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Ho NCW, Bethlehem RA, Seidlitz J, Nogovitsyn N, Metzak P, Ballester PL, Hassel S, Rotzinger S, Poppenk J, Lam RW, Taylor VH, Milev R, Bullmore ET, Alexander-Bloch AF, Frey BN, Harkness KL, Addington J, Kennedy SH, Dunlop K. Atypical brain aging and its association with working memory performance in major depressive disorder. Biol Psychiatry Cogn Neurosci Neuroimaging 2024:S2451-9022(24)00110-1. [PMID: 38679324 DOI: 10.1016/j.bpsc.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Patients with major depressive disorder (MDD) can present with altered brain structure and deficits in cognitive function similar to aging. Yet, the interaction between age-related brain changes and brain development in MDD remains understudied. In a cohort of adolescents and adults with and without MDD, we assessed brain aging differences and associations through a newly developed tool quantifying normative neurodevelopmental trajectories. METHODS 304 MDD participants and 236 non-depressed controls were recruited and scanned from three studies under the Canadian Biomarker Integration Network for Depression. Volumetric data were used to generate brain centile scores, which were examined for: a) differences in MDD relative to controls; b) differences in individuals with versus without severe childhood maltreatment; and c) correlations with depressive symptom severity, neurocognitive assessment domains, or escitalopram treatment response. RESULTS Brain centiles were significantly lower in the MDD group compared to controls. It was also significantly correlated with working memory in controls, but not the MDD group. No significant associations were observed in depression severity or antidepressant treatment response with brain centiles. Likewise, childhood maltreatment history did not significantly affect brain centiles. CONCLUSIONS Consistent with prior work on machine learning models that predict "brain age", brain centile scores differed in people diagnosed with MDD, and MDD was associated with differential relationships between centile scores and working memory. The results support the notion of atypical development and aging in MDD, with implications on neurocognitive deficits associated with aging-related cognitive function.
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Affiliation(s)
- Natalie C W Ho
- Keenan Research Centre for Biomedical Research, Unity Health Toronto, Toronto, Canada; Centre for Depression & Suicide Studies, Unity Health Toronto, Toronto, Canada; Faculty of Arts and Sciences, University of Toronto, Toronto, Canada
| | | | - Jakob Seidlitz
- Department of Psychiatry, University of Pennsylvania, Philadelphia, USA; Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, USA; Lifespan Brain Institute, The Children's Hospital of Philadelphia, Philadelphia, USA; Institute of Translational Medicine & Therapeutics, University of Pennsylvania, Philadelphia, USA
| | - Nikita Nogovitsyn
- Centre for Depression & Suicide Studies, Unity Health Toronto, Toronto, Canada
| | - Paul Metzak
- Department of Psychiatry, University of Calgary, Calgary, Canada
| | - Pedro L Ballester
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Stefanie Hassel
- Department of Psychiatry, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute and Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada
| | - Susan Rotzinger
- Keenan Research Centre for Biomedical Research, Unity Health Toronto, Toronto, Canada; Centre for Depression & Suicide Studies, Unity Health Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Mood Disorders Treatment and Research Centre, St. Joseph's Healthcare, Hamilton, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Jordan Poppenk
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Department of Psychology, Queen's University, Kingston, Canada; School of Computing, Queen's University, Kingston, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Valerie H Taylor
- Department of Psychiatry, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute and Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada
| | - Roumen Milev
- Department of Psychology, Queen's University, Kingston, Canada; Department of Psychiatry, Queen's University, Kingston, Canada; Providence Care Hospital, Kingston, Canada
| | | | - Aaron F Alexander-Bloch
- Department of Psychiatry, University of Pennsylvania, Philadelphia, USA; Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, USA; Lifespan Brain Institute, The Children's Hospital of Philadelphia, Philadelphia, USA; Institute of Translational Medicine & Therapeutics, University of Pennsylvania, Philadelphia, USA
| | - Benicio N Frey
- Mood Disorders Treatment and Research Centre, St. Joseph's Healthcare, Hamilton, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Kate L Harkness
- Department of Psychology, Queen's University, Kingston, Canada; Department of Psychiatry, Queen's University, Kingston, Canada
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute and Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada
| | - Sidney H Kennedy
- Keenan Research Centre for Biomedical Research, Unity Health Toronto, Toronto, Canada; Centre for Depression & Suicide Studies, Unity Health Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Katharine Dunlop
- Keenan Research Centre for Biomedical Research, Unity Health Toronto, Toronto, Canada; Centre for Depression & Suicide Studies, Unity Health Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
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Gerin MI, Viding E, Herringa RJ, Russell JD, McCrory EJ. A systematic review of childhood maltreatment and resting state functional connectivity. Dev Cogn Neurosci 2023; 64:101322. [PMID: 37952287 PMCID: PMC10665826 DOI: 10.1016/j.dcn.2023.101322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/13/2023] [Accepted: 11/08/2023] [Indexed: 11/14/2023] Open
Abstract
Resting-state functional connectivity (rsFC) has the potential to shed light on how childhood abuse and neglect relates to negative psychiatric outcomes. However, a comprehensive review of the impact of childhood maltreatment on the brain's resting state functional organization has not yet been undertaken. We systematically searched rsFC studies in children and youth exposed to maltreatment. Nineteen studies (total n = 3079) met our inclusion criteria. Two consistent findings were observed. Childhood maltreatment was linked to reduced connectivity between the anterior insula and dorsal anterior cingulate cortex, and with widespread heightened amygdala connectivity with key structures in the salience, default mode, and prefrontal regulatory networks. Other brain regions showing altered connectivity included the ventral anterior cingulate cortex, dorsolateral prefrontal cortex, and hippocampus. These patterns of altered functional connectivity associated with maltreatment exposure were independent of symptoms, yet comparable to those seen in individuals with overt clinical disorder. Summative findings indicate that rsFC alterations associated with maltreatment experience are related to poor cognitive and social functioning and are prognostic of future symptoms. In conclusion, maltreatment is associated with altered rsFC in emotional reactivity, regulation, learning, and salience detection brain circuits. This indicates patterns of recalibration of putative mechanisms implicated in maladaptive developmental outcomes.
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Affiliation(s)
- Mattia I Gerin
- Division of Psychology and Language Sciences, University College London, London, UK; Anna Freud National Centre for Children and Families, London, UK.
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Ryan J Herringa
- Department of Psychiatry, University of Wisconsin School of Medicine & Public Health, Madison, WI, UK
| | - Justin D Russell
- Department of Psychiatry, University of Wisconsin School of Medicine & Public Health, Madison, WI, UK
| | - Eamon J McCrory
- Division of Psychology and Language Sciences, University College London, London, UK; Anna Freud National Centre for Children and Families, London, UK
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Kasparek SW, Rosen ML, Lurie LA, Cikara M, Sambrook K, Cvencek D, Meltzoff AN, McLaughlin KA. Differentiating Between Us & Them: Reduced In-Group Bias as a Novel Mechanism Linking Childhood Violence Exposure with Internalizing Psychopathology. Res Child Adolesc Psychopathol 2023; 51:961-975. [PMID: 36862283 PMCID: PMC9979122 DOI: 10.1007/s10802-023-01035-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 03/03/2023]
Abstract
Strong in-group bonds, facilitated by implicit favoritism for in-group members (i.e., in-group bias), promote mental health across development. Yet, we know little about how the development of in-group bias is shaped by early-life experiences. Childhood violence exposure is known to alter social information processing biases. Violence exposure may also influence social categorization processes, including in-group biases, in ways that influence risk for psychopathology. We examined associations of childhood violence exposure with psychopathology and behavioral and neural indices of implicit and explicit bias for novel groups in children followed longitudinally across three time points from age 5 to 10 years old (n = 101 at baseline; n = 58 at wave 3). To instantiate in-group and out-group affiliations, youths underwent a minimal group assignment induction procedure, in which they were randomly assigned to one of two groups. Youth were told that members of their assigned group shared common interests (in-group) and members of the other group did not (out-group). In pre-registered analyses, violence exposure was associated with lower implicit in-group bias, which in turn was associated prospectively with higher internalizing symptoms and mediated the longitudinal association between violence exposure and internalizing symptoms. During an fMRI task examining neural responses while classifying in-group and out-group members, violence-exposed children did not exhibit the negative functional coupling between vmPFC and amygdala to in-group vs. out-group members that was observed in children without violence exposure. Reduced implicit in-group bias may represent a novel mechanism linking violence exposure with the development of internalizing symptoms.
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Affiliation(s)
| | - Maya L Rosen
- Department of Psychology, Harvard University, Cambridge, MA, USA
- Program in Neuroscience, Smith College, Northampton, MA, USA
| | - Lucy A Lurie
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mina Cikara
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Kelly Sambrook
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Dario Cvencek
- Institute for Learning & Brain Sciences, University of Washington, Seattle, WA, USA
| | - Andrew N Meltzoff
- Institute for Learning & Brain Sciences, University of Washington, Seattle, WA, USA
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Daniels TE, Mathis KJ, Gobin AP, Lewis-de Los Angeles WW, Smith EM, Chanthrakumar P, de la Monte S, Tyrka AR. Associations of early life stress with leptin and ghrelin in healthy young adults. Psychoneuroendocrinology 2023; 149:106007. [PMID: 36577337 PMCID: PMC9931677 DOI: 10.1016/j.psyneuen.2022.106007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Childhood adversity is a major risk factor for cardiometabolic health problems. Stress-related changes in diet suggest a role for endocrine factors that influence dietary intake, such as leptin and ghrelin. These hormones influence metabolism and may contribute to the relationship of early adversity, mental, and cardiometabolic health. This study examined levels of leptin and ghrelin in a sample of young adults with and without early life stress (ELS). METHODS Young adults ages 18-40 (N = 200; 68.5% female) were recruited from the community. Participants with ELS (N = 118) had childhood maltreatment, and a subset, n = 92 (78.0%) also had parental loss, and n = 65 (55.1%) also had a current psychiatric disorder. Control participants (N = 82) had no maltreatment, parental loss, or psychiatric disorders. Standardized interviews and self-reports assessed demographics, adversity, medical/psychiatric history, and health behaviors. Exclusion criteria included medical conditions and current medications other than hormonal contraceptives. Body Mass Index (BMI) and other anthropometrics were measured, and fasting plasma was assayed for total ghrelin and leptin with the Bio-Plex Pro Human Diabetes Panel. RESULTS While ELS was significantly associated with greater leptin (r = .16, p = .025), a finding which held when adjusted for age and sex (F(3196)= 28.32, p = .011), this relationship was abolished when accounting for BMI (p = .44). Participants with ELS also had significantly lower total ghrelin (r = .21, p = .004), which held adjusting for age and sex (p = .002) and was attenuated (p = .045) when the model included BMI (F=46.82, p < .001). Current psychiatric disorder was also a significant predictor of greater leptin (r = .28, p < .001) and lower ghrelin (r = .29, p = .003). In the model with ELS and covariates, psychiatric disorder remained significant (F=7.26, p = .008) and ELS was no longer significant (p = .87). Associations with severity and recent perceived stress were also examined. CONCLUSION The relationship of ELS and leptin was no longer significant when accounting for BMI, suggesting potential avenues for intervention. Ghrelin findings persisted after correction for BMI, which may be secondary to physiological differences in the regulation of these hormones (leptin is produced by adipocytes, whereas ghrelin is produced primarily in the GI tract). Lastly, these findings suggest that psychiatric functioning may be a key component contributing to the relationship of lower total ghrelin and childhood adversity.
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Affiliation(s)
- Teresa E Daniels
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA.
| | | | - Asi Polly Gobin
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - William W Lewis-de Los Angeles
- Department of Pediatrics, Hasbro Children's Hospital and Bradley Hospital, RI, USA; Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Eric M Smith
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | | | - Suzanne de la Monte
- Warren Alpert Medical School, Brown University, Providence, RI, USA; Departments of Medicine, Neurology, and Pathology and Laboratory Medicine, Rhode Island Hospital, Women and Infants Hospital of Rhode Island, and Providence VA Medical Center, Providence, RI, USA
| | - Audrey R Tyrka
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
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O'Shields J, Mowbray O, Patel D. Allostatic load as a mediator of childhood maltreatment and adulthood depressive symptoms: A longitudinal analysis. Psychoneuroendocrinology 2022; 143:105839. [PMID: 35728362 DOI: 10.1016/j.psyneuen.2022.105839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/06/2022] [Accepted: 06/10/2022] [Indexed: 11/28/2022]
Abstract
Childhood maltreatment (CM) is associated with several negative outcomes in adulthood, including major depression. People who experience CM that go on to develop symptoms of major depression in adulthood tend to have earlier depressive symptom onset and greater symptom severity than those who do not experience CM. Studies have utilized allostatic load (AL) to understand how CM "gets under the skin" to contribute to depressive symptoms. However, studies largely utilize cross-sectional designs and limited biomarkers. The present study uses data from Wave 2 and Wave 3 of the Midlife Development in the United States study in regression-based analyses, examining if AL mediates the relationship between CM and the number of depressive symptoms in adulthood. AL was measured at Wave 2 using the system risk method with 27 biomarkers across seven different systems. CM was measured using the Childhood Trauma Questionnaire at Wave 2. Number of depressive symptoms were measured using the Composite International Diagnostic Interview-Short Form at Wave 3. Past month perceived stress, age, household income, education, sex, racial/ethnic identity, and current prescription medication use at Wave 2 were included as controls. Analyses identified that CM was associated with AL cross-sectionally, and that both CM and AL at were associated with the number of depressive symptoms prospectively. AL partially mediated the effects of CM on the number of depressive symptoms. The present study is the first to identify the mediating role of AL in the relationship between CM and adulthood depressive symptoms in a longitudinal design.
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Affiliation(s)
| | | | - Dipali Patel
- University of Georgia, School of Social Work, USA
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6
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Bergeron S, Bigras N, Vaillancourt-Morel MP. Child Maltreatment and Couples' Sexual Health: A Systematic Review. Sex Med Rev 2022:S2050-0521(22)00029-4. [PMID: 36028437 DOI: 10.1016/j.sxmr.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/26/2022] [Accepted: 04/30/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Childhood maltreatment (CM) is an interpersonal trauma reported by 35% to 40% of individuals in population-based studies in North America. It refers to physical, sexual, and emotional abuse, as well as physical and emotional neglect. Although there is a growing body of cross-sectional work focusing on associations between CM and sexual health, most studies have ignored the broader relationship context in which sexuality is experienced. OBJECTIVES The current review sought to systematically and critically appraise all studies that reported on the association between CM and couples' sexual health, to inform clinical care and recommendations for research. METHODS The electronic literature search was conducted using PubMed, PsycNET (PsycINFO, PsychArticles), Medline, CINAHL, and Eric for peer-reviewed journal articles published before September 2021. Eligible studies had to report on the association between any form of CM and any dimension of sexual health in couples or individuals in a romantic relationship. RESULTS In total, 13 studies (18 articles) were included in this systematic review: 4 studies pertained to clinical couples and 9, to community couples; 2 studies used a longitudinal design and 11, a cross-sectional design; 3 studies examined CM as a whole, 2 studies examined multiple subtypes of CM separately, 1 study examined both CM as a whole and its subtypes separately, whereas the other 7 studies focused on childhood sexual abuse. Results indicated that studies using valid measures of sexual health outcomes found significant associations between CM and worse outcomes - including declines over time - in both clinical and community samples. Mediators and moderators of these associations were also identified. CONCLUSIONS Findings provide preliminary support for the role of CM in couples' sexual health. There is a need for future longitudinal studies involving both members of the couple, valid and multidimensional measures of sexual health, and potential mediators and moderators. Bergeron S, Bigras N, Vaillancourt-Morel M-P. Child Maltreatment and Couples' Sexual Health: A Systematic Review. Sex Med Rev 2022;XX:XXX-XXX.
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Charbonneau-Lefebvre V, Vaillancourt-Morel MP, Rosen NO, Steben M, Bergeron S. Attachment and Childhood Maltreatment as Moderators of Treatment Outcome in a Randomized Clinical Trial for Provoked Vestibulodynia. J Sex Med 2022; 19:479-495. [PMID: 35090839 DOI: 10.1016/j.jsxm.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/24/2021] [Accepted: 12/29/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although distal developmental factors, such as attachment and childhood maltreatment (CM), are associated with the occurrence, severity, and adjustment to provoked vestibulodynia (PVD)-the most prevalent form of vulvodynia-no studies to date have examined whether these variables are related to treatment efficacy in the context of PVD. Attachment and CM may act as moderating variables when examining different treatment modalities, whereby individuals with more insecure attachment orientations (anxiety/avoidance) or a history of CM may benefit less from treatments with higher interpersonal contexts, such as sex and couple therapy-a recommended treatment for PVD. AIM The present randomized clinical trial (RCT) examined attachment and CM as predictors and moderators of sexual satisfaction, distress, and function at post-treatment and 6-month follow-up while comparing 2 treatments for PVD: Topical lidocaine, and a novel cognitive behavioral couple therapy focused on women's pain and partners' sexuality. METHODS One hundred eight women with PVD were randomized to a 12-week treatment of either lidocaine or couple therapy. Women completed questionnaires at pretreatment, post-treatment, and at a 6-month follow-up. OUTCOMES (1) Global Measure of Sexual Satisfaction; (2) Female Sexual Distress Scale-Revised; (3) Female Sexual Function Index. RESULTS Both attachment and CM were significant moderators of treatment outcomes. At either post-treatment or 6-month follow-up, in the couple therapy condition, women with greater attachment avoidance had poorer outcomes on sexual distress, satisfaction and function, whereas women with higher levels of CM had poorer outcomes on sexual satisfaction and sexual function, compared to women in the lidocaine condition. CLINICAL IMPLICATIONS Although these novel findings need further replication, they highlight the importance for clinicians to take into account distal factors, for instance, attachment and CM, when treating sexual difficulties such as PVD, as these variables may affect more interpersonal dimensions of treatment (eg, trust, compliance, etc.) and ultimately, treatment progress. STRENGTHS & LIMITATIONS Using a rigorous RCT study design and statistical approach, this study is the first to examine attachment and CM as moderators in the treatment of sexual difficulties. It is however limited by the use of self-report measures, and further studies are necessary to validate the generalizability of current results to other sexual difficulties. CONCLUSION Findings support the role of interpersonal factors in the treatment of PVD and indicate that short-term psychological interventions, such as couple therapy, may be less beneficial for women with antecedents of CM and attachment insecurity. V Charbonneau-Lefebvre, M-P Vaillancourt-Morel, NO Rosen, et al. Attachment and Childhood Maltreatment as Moderators of Treatment Outcome in a Randomized Clinical Trial for Provoked Vestibulodynia. J Sex Med 2022;19:479-495.
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Affiliation(s)
| | | | - Natalie O Rosen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | - Marc Steben
- Department of Social and Preventive Medicine, Groupe de médecine familiale La Cité du Parc Lafontaine, Université de Montréal, Montreal, Canada
| | - Sophie Bergeron
- Department of Psychology, Université de Montréal, Montreal, Canada
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Wang YS, Friedman AL, Jakubowski KP, Wescott DL, Iyiewuare P, Feldman JS, Shaw DS, Roecklein KA. Childhood maltreatment reports in adult seasonal affective disorder: Associations with sleep disturbances, maladaptive cognitions, and brooding. J Affect Disord 2021; 288:31-40. [PMID: 33839556 PMCID: PMC8154709 DOI: 10.1016/j.jad.2021.03.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 02/25/2021] [Accepted: 03/17/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although childhood maltreatment has been studied in multiple psychopathologies, its role in Seasonal Affective Disorder (SAD) is unknown. The current study examined possible mediators of the relationship between retrospectively-reported childhood maltreatment and adult SAD symptom severity during a major depressive episode in winter. METHODS Participants (N = 113), ages 18 to 65, completed measures of childhood maltreatment, SAD severity, sleep disturbances, ruminative brooding, and maladaptive cognitions. Mediation analyses testing the relationship between childhood maltreatment and SAD symptom severity via sleep and cognitive factors were conducted using PROCESS (Hayes, 2012). RESULTS Mediation analyses suggested that insomnia, hypersomnia, brooding, and seasonal maladaptive beliefs may account for the association between childhood maltreatment and SAD symptom severity. LIMITATIONS Analyses were cross-sectional and should be interpreted with caution. Participants completed self-report childhood trauma measure retrospectively as adults. CONCLUSION The present study is the first to examine childhood maltreatment in SAD, a disorder commonly viewed with circadian etiology. Covariance between childhood maltreatment and SAD symptom severity is indirectly explained by sleep difficulties, cognitive factors, and brooding, which may suggest therapeutic targets if replicated in longitudinal or experimental manipulations of sleep and cognition.
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Affiliation(s)
- Yuqi S Wang
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Abbey L Friedman
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Karen P Jakubowski
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Delainey L Wescott
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Praise Iyiewuare
- Department of Psychology, University of Vermont, Burlington, Vermont, United States
| | - Julia S Feldman
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Daniel S Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Kathryn A Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States.
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Abstract
BACKGROUND There is ample evidence showing that childhood maltreatment (CM) is a risk factor for the development of depression in adulthood. However, little is known about the psychological processes mediating this relationship. This study used a large community sample to investigate the mediating role of emotional, cognitive and/or interpersonal dysfunctions on the one hand and posttraumatic stress disorder symptoms on the other hand. METHODS One thousand twenty seven participants of a community sample filled out an online survey. Mediation analyses were computed via linear structural equation modelling. RESULTS Results showed a significant mediation of the association between CM and adult depression via emotional impairments, depressogenic attribution style and symptoms of posttraumatic stress disorder. Our study design was cross-sectional and therefore did not allow testing temporal precedence of mediators and causality. Data was collected retrospectively, a confounding effect of current depressive symptoms on retrospective recall of CM therefore cannot be ruled out. CONCLUSIONS The a priori mediation model showed a good fit with the data. The model suggests promising objectives for further research on CM-related depression and potential treatment targets in the future.
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Affiliation(s)
- Anne Klumparendt
- Department of Psychology, University of Münster, Fliednerstr. 21, 48149 Muenster, Germany
- Christoph-Dornier-Foundation for Clinical Psychology, Münster, Germany
| | - Janna Nelson
- Department of Psychology, University of Münster, Fliednerstr. 21, 48149 Muenster, Germany
- Christoph-Dornier-Foundation for Clinical Psychology, Münster, Germany
| | - Jens Barenbrügge
- Department of Psychology, University of Münster, Fliednerstr. 21, 48149 Muenster, Germany
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Munich, Germany
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Dias A, Sales L, Mooren T, Mota-Cardoso R, Kleber R. Child maltreatment, revictimization and Post-Traumatic Stress Disorder among adults in a community sample. Int J Clin Health Psychol 2017; 17:97-106. [PMID: 30487885 DOI: 10.1016/j.ijchp.2017.03.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 03/27/2017] [Indexed: 01/05/2023] Open
Abstract
Background/Objective: Childhood maltreatment (CM) has been associated with revictimization and post-traumatic stress disorder (PTSD). However, this relation is hardly examined in South European countries, and in community samples. We tested these associations in a convenience sample of 1,200 Portuguese adults in the community. Method: Data were collected using self-report questionnaires, the Post Traumatic Diagnostic Scale (PDS) and the Childhood Trauma Questionnaire–Short Form (CTQ-SF). Odds ratios, logistic and hierarchical regression were used to analyze the data. Results: Exposure to CM increased more than twofold the risk of being revictimized and threefold a PTSD diagnosis. Highly prevalent traumatic events such as accidents were associated with CM. More than 30% of adults with PTSD were exposed to emotional abuse. After adjusting for demographics, emotional abuse remained a significant predictor for revictimization and PTSD, having the largest effect on the prediction of PTSD severity (β = .24). Conclusions: Findings underline the injurious potential of emotional abuse during childhood in adults in the community. More knowledge is needed about the mechanisms linking CM with further traumatic exposure and PTSD across the lifespan to better inform preventive and therapeutic actions.
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Yeung EW, Davis MC, Ciaramitaro MC. Cortisol Profile Mediates the Relation Between Childhood Neglect and Pain and Emotional Symptoms among Patients with Fibromyalgia. Ann Behav Med 2016; 50:87-97. [PMID: 26404060 DOI: 10.1007/s12160-015-9734-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND The relation between childhood trauma and chronic pain and emotional symptoms in adulthood has been well-documented, although physiological mechanisms mediating this link have not been elaborated. PURPOSE This study examined the mediating role of cortisol profile in the linkage between childhood maltreatment and pain and emotional symptoms in individuals with fibromyalgia (FM). METHODS One hundred seventy-nine adults with FM first provided retrospective self-reports of childhood maltreatment, then attended a standardized session during which cortisol was sampled across 1.5 hours and, subsequently, completed assessments of daily pain, depressive symptoms, and anxiety. Latent growth curve modeling estimated the hypothesized mediation models. RESULTS Childhood neglect predicted a flattened cortisol profile, which, in turn, predicted elevated daily pain and emotional symptoms. The cortisol profile partially mediated the neglect-symptom relation. CONCLUSIONS Early maltreatment may exert enduring effects on endocrine regulation that contributes to pain and emotional symptoms in adults with chronic pain.
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Abstract
OBJECTIVE Recent work has emphasized the role of violent victimization, along with risky contexts like sex exchange, in pathways to problems of externalizing and substance use in women. Nonetheless, few studies have empirically tested gender differences involving the roles of adversity factors (e.g., childhood violent maltreatment, sex exchange) in drug use patterns. The present study tested a model of gender differences in relationships between childhood physical and sexual abuse, sex exchange, and two indicators of drug use: engagement and symptoms of disorder. METHOD We recruited an ethnically-diverse sample of 304 (130 women) adults with recent histories of violence and/or drug use, who completed a substance use diagnostic interview, the Childhood Trauma Questionnaire, and a sex exchange questionnaire. RESULTS First, structural equation modeling revealed that childhood sexual and physical abuse were related to increased drug engagement in women and men, respectively, above the influence of early childhood contextual variables (e.g., neighborhood, family) and age. Second, sexual abuse was related to sex exchange, which in turn was related to drug use symptoms in women but not men. CONCLUSIONS These data provide empirical support for distinct trauma-related pathways to drug use problems in men and women, which has implications for gendered explanations and prevention approaches.
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Shahar B, Doron G, Szepsenwol O. Childhood Maltreatment, Shame-Proneness and Self-Criticism in Social Anxiety Disorder: A Sequential Mediational Model. Clin Psychol Psychother 2014; 22:570-9. [PMID: 25196782 DOI: 10.1002/cpp.1918] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 07/24/2014] [Accepted: 08/01/2014] [Indexed: 11/07/2022]
Abstract
UNLABELLED Previous research has shown a robust link between emotional abuse and neglect with social anxiety symptoms. However, the mechanisms through which these links operate are less clear. We hypothesized a model in which early experiences of abuse and neglect create aversive shame states, internalized into a stable shame-based cognitive-affective schema. Self-criticism is conceptualized as a safety strategy designed to conceal flaws and prevent further experiences of shame. However, self-criticism maintains negative self-perceptions and insecurity in social situations. To provide preliminary, cross-sectional support for this model, a nonclinical community sample of 219 adults from Israel (110 females, mean age = 38.7) completed measures of childhood trauma, shame-proneness, self-criticism and social anxiety symptoms. A sequential mediational model showed that emotional abuse, but not emotional neglect, predicted shame-proneness, which in turn predicted self-criticism, which in turn predicted social anxiety symptoms. These results provide initial evidence supporting the role of shame and self-criticism in the development and maintenance of social anxiety disorder. The clinical implications of these findings are discussed. KEY PRACTITIONER MESSAGE Previous research has shown that histories of emotional abuse and emotional neglect predict social anxiety symptoms, but the mechanisms that underlie these associations are not clear. Using psycho-evolutionary and emotion-focused perspectives, the findings of the current study suggest that shame and self-criticism play an important role in social anxiety and may mediate the link between emotional abuse and symptoms. These findings also suggest that therapeutic interventions specifically targeting shame and self-criticism should be incorporated into treatments for social anxiety, especially with socially anxious patients with abuse histories.
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Affiliation(s)
- Ben Shahar
- Interdisciplinary Center, School of Psychology, Herzliya, Israel
| | - Guy Doron
- Interdisciplinary Center, School of Psychology, Herzliya, Israel
| | - Ohad Szepsenwol
- Interdisciplinary Center, School of Psychology, Herzliya, Israel
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Kim JH, Martins SS, Shmulewitz D, Santaella J, Wall MM, Keyes KM, Eaton NR, Krueger R, Grant BF, Hasin DS. Childhood maltreatment, stressful life events, and alcohol craving in adult drinkers. Alcohol Clin Exp Res 2014; 38:2048-55. [PMID: 24961735 PMCID: PMC4107183 DOI: 10.1111/acer.12473] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 04/16/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND Little is known about the relationship between stressful life events and alcohol craving in the general population, and whether a history of childhood maltreatment sensitizes individuals to crave alcohol after adult stressors. METHODS Participants were 22,147 past-year drinkers from Wave 2 (2004 to 2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. A structured, face-to-face interview assessed past-year stressful life events, alcohol craving, and history of childhood maltreatment. Logistic regression was used to generate adjusted odds ratios (aOR) to evaluate the relationship between stressful life events and craving, adjusting for demographic characteristics and parental history of alcoholism. Interaction between stressful life events and childhood maltreatment was also assessed. RESULTS Compared to participants with no stressful life events, those with ≥ 3 events had increased odds of moderate alcohol craving (aOR = 3.15 [95% CI = 2.30 to 4.33]) and severe craving (aOR = 8.47 [95% CI = 4.78 to 15.01]). Stressful life events and childhood maltreatment interacted in predicting severe craving (p = 0.017); those with ≥ 3 events were at higher risk of craving if they had been exposed to childhood maltreatment. CONCLUSIONS A direct relationship between stressful life events and risk of alcohol craving was observed. Further, history of childhood maltreatment increased the salience of stressful life events in adulthood. Future studies should examine the role of psychiatric comorbidity in more complex models of stress sensitization and alcohol craving.
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Affiliation(s)
- June H Kim
- Mailman School of Public Health, Columbia University, New York, New York
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