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Meulewaeter F, De Pauw SSW, Vanderplasschen W. Mothering, Substance Use Disorders and Intergenerational Trauma Transmission: An Attachment-Based Perspective. Front Psychiatry 2019; 10:728. [PMID: 31681040 PMCID: PMC6813727 DOI: 10.3389/fpsyt.2019.00728] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 09/11/2019] [Indexed: 01/23/2023] Open
Abstract
Background: A growing body of research underlines that interpersonal trauma in childhood leads to heightened susceptibility for substance use disorders (SUDs) in later life. Little research has been conducted on parenting experiences of mothers in recovery from substance use, taking into account their own upbringing as a child and the potential aftermath of interpersonal childhood trauma. Methods: Through in-depth qualitative interviews, 23 mothers with SUDs reflected on parenting experiences and parent-child bonding, related to both their children and parents. Interviews were transcribed verbatim and data were analyzed adopting thematic analysis. Results: Throughout the narratives, consequences of trauma on mothers' sense of self and its subsequent impact on parenting arose as salient themes. Five latent mechanisms of intergenerational trauma transmission were identified: 1) early interpersonal childhood trauma experiences in mothers; 2) trauma as a precursor of substance use; 3) substance use as a (self-fooling) enabler of parental functioning; 4) continued substance use impacting parental functioning; and 5) dysfunctional parental functioning and its relational impact upon offspring. Discussion: Findings suggest disruptive attachment can increase the vulnerability for SUDs on the one hand, but can be an expression of underlying trauma on the other, hence serving as a covert mechanism by which trauma can be transmitted across generations. Results indicate the need for preventive, attachment-based and trauma-sensitive interventions targeted at disruptive intergenerational patterns.
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Mohammadi MR, Alavi SS, Ahmadi N, Khaleghi A, Kamali K, Ahmadi A, Hooshyari Z, Mohamadian F, Jaberghaderi N, Nazaribadie M, Sajedi Z, Farshidfar Z, Kaviani N, Davasazirani R, Shahbakhsh AJ, Rad MR, Shahbazi K, Khodaverdloo RR, Tehrani LN, Nasiri M, Naderi F, Kiani A, Chegeni M, Hashemi Nasab SM, Ghaneian M, Parsamehr H, Nilforoushan N, Amiri S, Fooladi MF, Mohammadzadeh S, Ahmadipour A, Sarraf N, Hojjat SK, Nadermohammadi M, Mostafavi SA, Zarafshan H, Salmanian M, Shakiba A, Ashoori S. The prevalence, comorbidity and socio-demographic factors of depressive disorder among Iranian children and adolescents: To identify the main predictors of depression. J Affect Disord 2019; 247:1-10. [PMID: 30640024 DOI: 10.1016/j.jad.2019.01.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 12/23/2018] [Accepted: 01/04/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Depressive disorders are a major public health problem in developed and developing countries. Recently, several risk factors have been described for depressive disorders in children and adolescents. The aim of the present study was to identify the main risk factors that can affect the incidence of depression in Iranian children and adolescents. METHODS A total of 30,546 children and adolescents (between 6 and 18 years of age) participated in a cross-sectional study to identify the predictors of depressive disorders. Depressive disorders were assessed using the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL). In addition, a demographic characteristics questionnaire was completed by parents of the participants. The data was analyzed using the SPSS22 software via performing the descriptive analysis and the multiple logistic regression analysis methods. P-values less than 0.05 were considered statistically significant. RESULTS Results showed that a higher age (15-18), being female, and the father's unemployment were associated with an increased odds ratio for depressive disorders. The age of 10-14 (OR = 2.1; 95% CI, 1.57-2.81), the age of 15-18 (OR = 4.44; 95% CI, 3.38-5.83), female gender (OR = 1.44; 95% CI, 1.2-1.73) and the father's unemployment (OR = 1.59; 95% CI, 1.01-2.5) were significant positive predictors, whereas, the mother's job (as a housewife) (OR = 0.66; 95% CI, 0.45-0.96) and a history of psychiatric hospitalization of the father and mother (OR = 0.34; 95% CI, 0.15-0.78 and OR = 0.34; 95% CI, 0.14-0.84) were negative predictors for depressive symptoms. CONCLUSION Depressive symptoms are common in children and adolescents and are correlated with age and gender. The assessment of the prevalence of psychiatric disorders, especially the depressive disorders and their comorbidities, may help to prevent mood disorders in children and adolescents.
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Affiliation(s)
- Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Seyyed Salman Alavi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nastran Ahmadi
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Ali Khaleghi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Koorosh Kamali
- Department of Public Health, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Ameneh Ahmadi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zahra Hooshyari
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fathola Mohamadian
- Department of Psychology, Psychosocial Injuries Research Center, Ilam University of Medical Science, Ilam, Iran.
| | - Nasrin Jaberghaderi
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Marzieh Nazaribadie
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Zahra Sajedi
- Faculty of Psychology and Educational Sciences, University of Semnan, Semnan, Iran.
| | | | - Nahid Kaviani
- Health Deputy, Kerman University of Medical Sciences, Kerman, Iran.
| | - Reza Davasazirani
- Community Mental Health and Addiction Health Department of Khuzestan Province, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | | | | | | | | | | | | | - Fatemeh Naderi
- Hormozgan University of Medical Sciences, Hormozgan, Iran.
| | - Arezou Kiani
- Urmia University of Medical Sciences, Urmia, Iran.
| | | | | | - Mahnaz Ghaneian
- Department of Psychology, Islamic Azad University, Najafabad Branch, Najafabad, Iran.
| | - Hosein Parsamehr
- Lorestan University of Medical Sciences, Imam Reza Psychiatric Hospital, Khorramabad, Iran.
| | | | - Shahrokh Amiri
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mahbod Fadaei Fooladi
- Department of Psychology and Educational Sciences, Allameh Tabatabai University, Tehran, Iran.
| | - Soleiman Mohammadzadeh
- Department of Psychiatry, Neuroscience Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Ahmad Ahmadipour
- Department of Psychiatry, Booshehr University of Medical Sciences, Khalij-E Fars Hospital. Booshehr, Iran.
| | - Nasrin Sarraf
- Department of Child and Adolescents Psychiatry, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Seyed Kaveh Hojjat
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran.
| | | | - Seyed-Ali Mostafavi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hadi Zarafshan
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Maryam Salmanian
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Alia Shakiba
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Simin Ashoori
- Mashhad University of Medical Sciences, Mashhad, Iran.
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Lewis AJ. Attachment-Based Family Therapy for Adolescent Substance Use: A Move to the Level of Systems. Front Psychiatry 2019; 10:948. [PMID: 32116807 PMCID: PMC7025563 DOI: 10.3389/fpsyt.2019.00948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 11/29/2019] [Indexed: 12/14/2022] Open
Abstract
This paper provides an account of the theoretical basis of a family-based intervention called Behaviour Exchange and Systems Therapy (BEST). The model described here has also been applied to adolescents with substance abuse and other mental health problems such as depression and anxiety disorders in both children and adolescents. Evaluative studies of the model have been published including randomised clinical trials as well as qualitative analyses. The current paper discusses a theory of the family system as a discourse and represents an integration of aspects of attachment, psychoanalytic, and systems theories. Key concepts elaborated are the attachment-family system, the family as a single discourse, the use of segregation as a defense in relation to trauma and loss and its manifestation in a family narrative, and the role of the family secure base in affect regulation. The paper also briefly describes specific treatment techniques that are derived from the theoretical model. Our approach has wide application as a discourse focused treatment for children and adolescents using a family systems approach. Future work requires the comparison of this model to similar attachment-based models of intervention for children and families, further development and validation of measures able to be used for whole families in a clinical setting, and further empirical demonstration of treatment efficacy in a variety of clinical settings.
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Affiliation(s)
- Andrew J Lewis
- Discipline of Psychology, Murdoch University, Perth, WA, Australia
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Lewis AJ, Rowland B, Tran A, Solomon RF, Patton GC, Catalano RF, Toumbourou JW. Adolescent depressive symptoms in India, Australia and USA: Exploratory Structural Equation Modelling of cross-national invariance and predictions by gender and age. J Affect Disord 2017; 212:150-159. [PMID: 28192764 DOI: 10.1016/j.jad.2017.01.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 01/11/2017] [Accepted: 01/19/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND The present study compares depressive symptoms in adolescents from three countries: Mumbai, India; Seattle, United States; and Melbourne, Australia measured using the Short Moods and Feelings Questionnaire (SMFQ). The study cross nationally compares SMFQ depressive symptom responses by age and gender. METHODS Data from a cross-nationally matched survey were used to compare factorial and measurement characteristics from samples of students from Grade 7 and 9 in Mumbai, India (n=3268) with the equivalent cohorts in the Washington State, USA (n=1907) and Victoria, Australia (n=1900). Exploratory Structural Equation Modelling (ESEM) was used to cross-nationally examine factor structure and measurement invariance. RESULTS A number of reports suggesting that SMFQ is uni-dimensional were not supported in findings from any country. A model with two factors was a better fit and suggested a first factor clustering symptoms that were affective and physiologically based symptoms and a second factor of self-critical, cognitive symptoms. The two-factor model showed convincing cross national configural invariance and acceptable measurement invariance. The present findings revealed that adolescents in Mumbai, India, reported substantially higher depressive symptoms in both factors, but particularly for the self-critical dimension, as compared to their peers in Australia and the USA and that males in Mumbai report high levels of depressive symptoms than females in Mumbai. LIMITATIONS the cross sectional study collected data for adolescents in Melbourne and Seattle in 2002 and the data for adolescents in Mumbai was obtained in 2010-2011 CONCLUSIONS: These findings suggest that previous findings in developed nations of higher depressive symptoms amongst females compared to males may have an important cultural component and cannot be generalised as a universal feature of adolescent development.
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Affiliation(s)
- Andrew J Lewis
- School of Psychology and Exercise Science Murdoch University, Perth, WA, Australia; Harry Perkins Medical Research Institute, Fiona Stanley Hospital, Perth, WA, Australia.
| | - Bosco Rowland
- School of Psychology, Faculty of Health Deakin University, Burwood, Victoria, Australia
| | - Aiden Tran
- Gatehouse Centre, Royal Children's Hospital, 50 Flemington Rd Parkville 3052, Victoria, Australia
| | - Renatti F Solomon
- School of Psychology and Exercise Science Murdoch University, Perth, WA, Australia; Department of Psychology, KBP College and Institute for Child and Adolescent Health Research, Mumbai, India
| | - George C Patton
- Murdoch Children's Research Institute, The Royal Children's Hospital Campus Melbourne, Centre for Adolescent Health, Victoria, Australia; The University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Victoria, Australia
| | | | - John W Toumbourou
- School of Psychology, Faculty of Health Deakin University, Burwood, Victoria, Australia
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