Self-Regulation and Shame as Mediators Between Childhood Experiences and Young Adult Health

An analysis of risk factors and current status of depressive mood in mid-to-late adolescence and early adulthood in northern China

Introduction

At present, the incidence of adolescent depression is increasing each year, having a wide and profound impact on adolescents. This study investigated the mood state of mid-to-late adolescents and young adults and analyzed related factors; clarified the incidence of depression, suicide, and self-injurious thoughts/behaviors in this population; and conducted relevant analysis of related factors of depression and anxiety.

Methods

Study subjects were students aged 14-25 years, from three high schools and one university in Liaoning Province. Study subjects were evaluated using several questionnaires that combined online and offline methods. Specifically, the Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Simplified Coping Style Questionnaire (SCSQ), Child Depression Inventory (CDI), the Chinese version of the Spence Child Anxiety Scale (SCAS), and a general questionnaire were utilized. Single-factor ANOVA, t-test, Chi-square, and multiple regression analysis were used to analyze the data.

Results

The results showed that, among the 14-17-year-old subjects, the incidence of depression was 336 (14.7%), the incidence of anxiety was 763 (33.5%). Among the 18-25-year-old subjects, the incidence of depression was 34 (8.6%), the incidence of anxiety was 7 (1.8%). In the general questionnaire, 2081 (77.8%) individuals were depressed, 689 (25.8%) had thoughts of self-injury, and 323 (12.1%) had self-injurious behaviors. Among the 14-17-year-old subjects, 1789 (78.46%) were depressed, 689 (30.22%) had self-injury thoughts, and 319 (1.71%) had self-injurious behaviors. Among the 18-25-year-old subjects, 292 (73.92%) were depressed, but 4 (1.01%) had self-injurious behaviors. The incidence of depression and anxiety in adolescents is high, presenting with a certain risk of self-injury. However, age is an important factor in the occurrence of depression and anxiety; among the 18-25-year-old subjects, the incidence of depression (8.6% vs. 4.7%) and anxiety (1.8% vs. 33.5%) was lower than that among the 14-17-year-old population. Through comparative analysis, adolescents aged 14-17 remained at high risk of depression and anxiety.

Discussion

In the analysis of risk factors for depression and anxiety, relationships with classmates, teachers, and parents were reported as important influencing factors of emotional state. Further, a good coping style was found to be protective against depression and anxiety.

Adverse childhood experiences and aggression in adulthood: The moderating role of positive childhood experiences

BACKGROUND

Adverse childhood experiences (ACEs) have a significant impact on a person's psychological development and predispose them to various harmful consequences in adulthood, such as different forms of aggression. Contrarily, positive childhood experiences (PCEs) operate as protective factors, buffering against the adverse effects of ACEs and promoting adaptive behaviors and psychological well-being. However, the role of PCEs in the relationship between ACEs and aggression remains relatively unexplored.

OBJECTIVE

To explore the moderation role of PCEs in the relationship between ACEs and aggression and its different components across sexes in a community sample.

METHODS

A sample of 1541 Portuguese adults answered an online protocol with a sociodemographic questionnaire, the Benevolent Childhood Experiences Scale, the Childhood History Questionnaire, and the Buss-Perry Aggression Questionnaire.

RESULTS

ACEs were positively correlated with aggression, including physical and verbal aggression, anger, and hostility, with women reporting a higher prevalence of ACEs and higher levels of anger. Men revealed higher scores in physical and verbal aggression. Furthermore, moderation analyses clarified the moderating effect of PCEs on the relationship between ACEs and aggression in women and between ACEs and anger in both sexes. PCEs attenuate the adverse impact of ACEs, reducing aggression and anger levels.

CONCLUSIONS

This study stresses the complex interplay between childhood experiences and adult aggression, highlighting the differential effects of ACEs and PCEs across men and women. By clarifying these dynamics, interventions can be tailored to bolster protective factors like PCEs. This will ultimately foster healthier developmental trajectories and reduce the prevalence of aggression in adulthood.

Positive Childhood Experiences and the Indirect Relationship With Improved Emotion Regulation in Adults With ADHD Through Social Support

OBJECTIVE

To identify direct and indirect associations between PCEs and social support to emotion regulation outcomes in adults with ADHD.

METHOD

Adults with ADHD (n = 81) reported PCEs, current social support, and emotion regulation. Conditional effects modeling examined the direct and indirect relationships between PCEs and emotion dysregulation through social support.

RESULTS

Higher PCEs were indirectly related to improved emotion regulation through increased social support generally (β = -.70, 95% CI [-1.32, -0.17], and specifically through belonging (β = -.43, 95% CI [ -0.87, -0.05], self-esteem (β = -.61, 95% CI [-1.08, -0.27], and tangible social support (β = -.50, 95% CI [-1.07, -0.02].

CONCLUSIONS

PCEs may protect emotion regulation in adults with ADHD through social support, possibly through facilitating social connections, increasing access to social support, and sustaining emotion regulation strategies.

Life experience pathways to college student emotional and mental health: A structural equation model

Objective: Previous research suggests that both adverse childhood experiences (ACEs), positive childhood experiences (PCEs), and current life experiences are associated with emotional wellbeing and mental health. The purpose of this study was to explore the influence of these life experience and coping processes on college student emotional and mental health. Participants: College students (N = 555) were recruited from a large western university. Methods: Participants completed an online cross-sectional survey measuring early and current life experiences, cognitive and emotional coping efforts, and emotional and mental health outcomes. Data were analyzed using structural equation modeling. Results: There was an indirect effect of PCEs on emotional and mental health through cognitive and emotional coping efforts. No association was observed between ACEs and mental health. Conclusions: Increases in PCEs are protective, enhance coping efforts, and strengthen emotional and mental health outcomes among college students.

Shame, fear of compassion, self-criticism, and self-reassurance mediate the effect of early life events on emotional disorders among male prisoners: A structural equation modeling analysis

BACKGROUND

Early negative experiences in childhood are potent predictors of criminal behavior in youth and adulthood. This study aimed to identify the mediation effects of Shame, Fear of Compassion, Self-criticism, and Self-reassurance on the effect of Early Life Events on Emotional Disorders.

METHOD

This cross-sectional study was conducted among 368 male prisoners (Mean age: 33.26 ± 8.41 years) with convenient sampling method, from Ilam, Iran. A set of self-reported instruments were used for data collection. The ultimate model was constructed using structural equation modeling after confirming the construct validity of the measures via confirmatory factor analysis.

RESULTS

Shame, fear of compassion, self-criticism, and self-reassurance significantly mediated the relationship between Early Life Events and emotional disorders. The mediating effect accounted for 77 % of the total effect in the mediating model. According to Pearson's correlation, a positive and significant relationship existed between early life events and self-criticism, shame, fear of compassion and emotional disorders (P < .001). In conclusion, the presented model has an appropriate and acceptable fit, as evidenced by the results of the chi-square test (χ2 = 48.067, p < .001) and other relevant fit indices. However, self-reassurance's mediating role was insignificant (P > .05).

CONCLUSIONS

The present results showed that shame, fear of compassion, and self-criticism are important mediators in the relationship between early life events and emotional disorders among male prisoners. So, it is necessary to develop related protocols to increase the mental health of prisoners.

The Associations of Adverse Childhood Experiences (ACEs) With Substance Use in Young Adults: A Systematic Review

Introduction

Young adulthood is a transitional period between adolescence and adulthood. Due to the unique pressures of taking on a new social role and associated uncertainties, young adults are at heightened risk for drug and alcohol use. Furthermore, adverse childhood experiences (ACEs) increases the likelihood of using maladaptive coping strategies such as using substances to avoid or soothe negative emotions. The current review aimed to summarize the associations between exposure to ACEs before the age of 18 years and subsequent drug or alcohol use between the ages of 18 and 25 years.

Methods

The review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search of the Web of Science, PubMed, and PsycINFO databases was conducted in February 2022.

Results

The initial search yielded 7178 articles, with 777 duplicates. Consequently, 6401 titles were inspected for relevance. After reading the full text, 88 articles were included in the review.

Conclusion

This review provides clear evidence that exposure to multiple ACEs is a robust risk factor for the use of alcohol, cannabis and other drugs by young adults. Poor self-regulation and maladaptive coping strategies were identified as mechanisms explaining this link; however, further detailed research is needed.

Protective factors for psychosocial outcomes following cumulative childhood adversity: systematic review

BACKGROUND

The long-term cumulative impact of exposure to childhood adversity is well documented. There is an increasing body of literature examining protective factors following childhood adversity. However, no known reviews have summarised studies examining protective factors for broad psychosocial outcomes following childhood adversity.

AIMS

To summarise the current evidence from longitudinal studies of protective factors for adult psychosocial outcomes following cumulative exposure to childhood adversity.

METHOD

We conducted a formal systematic review of studies that were longitudinal; were published in a peer-reviewed journal; examined social, environmental or psychological factors that were measured following a cumulative measure of childhood adversity; and resulted in more positive adult psychosocial outcomes.

RESULTS

A total of 28 studies from 23 cohorts were included. Because of significant heterogeneity and conceptual differences in the final sample of articles, a meta-analysis was not conducted. The narrative review identified that social support is a protective factor specifically for mental health outcomes following childhood adversity. Findings also suggest that aspects of education are protective factors to adult socioeconomic, mental health and social outcomes following childhood adversity. Personality factors were protective for a variety of outcomes, particularly mental health. The personality factors were too various to summarise into meaningful combined effects. Overall GRADE quality assessments were low and very low, although these scores mostly reflect that all observational studies are low quality by default.

CONCLUSIONS

These findings support strategies that improve connection and access to education following childhood adversity exposure. Further research is needed for the roles of personality and dispositional factors, romantic relationship factors and the combined influences of multiple protective factors.

Associations of adverse and protective childhood experiences with thwarted belongingness, perceived burdensomeness, and suicide risk among sexual minority men

BACKGROUND

Sexual minority men (SMM) experience higher suicidal ideation and suicide attempts than the general population. We examined the associations of adverse childhood experiences (ACES) and protective and compensatory childhood experiences (PACES) with suicidal ideation and suicide attempts in adulthood via thwarted belongingness and perceived burdensomeness among SMM.

METHODS

Data are from the UNITE study, a national longitudinal cohort study of HIV-negative SMM from the 50 U.S. states and Puerto Rico. Between 2017 and 2019, participants (N = 6303) completed web-based assessments at baseline and 12-month follow-up. ACES and PACES occurring before the age of 18, and current symptoms of thwarted belongingness and perceived burdensomeness were assessed at baseline. Past-week suicidal ideation and past-year suicide attempt were assessed at follow-up.

RESULTS

424 (6.7%) participants reported past-week suicidal ideation and 123 (2.0%) reported a past-year suicide attempt. The results of our multivariate model suggest that each additional adverse childhood experience was prospectively associated with 14% higher odds of past-week suicidal ideation (AOR = 1.14, 95% CI 1.09-1.19) and 19% higher odds of past-year suicide attempt (AOR = 1.19, 95% CI 1.11-1.29). Each additional protective childhood experience was prospectively associated with 15% lower odds of past-week suicidal ideation (AOR = 0.85, 95% CI 0.81-0.90) and 11% lower odds of past-year suicide attempt (AOR = 0.89, 95% CI 0.82-0.98). Perceived burdensomeness partially mediated these prospective associations.

CONCLUSION

To reduce suicide, screening and treating perceived burdensomeness among SMM with high ACES may be warranted. PACES may decrease perceived burdensomeness and associated suicide risk.

Positive Childhood Experiences and Chronic Pain Among Children and Adolescents in the United States

Positive childhood experiences (PCEs) are associated with better mental and physical health outcomes and moderate the negative effects of adverse childhood experiences (ACEs). However, knowledge of the associations between PCEs and childhood chronic pain is limited. We conducted a cross-sectional analysis of 2019 to 2020 National Survey of Children's Health (NSCH) to evaluate associations between PCEs and childhood chronic pain. Parents of 47,514 children ages 6 to 17 years old reported on their child's exposure to 7 PCEs and 9 ACEs. Associations between PCEs and chronic pain were evaluated using weighted, multivariate logistic regression analyses adjusted for sociodemographic factors. We found that PCEs had dose-dependent associations with pediatric chronic pain; children exposed to higher numbers of PCEs (5-7 PCEs) had the lowest reported rate of chronic pain (7.1%), while children exposed to 2 or fewer PCEs had the highest rate of chronic pain (14.7%). The adjusted analysis confirmed that children experiencing 5 to 7 PCEs had significantly lower odds of chronic pain relative to children experiencing 0 to 2 PCEs (adjusted odds ratio (aOR): .47, 95% confidence interval (CI): .39-.61, P < .0001). PCEs moderated associations between ACEs and chronic pain: among children reporting 2 or more ACEs, those reporting 5 to 7 PCEs were significantly less likely to report chronic pain as compared to children only reporting 0 to 2 PCEs (aOR: .64, 95%CI: .45-.89, P = .009). In conclusion, children with greater PCEs exposure had lower prevalence rates of chronic pain. Furthermore, PCEs was associated with reduced prevalence of chronic pain among children exposed to ACEs. PERSPECTIVE: This article estimates associations between survey-measured PCEs and pediatric chronic pain among children in the United States. Promoting PCEs could improve pediatric pain outcomes.

COVID-19 Stress, Religious Affiliation, and Mental Health Outcomes Among Adolescents

PURPOSE

To examine the relationship between religious affiliation, stressors due to the COVID-19 pandemic, and mental health challenges in a representative sample of adolescents.

METHODS

The sample was composed of 71,001 Utah adolescents who participated in a survey by the Utah Department of Health in 2021. Data are representative of all Utah adolescents in grades 6, 8, 10, and 12. Bootstrapped mediation was used to test indirect effects of religious affiliation on mental health challenges through COVID-19 stressors.

RESULTS

Religious affiliation was related to significantly lower rates of teen mental health challenges as measured by suicidal thoughts, suicide attempts, and depression. For religiously affiliated adolescents, the rate of considering and attempting suicide was nearly half of that of unaffiliated adolescents. In mediation analyses, affiliation was indirectly related to mental health challenges (suicide ideation, suicide attempt, and depression) through stressors from COVID-19, including affiliated adolescents experiencing the following: less anxiety, fewer family fights, fewer school difficulties, and fewer skipped meals. However, affiliation was positively related to becoming sick with COVID-19 (or having COVID-19 symptoms), which was related to more suicidal thoughts.

CONCLUSIONS

Findings suggest that adolescent religious affiliation may be a promotive factor that decreases mental health challenges through a reduction in COVID-19-related stressors, except religious individuals may be more likely to become sick. To increase positive mental health outcomes among adolescents during pandemic times, consistent and clear policies that facilitate religious connections that also align with good physical health measures will be critical.

The role of positive childhood experiences in the link between childhood maltreatment and affective lability in a sample of incarcerated men and women

BACKGROUND

Individuals with a history of child maltreatment (CM) tend to show high affective lability (AL) and criminal behavior. However, positive childhood experiences (PCEs) may act as a protective factor even in the presence of child maltreatment.

OBJECTIVE

The present study aimed to analyze the relationship between CM, PCEs, and AL in adulthood, identify the predictors of AL and analyze the moderating role of PCEs in the relationship between CM and AL in a sample of 424 incarcerated men (n = 343) and women (n = 81), aged between 18 and 73 years (M = 37.88).

METHODS

Participants responded to an online protocol consisting of a sociodemographic questionnaire, the Childhood Trauma Questionnaire (CTQ), the Benevolent Childhood Experiences Scale (BCEs), and the Affective Lability Scale - Short Version (ALS-18).

RESULTS

CM was positively associated with AL and negatively associated with PCEs, and PCEs are negatively associated with AL. Regression analyses, after controlling for age, sex, and education, confirmed the role of PCEs on AL, above and beyond CM. However, moderation analysis showed that PCEs did not moderate the relationship between CM and AL for either men or women.

CONCLUSIONS

These results highlight the complexity of human development and behavior from early childhood into adulthood. Further studies are needed to better understand the role of PCEs in the relationship between ACEs and AL among inmates in order to develop more appropriate prevention and intervention programs.

Examining relationships between positive and adverse childhood experiences with physical and mental health indicators in a low-income adult sample

BACKGROUND

Emerging research on positive and adverse childhood experiences (PCEs and ACEs) indicates that both may be important to adult health, but little is understood about the pathways through which childhood experiences affect adult health.

OBJECTIVE

The aims of this study were to 1) examine how shame may mediate the relationship between childhood experiences and health, and 2) whether PCEs moderated the relationship between ACEs, shame, and adult health.

PARTICIPANTS AND SETTING

The sample consisted of 206 low-income adults ages 18-55 who were living in a community in the Intermountain West.

METHODS

Participants were recruited at a local food bank and community center where various services for low-income residents were offered. Each participant completed a 15-20-minute survey. The data were analyzed using a structural equation modeling (SEM) framework.

RESULTS

Shame mediated the relationship between both ACEs and PCEs with depression in the expected direction. Among participants with low-to-moderate PCEs, ACEs were directly associated with shame and tobacco usage. Among participants with high PCEs, ACEs were not associated with shame, depression, nor stress, and the relationship between ACEs and tobacco usage was attenuated.

CONCLUSION

Shame may be an important pathway through which childhood experiences affect adult health. Additionally, promoting high levels of PCEs may mitigate the negative effects of early adversity on adult health.

The mediation role of shame proneness in the association between perceived parenting and the severity of addictive behaviors: risk or protective factor?

Adverse early interactions with parents deeply affect the socio-emotional development of an individual, leading to feelings of inferiority and negatively influencing the development of self-conscious emotions, such as shame. Moreover, dysfunctional parenting was found in the histories of people suffering from substance and behavioral addictions. In this context, there is currently no agreement in the literature regarding the role of shame proneness on the severity of the addiction. The present study aimed to evaluate the mediating (risk or protective) role of the two shame dimensions (withdrawal action tendencies and negative self-evaluation) in the association between dysfunctional parenting and the severity of addiction, testing two structural equation models (SEMs; for substance and behavioral addiction respectively). An online survey recruiting 710 Italian young adults was administered using the Measure of Parental Styles, the Guilt and Shame Proneness Scale, and the brief Screener for Substance and Behavioral Addiction. The SEMs confirmed the predictive role of dysfunctional parenting on the severity of the addiction. Moreover, two dimensions of shame mediated the association in opposite ways. The withdrawal action tendencies positively mediated the association between dysfunctional parenting and the severity of substance and behavioral addiction, potentially acting as a risk factor. Negative self-evaluation negatively mediated the association between dysfunctional parenting and the severity of substance addiction, playing a potential protective role. In a therapeutic context, the findings emphasized the importance of evaluating the different dimensions of shame experiences among addicted individuals and assessing the strategies used to withdraw from these experiences.

Family cohesion, shame-proneness, expressive suppression, and adolescent mental health-A path model approach

Objective

The family remains one of the most important relationship systems into early adulthood and provides an important foundation for lifelong mental health. Dysfunctional family cohesion can promote adjustment problems in adolescents and might also affect adolescents' self-concept and strategies for coping with emotional distress. To test these relationships and the underlying mechanisms, we proposed a dual mediation model describing the associations between family cohesion and internalizing and externalizing problems, mediated by shame-proneness and expressive suppression.

Methods

A sample of 526 German-speaking adolescents aged 14 to 18 years from Austria, Germany, and Switzerland participated in an online self-report survey encompassing questionnaires on family cohesion, shame-proneness, expressive suppression, and psychological problems. We tested a path model to examine the indirect pathways of the associations between family cohesion and internalizing and externalizing problems via shame-proneness and expressive suppression, while controlling for age, gender, and guilt-proneness.

Results

We found a significant dual mediation of the associations between family cohesion and internalizing and externalizing problems by shame-proneness and expressive suppression. The indirect pathways were all significant, except for the indirect pathway from family cohesion to externalizing problems via shame-proneness.

Discussion

Our results provide a model for the mechanisms by which disrupted family cohesion can be related to psychological problems in adolescents. Expressive suppression emerged as crucial when considering the consequences of shame-proneness in adolescents, as it was only indirectly related to externalizing problems via expressive suppression.