an adult patient with posttraumatic stress disorder following sexual and physical abuse. DBT-PTSD was used to treat the patient's complex psychopathological problems and to decrease her risky sexual behavior, which manifested itself in highly dangerous sexual practices with her partner. The treatment took place over a period of 18 months, with a total of 72 sessions. At the end of the treatment, the patient no longer met criteria for PTSD as indicated by large reductions in the assessments used. Furthermore, she managed to distance herself from risky sexual practices and to remain in a satisfying relationship.
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Affiliation(s)
- Regina Steil
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Goethe University, Frankfurt, Frankfurt, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University, Giessen, Germany
| | - Angelina Schneider
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Goethe University, Frankfurt, Frankfurt, Germany
| | - Laura Schwartzkopff
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Goethe University, Frankfurt, Frankfurt, Germany
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45
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Butler AC. Sexual and Physical Assault Before Age 18 and Young Adults' Perception of Unfair Treatment. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP10296-NP10328. [PMID: 33448237 DOI: 10.1177/0886260520985481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Research indicates that sexual and physical assault generate negative emotions of shame and anger, undermine self-esteem, and increase interpersonal sensitivity. This in turn may bring about behavioral changes and cognitive bias, which may adversely affect victims' social interactions. The purpose of this study was to examine whether sexual or physical assault before age 18 is associated with a heightened sense of being treated unfairly in early adulthood. A nationally representative sample of young adults age 18-21 (N = 2,770; 49% female) self-reported on whether they had ever been sexually or physically assaulted, whether it first occurred in childhood or adolescence, and how frequently they are treated unfairly in their everyday interactions with other people, as measured by the Everyday Discrimination Scale (EDS). Multivariate regression results indicated that child (≤age 12) physical assault and adolescent-onset (age 13-17) physical assault were associated with higher scores on the EDS for both men and women. Child sexual assault was associated with the EDS for men; adolescent-onset sexual assault was associated with the EDS for women. Violence as a minor was associated with each item of the EDS (e.g., treated with less respect, less courtesy, other people act of afraid of you, etc.). Violence victims attributed their elevated levels of perceived unfair treatment to their gender, race, age, and aspects of their physical appearance. Overall, the results suggest a mechanism through which a history of sexual and physical assault can affect social interactions.
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46
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Froelich J, Timko C, Woodhead EL. Motives for substance use and 6-month substance use outcomes among detoxification patients with a history of physical or sexual abuse or posttraumatic stress disorder. J Trauma Stress 2022; 35:976-987. [PMID: 35255172 DOI: 10.1002/jts.22806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 11/11/2022]
Abstract
Trauma-exposed individuals with a history of physical or sexual abuse or documented posttraumatic stress disorder (PTSD) diagnosis may use substances to address trauma-related symptoms. However, the motives for using substances among adults with a trauma history or PTSD are unclear despite their informative role in treatment planning. Additionally, trauma is associated with poorer substance use outcomes, although this has not been examined among detoxification patients. The current study examined motives for substance use at baseline and substance use outcomes during 6 months postbaseline among 298 veteran detoxification patients (i.e., alcohol, opioids, or both) with and without (a) a history of physical or sexual abuse and (b) a PTSD diagnosis. At baseline, participants with a physical or sexual abuse history were more likely to report the use of substances to temporarily lower stress, forget problems, and avoid uncomfortable feelings than those without this history, ds = 0.25-0.40. Compared with participants without a PTSD diagnosis, participants with diagnosed PTSD were more likely to report using substances to temporarily lower stress, d = 0.25. Longitudinal analyses demonstrated that the baseline characteristics of physical abuse history, sexual abuse history, and diagnosed PTSD were all associated with higher scores on a measure of risk factors for relapse (e.g., cravings, family/social problems) as assessed during the postdetoxification period, φ = .13, .10, and .09, respectively. Detoxification patients with physical and/or sexual abuse histories or PTSD diagnoses may need treatments that better address trauma symptoms to help them sustain abstinence.
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Affiliation(s)
- Jessilyn Froelich
- National Center for PTSD, Veterans Affairs (VA) Health Care System, Menlo Park, California, USA.,Department of Psychology, San José State University, San José, California, USA
| | - Christine Timko
- Center for Innovation to Implementation, Veterans Affairs (VA) Health Care System, Menlo Park, California, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Erin L Woodhead
- Department of Psychology, San José State University, San José, California, USA
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47
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Betz LT, Penzel N, Kambeitz J. A network approach to relationships between cannabis use characteristics and psychopathology in the general population. Sci Rep 2022; 12:7163. [PMID: 35504926 PMCID: PMC9065088 DOI: 10.1038/s41598-022-11092-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 04/08/2022] [Indexed: 11/27/2022] Open
Abstract
Cannabis use characteristics, such as earlier initiation and frequent use, have been associated with an increased risk for developing psychotic experiences and psychotic disorders. However, little is known how these characteristics relate to specific aspects of sub-clinical psychopathology in the general population. Here, we explore the relationships between cannabis use characteristics and psychopathology in a large general population sample (N = 2,544, mean age 29.2 years, 47% women) by employing a network approach. This allows for the identification of unique associations between two cannabis use characteristics (lifetime cumulative frequency of cannabis use, age of cannabis use initiation), and specific psychotic experiences and affective symptoms, while controlling for early risk factors (childhood trauma, urban upbringing). We found particularly pronounced unique positive associations between frequency of cannabis use and specific delusional experiences (persecutory delusions and thought broadcasting). Age of cannabis use initiation was negatively related to visual hallucinatory experiences and irritability, implying that these experiences become more likely the earlier use is initiated. Earlier initiation, but not lifetime frequency of cannabis use, was related to early risk factors. These findings suggest that cannabis use characteristics may contribute differentially to risk for specific psychotic experiences and affective symptoms in the general population.
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Affiliation(s)
- Linda T Betz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
| | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
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48
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Pham AT, Nunes KL, Maimone S, Jung S. Childhood sexual victimization, pedophilic interest, and antisocial orientation. SEXUAL OFFENDING 2022. [DOI: 10.5964/sotrap.5425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
According to the sexually abused-abuser hypothesis, childhood sexual victimization (CSV) among males increases the likelihood of later sexual offending against children. Why CSV is related to sexual offending against children, however, has yet to be determined. To explore mechanisms that may link CSV to sexual offending, we tested the relationship between CSV and the two main risk domains: pedophilic interest and antisocial orientation. In four studies, men convicted of sexual offences against children under 15 who reported experiencing CSV were generally more sexually interested in children—especially male children—and were more antisocial than those who did not report experiencing CSV. A meta-analysis of the results across our four studies showed that CSV was moderately associated with greater antisociality, but less so with pedophilic interests. Future research should test the extent to which pedophilic interest and antisocial orientation explain the relationship between CSV and sexual offending against children among convicted sexual offenders.
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49
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Siciliano RE, Anderson AS, Compas BE. Autonomic nervous system correlates of posttraumatic stress symptoms in youth: Meta-analysis and qualitative review. Clin Psychol Rev 2022; 92:102125. [PMID: 35078039 PMCID: PMC8858870 DOI: 10.1016/j.cpr.2022.102125] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/25/2021] [Accepted: 01/09/2022] [Indexed: 11/17/2022]
Abstract
Physiological dysregulation is a key diagnostic criterion for posttraumatic stress disorder (PTSD). While PTSD is defined by trauma exposure, symptom presentations are varied. Similarly, findings of autonomic nervous system (ANS), including parasympathetic (PNS) and sympathetic nervous system (SNS), function in youth exposed to trauma are mixed (e.g., hyporeactivity and hyperreactivity). The present meta-analysis quantitatively assesses the relation between ANS measures broadly, and PNS- and SNS-specific measures, and posttraumatic stress symptoms (PTSS) in youth (ages 4.98 to 19.55 years) across 38 cross-sectional and longitudinal studies (N = 3488). Findings demonstrate that heightened ANS activity is related to increased PTSS during stress tasks (r = 0.07), while decreased SNS activity at rest corresponded to increased PTSS (r = -0.09). The correlation between PNS measures and PTSS was non-significant. The moderation effect of age on the relation between PNS activity measured during stress tasks and PTSS approached significance, such that younger children showed a stronger negative relation between symptoms and PNS activity compared to older youth. Qualitative review of included studies revealed significant variability across sample and stressor characteristics and study methodology. Findings indicate the importance of autonomic dysregulation in youth with PTSS. Additional considerations for future research are discussed.
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Affiliation(s)
- Rachel E. Siciliano
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Allegra S. Anderson
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Bruce E. Compas
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
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50
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Sussman TJ, Santaella-Tenorio J, Duarte CS, Wall MM, Ramos-Olazagasti M, Suglia SF, Canino G, Bird H, Martins SS. Do Trajectories of Sensation Seeking Vary by Sex and Child Maltreatment Subtypes? JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP3377-NP3399. [PMID: 32783490 PMCID: PMC7878577 DOI: 10.1177/0886260520943722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Child maltreatment and elevated sensation seeking are associated with a wide range of negative outcomes. Longitudinal data from a study of Puerto Ricans living in two sociocultural contexts were used to determine whether child maltreatment subtypes, sex, or sociocultural context relate to trajectories of sensation seeking. Participants were 2,489 individuals from the Boricua Youth Study (48.5% girls) living in New York and in Puerto Rico (PR; 5-15 years old at Wave 1). Subtypes of child maltreatment were measured using child report on the Parent-Child Conflict Tactics Scale and the Sexual Victimization Scale at Wave 1. The association between child maltreatment subtypes, sex, sociocultural context, and previously established sensation-seeking trajectories across three waves of data collection was probed using multinomial logistic regression. Girls, but not boys, who experienced neglect (adjusted odds ratio; AOR; 95% confidence interval [95% CI] = 5.33 [1.35, 21.03]), or physical abuse (AOR [95% CI] = 3.66 [1.07, 12.54]), were more likely to have an elevated sensation-seeking trajectory than a normative trajectory. For boys, none of the maltreatment subtypes were linked to the elevated sensation-seeking class. Girls exposed to verbal abuse (AOR [95% CI] = 0.33 [0.15, 0.75]) and boys exposed to physical abuse (AOR [95% CI] = 0.39 [0.16, 0.97]) were less likely to belong to the low sensation-seeking class. No significant interactions between sociocultural context (i.e., PR vs. New York) and maltreatment subtype on the development of sensation seeking were found. This research suggests sensation-seeking levels vary by experiences of childhood maltreatment, and that sex moderates the relationship between child maltreatment experiences and sensation seeking, with an association between some maltreatment subtypes and elevated sensation-seeking trajectories found in girls, but not boys. These results underline the importance of considering sex when examining how child maltreatment relates to outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | - Hector Bird
- Columbia University, New York City, NY, USA
- Ponce Medical School, PR, USA
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