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Gander M, Buchheim A, Sevecke K. Personality Disorders and Attachment Trauma in Adolescent Patients with Psychiatric Disorders. Res Child Adolesc Psychopathol 2024; 52:457-471. [PMID: 37889355 PMCID: PMC10896792 DOI: 10.1007/s10802-023-01141-1] [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] [Accepted: 10/09/2023] [Indexed: 10/28/2023]
Abstract
This study examined how personality disorders (PD) differ with respect to gender, attachment status and traumatic childhood experiences in adolescent psychiatric inpatients. In particular, we investigated attachment-related traumatic material underlying adolescent PD. Our sample consisted of 175 inpatient adolescents aged 14 to 18 years (77% female, Mage = 15.13, SD = 1.35; 23% male, Mage =14.85, SD = 1.41). Thirty-nine patients (22%) fulfilled the diagnostic criteria for a PD according to the SCID-II PD: 51% avoidant, 13% obsessive-compulsive, 13% antisocial, 19% borderline, 2% paranoid and 2% histrionic. In the total sample, eighty-three (47%) of our inpatients were classified with an unresolved attachment status using the Adult Attachment Projective Picture System (AAP). We did not find any significant gender differences for patients with and without a PD. Our results revealed a higher percentage of unresolved attachment status in patients with a PD. The in-depth analysis of the total sample showed that patients with a PD demonstrated more traumatic material in their attachment interviews indicating a greater severity of attachment trauma. Furthermore, patients with a PD reported higher scores on emotional and physical neglect. Intervention strategies targeting traumatic attachment-related themes might be useful to treat adolescents with PD.
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Affiliation(s)
- Manuela Gander
- Institute of Psychology, University of Innsbruck, Universitätsstrasse 5-7, Innsbruck, 6020, Austria.
- Department of Child and Adolescent Psychiatry, Tirol Kliniken, Milserstrasse 10, 6060 Hall in Tirol, Tirol, Austria.
| | - Anna Buchheim
- Institute of Psychology, University of Innsbruck, Universitätsstrasse 5-7, Innsbruck, 6020, Austria
| | - Kathrin Sevecke
- Department of Child and Adolescent Psychiatry, Tirol Kliniken, Milserstrasse 10, 6060 Hall in Tirol, Tirol, Austria
- Department of Child and Adolescent Psychiatry, Medical University of Innsbruck, Innsbruck, 6020, Austria
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Kayan Ocakoğlu B, Kafalı HY, Ocakoğlu FT, Kardaş B, Kardaş Ö, Işık A, Müjdecioğlu G, Akpınar S, Karakaya SEK, Balca Y, Yektaş Ç. Relations of Childhood Trauma and Emotional Dysregulation with Suicide Ideation and Suicidal Behaviour Severity in a Clinical Sample of Depressive Female Adolescents. Iran J Psychiatry 2023; 18:443-454. [PMID: 37881414 PMCID: PMC10593995 DOI: 10.18502/ijps.v18i4.13631] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/26/2022] [Accepted: 12/19/2022] [Indexed: 10/27/2023]
Abstract
Objective: This study aimed to explore the aspects of emotional dysregulation (ED) and childhood trauma (CT) which are associated with suicide ideation (SI) and suicidal behaviour (SB) severity in depressive female adolescents who previously attempted suicide. Method : In this cross-sectional study, we evaluated SI and SB severity. The Columbia-Suicide Severity Rating Scale (C-SSRS) was administered to 80 depressive female patients who had suicide attempts within the last month. Current suicide ideation (C-SI) and total score (C-TS), lifetime- suicide ideation (L-SI), and total score (L-TS) were obtained with the C-SSRS. Patients were recruited from five different provinces in Turkey. Additionally, the patients completed the Difficulties in Emotion Regulation Scale (DERS), Childhood Trauma Questionnaire (CTQ), and Beck Depression Inventory (BDI). The Pearson correlation test and a multiple linear regression analysis were used to determine variables predictive of suicide scores. Results: The results of multiple linear regression analysis indicated that the BDI and DERS - total scores explained 35% (adjusted R) of the variance in C-SI ((F (2;67) = 19.61, P < 0.001). C-TS was explained by 'BDI,' 'emotional neglect' and 'DERS impulse' (38% (adjusted R) (F (3;66) = 15.15, P < 0.001). L-SI was only associated with DERS strategies (explains 13% (adjusted R) of the variance in L-SI (F (1;68) = 10.411, P = 0.02). Concerning the C-SSRS L-TS, the DERS impulse and CTQ total accounted for 24% (adjusted R) of the variance (F (2;67) = 10.620, P < 0.001). Conclusion: The results of our study suggest that adolescents who have experienced emotional neglect and depressive symptoms are more at risk for suicidal ideation and behaviour. In addition, depressed adolescents who show impulsive behaviours and restricted emotional strategies are also at risk. Identifying neglected depressed adolescents and teaching impulse control and effective emotional strategies is important for the prevention of suicidal behaviours and thoughts.
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Affiliation(s)
- Binay Kayan Ocakoğlu
- Clinic of Child and Adolescent Psychiatry, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, University of Health Sciences, Istanbul, Turkey
| | - Helin Yılmaz Kafalı
- Ministry of Health Ankara City Hospital Child and Adolescent Psychiatry Department, Ankara, Turkey
| | - Fevzi Tuna Ocakoğlu
- İstanbul Private French Lape Hospital Child and Adolescent Psychiatry Clinic, Istanbul, Turkey
| | - Burcu Kardaş
- Kocaeli University Faculty of Medicine Child and Adolescent Psychiatry Department, Kocaeli, Turkey
| | - Ömer Kardaş
- Kocaeli University Faculty of Medicine Child and Adolescent Psychiatry Department, Kocaeli, Turkey
| | - Adem Işık
- Van Regional Training and Research Hospital, Van, Turkey
| | | | - Serap Akpınar
- Ministry of Health Ankara City Hospital Child and Adolescent Psychiatry Department, Ankara, Turkey
| | | | - Yeliz Balca
- Diyarbakır Child Diseases Hospital Child and Adolescent Psychiatry Clinic, Diyarbakır, Turkey
| | - Çiğdem Yektaş
- Uskudar University Child and Adolescent Psychiatry Department, Istanbul, Turkey
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Ahn J, Lee SW, Kim K, Jin B, Chung US. The Relationship Between Childhood Trauma Experience and Complicated Grief: The Importance of Psychological Support for Individuals Coping With Pet Loss in Korea. J Korean Med Sci 2023; 38:e305. [PMID: 37724498 PMCID: PMC10506898 DOI: 10.3346/jkms.2023.38.e305] [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: 04/06/2023] [Accepted: 05/23/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Loss of companion animals can result in various psychological reactions, including complicated grief, depression, anxiety, and insomnia. However, research on the prevalence of patients requiring clinical intervention is limited. Moreover, research examining the relationship between childhood trauma and psychological symptoms after pet loss is lacking. Therefore, this study aimed to investigate the rates of clinically significant psychological distress after pet loss and the impact of childhood trauma on adults who have experienced pet loss. METHODS An online survey was conducted with non-clinical adult participants who had experienced the loss of a companion animal. Psychiatric characteristics were evaluated using standardized assessments, including the Inventory of Complicated Grief (ICG), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), and the Insomnia Severity Index (ISI). Childhood trauma was evaluated using the Childhood Trauma Questionnaire (CTQ). RESULTS In a sample of 137 individuals who had experienced pet loss, the percentages of those who exceeded the cutoff points were 55% for the ICG, 52% for the PHQ-9, 40% for the GAD-7, and 32% for the ISI. The group that reported childhood trauma exhibited significantly higher scores on the ICG (t = 2.16, P = 0.032), PHQ-9 (t = 3.05, P = 0.003), GAD-7 (t = 2.61, P = 0.010), and ISI (t = 2.11, P = 0.037) than in the group without childhood trauma. For participants who experienced pet loss for less than one year, there was no significant difference in the ICG between the trauma and non-trauma groups, as both had extremely high scores. However, the trauma group had a significantly higher PHQ-9 (t = 2.58, P = 0.012) than the non-trauma group. In contrast, for participants who experienced pet loss for more than one year, the trauma group had a significantly higher ICG (t = 2.22, P = 0.03) than the non-trauma group, while there was no significant difference in the PHQ-9. Additionally, the emotional abuse scores on the CTQ were most significantly correlated with the ICG scores even after controlling for depressive symptoms. CONCLUSION People who experienced pet loss had significant psychological symptoms, ranging from 32% to 55%. Childhood trauma experiences affect complicated grief, depressive symptoms, anxiety symptoms, insomnia and prolonged grief disorder after pet loss. After pet loss, people with childhood trauma may require more psychological help than those without trauma.
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Affiliation(s)
- Jisung Ahn
- Department of Psychiatry, Kyungpook National University, Daegu, Korea
| | - Sang Won Lee
- Department of Psychiatry, Kyungpook National University Chilgok Hospital, Daegu, Korea
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Kyungmin Kim
- Department of Psychiatry, Kyungpook National University Chilgok Hospital, Daegu, Korea
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Bohyun Jin
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
- Department of Psychiatry, Kyungpook National University Children's Hospital, Daegu, Korea
| | - Un Sun Chung
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
- Department of Psychiatry, Kyungpook National University Children's Hospital, Daegu, Korea.
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Rosada C, Bauer M, Golde S, Metz S, Roepke S, Otte C, Buss C, Wingenfeld K. Childhood trauma and cortical thickness in healthy women, women with post-traumatic stress disorder, and women with borderline personality disorder. Psychoneuroendocrinology 2023; 153:106118. [PMID: 37137210 DOI: 10.1016/j.psyneuen.2023.106118] [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: 10/30/2022] [Revised: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Structural brain changes have been associated with childhood trauma (CT) and several trauma-associated mental disorders. It is not known whether specific brain alterations are rather associated with CT as such or with disorders that are common sequelae of CT. In this study, we characterized cortical thickness in three distinct groups with CT: healthy women (HC/CT), women with posttraumatic stress disorder (PTSD/CT) and women with borderline personality disorder (BPD/CT). These three CT-exposed groups were compared with healthy controls not exposed to CT (HC). METHODS We recruited 129 women (n = 70 HC, n = 25 HC/CT, n = 14 PTSD/CT, and n = 20 BPD/CT) and acquired T1-weighted anatomical images. FreeSurfer was used for conducting whole-brain cortical thickness between-group comparisons, applying separate generalized linear models to compare cortical thickness of each CT-exposed group with HC. RESULTS The HC/CT group had lower cortical thickness in occipital lobe areas (right lingual gyrus, left lateral occipital lobe) than the HC group. The BPD/CT group showed a broader pattern of reduced cortical thickness compared to the HC group, including the bilateral superior frontal gyrus, and bilateral isthmus, the right posterior, and left caudal anterior of the cingulate cortex as well as the right lingual gyrus of the occipital lobe. We found no differences between PTSD/CT and HC. CONCLUSIONS Cortical thickness reduction in the right lingual gyrus of the occipital lobe seem to be related to CT but is also present in BPD patients even after adjusting for severity of CT. Possibly, reduced cortical thickness in the lingual gyrus presents a CT-related vulnerability factor for CT-related adult psychopathologies such as BPD. Reduced cortical thickness in the frontal and cingulate cortex may represent unique neuroanatomical markers of BPD possibly related to difficulties in emotion regulation.
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Affiliation(s)
- Catarina Rosada
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, 12203 Berlin, Germany.
| | - Martin Bauer
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt Universität zu Berlin, and Berlin Institute of Health, Institute of Medical Psychology, 10117 Berlin, Germany
| | - Sabrina Golde
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität, 14195 Berlin, Germany
| | - Sophie Metz
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt Universität zu Berlin, and Berlin Institute of Health, Institute of Medical Psychology, 10117 Berlin, Germany
| | - Stefan Roepke
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, 12203 Berlin, Germany
| | - Christian Otte
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, 12203 Berlin, Germany
| | - Claudia Buss
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt Universität zu Berlin, and Berlin Institute of Health, Institute of Medical Psychology, 10117 Berlin, Germany; Development, Health and Disease Research Program, University of California, Irvine, CA 92617, USA; Department of Pediatrics, University of California, Irvine, CA 92617, USA
| | - Katja Wingenfeld
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, 12203 Berlin, Germany
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Kollias K, Kosteletos J, Stefanatou P, Xenaki LA, Vlachos I, Selakovic M, Ralli I, Stefanis N. Three scales about childhood trauma, traumatic experiences and bullying: Greek translation, test-retest reliability. Psychiatriki 2023; 34:73-78. [PMID: 36538821 DOI: 10.22365/jpsych.2022.103] [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] [Indexed: 05/23/2023]
Abstract
Exposure to traumatic life events is one of the most robust predictors for psychosis. The Childhood Trauma Questionnaire-Short Form (CTQ-SF), a version of Childhood Experience of Care and Abuse (CECAEUGEI) and a version of the Bullying Questionnaire (BQEUGEI) refer to early life adversities, traumatic episodes and bullying. Those scales belong to a battery of psychometric tools detecting environmental and genetic factors associated with First Episode Psychosis (FEP) that was employed in the Athens-FEP study. The goal of this paper is to present those three versions, regarding their content, their use in the international research, their translation in Greek and their test-retest reliability. The three questionnaires were translated by two independent translators, administered twice to 32 subjects with FEP, with a three weeks intermediate period. Intraclass correlation coefficients (ICCs) were used to investigate agreement between scores of the first and second administration. There was a statistically significant agreement for all measurements of the three questionnaires. Cronbach's a were also calculated and were acceptable and over 0.7. Our study is an indication that the translated versions are reliable, although a more thorough test of their psychometric properties is needed. Both might be used in the Greek research field as part of a broad package of psychometric tools, specifically addressed to patients with FEP.
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Affiliation(s)
- Konstantinos Kollias
- First Psychiatric Department of National and Kapodistrian University, Eginition Hospital, Athens, Greece
| | - John Kosteletos
- First Psychiatric Department of National and Kapodistrian University, Eginition Hospital, Athens, Greece
| | - Pentagiotissa Stefanatou
- First Psychiatric Department of National and Kapodistrian University, Eginition Hospital, Athens, Greece
| | - Lida-Alkisti Xenaki
- First Psychiatric Department of National and Kapodistrian University, Eginition Hospital, Athens, Greece
| | - Ilias Vlachos
- First Psychiatric Department of National and Kapodistrian University, Eginition Hospital, Athens, Greece
| | - Mirjana Selakovic
- First Psychiatric Department of National and Kapodistrian University, Eginition Hospital, Athens, Greece
| | - Irene Ralli
- First Psychiatric Department of National and Kapodistrian University, Eginition Hospital, Athens, Greece
| | - Nikos Stefanis
- First Psychiatric Department of National and Kapodistrian University, Eginition Hospital, Athens, Greece
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Goreis A, Pfeffer B, Zesch HE, Klinger D, Reiner T, Bock MM, Ohmann S, Sackl-Pammer P, Werneck-Rohrer S, Eder H, Skala K, Czernin K, Mairhofer D, Rohringer B, Bedus C, Lipp R, Vesely C, Plener PL, Kothgassner OD. Conspiracy beliefs and COVID-19 guideline adherence in adolescent psychiatric outpatients: the predictive role of adverse childhood experiences. Child Adolesc Psychiatry Ment Health 2023; 17:13. [PMID: 36694261 PMCID: PMC9873214 DOI: 10.1186/s13034-022-00554-y] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/30/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Conspiracy beliefs have become widespread throughout the COVID-19 pandemic. Previous studies have shown that endorsing conspiracy beliefs leads to lower protective guideline adherence (i.e., wearing face masks), posing a threat to public health measures. The current study expands this research across the lifespan, i.e., in a sample of adolescents with mental health problems. Here, we investigated the association between conspiracy beliefs and guideline adherence while also exploring the predictors of conspiracy beliefs. METHODS N = 93 adolescent psychiatric outpatients (57% female, mean age: 15.8) were assessed using anonymous paper-pencil questionnaires. Endorsement of generic and COVID-19 conspiracy beliefs was assessed, in addition to items measuring adherence to protective guidelines and mental health (stress, depressive symptoms, emotional/behavioral problems, and adverse childhood experiences). Multiple regressions and supervised machine learning (conditional random forests) were used for analyses. RESULTS Fourteen percent of our sample fully endorsed at least one COVID-19 conspiracy theory, while protective guidelines adherence was relatively high (M = 4.92, on a scale from 1 to 7). The endorsement of COVID-19 conspiracy beliefs-but not of generic conspiracy beliefs-was associated with lower guideline adherence (β = - 0.32, 95% CI - 0.53 to - 0.11, p < .001). Conditional random forests suggested that adverse childhood experiences and peer and conduct problems were relevant predictors of both conspiracy belief categories. CONCLUSION While a significant proportion of our sample of adolescents in psychiatric treatment endorsed conspiracy beliefs, the majority did not. Furthermore, and to some degree, contrary to public perception, we found that adolescents show relatively good adherence to public health measures-even while experiencing a high degree of mental distress. The predictive value of adverse childhood experiences and peer/conduct problems for conspiracy beliefs might be explained by compensatory mechanisms to ensure the safety, structure, and inclusion that conspiracies provide.
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Affiliation(s)
- Andreas Goreis
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Bettina Pfeffer
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Heidi Elisabeth Zesch
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Diana Klinger
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Tamara Reiner
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | | | - Susanne Ohmann
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Petra Sackl-Pammer
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Sonja Werneck-Rohrer
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Harald Eder
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Katrin Skala
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Klara Czernin
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Dunja Mairhofer
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Bernhard Rohringer
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Carolin Bedus
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Ronja Lipp
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christine Vesely
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Paul L. Plener
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria ,grid.6582.90000 0004 1936 9748Department of Child- and Adolescent Psychiatry and Psychotherapy, Medical University of Ulm, Ulm, Germany
| | - Oswald D. Kothgassner
- grid.22937.3d0000 0000 9259 8492Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria
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7
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Gathier AW, Verhoeven JE, van Oppen PC, Penninx BWJH, Merkx MJM, Dingemanse P, Stehouwer KMKS, van den Bulck CMM, Vinkers CH. Design and rationale of the REStoring mood after early life trauma with psychotherapy (RESET-psychotherapy) study: a multicenter randomized controlled trial on the efficacy of adjunctive trauma-focused therapy (TFT) versus treatment as usual (TAU) for adult patients with major depressive disorder (MDD) and childhood trauma. BMC Psychiatry 2023; 23:41. [PMID: 36650502 PMCID: PMC9843991 DOI: 10.1186/s12888-023-04518-0] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/02/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a common, recurrent mental disorder and a leading cause of disability worldwide. A large part of adult MDD patients report a history of childhood trauma (CT). Patients with MDD and CT are assumed to represent a clinically and neurobiologically distinct MDD subtype with an earlier onset, unfavorable disease course, stress systems' dysregulations and brain alterations. Currently, there is no evidence-based treatment strategy for MDD that specifically targets CT. Given the central role of trauma in MDD patients with CT, trauma-focused therapy (TFT), adjunctive to treatment as usual (TAU), may be efficacious to alleviate depressive symptoms in this patient population. METHODS The RESET-psychotherapy study is a 12-week, single-blind, randomized controlled trial testing the efficacy of TFT in 158 adults with moderate to severe MDD, as a 'stand-alone' depression diagnosis or superimposed on a persistent depressive disorder (PDD), and CT. TFT (6-10 sessions of Eye Movement Desensitization and Reprocessing and/or imagery rescripting) + TAU is compared to TAU only. Assessments, including a wide range of psychological/psychiatric and biological characteristics, take place before randomization (T0), during treatment (T1), at post-treatment (T2) and at 6-month follow-up (T3). Pre-post treatment stress-related biomarkers in hair (cortisol) and blood (epigenetics and inflammation) will be assessed to better understand working mechanisms of TFT. A subgroup of 60 participants will undergo structural and functional Magnetic Resonance Imaging (MRI) assessments to determine pre-post treatment brain activity. The primary outcome is self-reported depression symptom severity at post-treatment, measured with the 30-item Inventory of Depressive Symptomatology - Self Report (IDS-SR). DISCUSSION If adjunctive TFT efficaciously alleviates depressive symptoms in MDD patients with CT, this novel treatment strategy could pave the way for a more personalized and targeted MDD treatment. TRIAL REGISTRATION ClinicalTrials.gov, registered at 08-12-2021, number of identification: NCT05149352.
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Affiliation(s)
- Anouk W. Gathier
- grid.509540.d0000 0004 6880 3010Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, The Netherlands ,Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
| | - Josine E. Verhoeven
- grid.509540.d0000 0004 6880 3010Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, The Netherlands ,Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest Mental Health Care, Amsterdam, The Netherlands
| | - Patricia C. van Oppen
- grid.509540.d0000 0004 6880 3010Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, The Netherlands ,Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest Mental Health Care, Amsterdam, The Netherlands
| | - Brenda W. J. H. Penninx
- grid.509540.d0000 0004 6880 3010Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, The Netherlands ,Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands ,grid.484519.5Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, The Netherlands
| | | | - Pieter Dingemanse
- grid.413664.2Altrecht GGZ, Nieuwe Houtenseweg 12, Utrecht, The Netherlands
| | | | | | - Christiaan H. Vinkers
- grid.509540.d0000 0004 6880 3010Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, The Netherlands ,Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest Mental Health Care, Amsterdam, The Netherlands ,grid.484519.5Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, The Netherlands
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de Koning RM, Kuzminskaite E, Vinkers CH, Giltay EJ, Penninx BWJH. Childhood trauma and LPS-stimulated inflammation in adulthood: Results from the Netherlands Study of Depression and Anxiety. Brain Behav Immun 2022; 106:21-29. [PMID: 35870669 DOI: 10.1016/j.bbi.2022.07.158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 04/09/2022] [Revised: 06/30/2022] [Accepted: 07/18/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Childhood trauma (CT) is robustly associated with psychiatric disorders including major depressive and anxiety disorders across the life span. The innate immune system may play a role in the relation between CT and stress-related psychopathology. However, whether CT influences the innate production capacity of cytokine levels following ex vivo stimulation by lipopolysaccharide (LPS), is currently unknown. METHODS Using data from the Netherlands Study of Depression and Anxiety (NESDA, n=1237), we examined whether CT (emotional neglect, emotional, physical, and sexual abuse before the age of 16), assessed by the Childhood Trauma Interview, was associated with levels in supernatants of interferon (IFN)γ, interleukin-2 (IL-2), IL-4, IL-6, IL-8, IL-10, IL-18, monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein (MIP)-1α, MIP-1β, matrix metalloproteinase-2 (MMP-2), TNFα and TNFβ after ex vivo stimulation with LPS. Cytokines were analysed individually and cumulatively (overall inflammation index and number of cytokines in high-risk quartile (HRQ)) using linear regression analyses. RESULTS After adjustment for demographic, lifestyle, and health-related covariates, total CT severity was associated with the overall inflammation index (β = 0.085, PFDR = 0.011), the number of cytokines in HRQ (β = 0.063, PFDR = 0.036), and individual markers of IL-2 (β = 0.067, PFDR = 0.036), IL-6 (β = 0.091 PFDR = 0.011), IL-8 (β = 0.085 PFDR = 0.011), IL-10 (β = 0.094 PFDR = 0.011), MCP-1 (β = 0.081 PFDR = 0.011), MIP-1α (β = 0.061 PFDR = 0.047), MIP1-β (β = 0.077 PFDR = 0.016), MMP-2 (β = 0.070 PFDR = 0.027), and TNFβ (β = 0.078 PFDR = 0.016). Associations were strongest for individuals with severe CT, reporting multiple types or higher frequencies of trauma. Half of the findings persisted after adjustment for psychiatric status. The findings were consistent across different CT types. CONCLUSION Childhood Trauma is associated with increased LPS-stimulated cytokine levels, with evidence for a dose-response relationship. Our results highlight a dysregulated innate immune system capacity in adults with CT, which could contribute to an increased vulnerability for psychopathology and somatic disorders across the lifespan.
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Affiliation(s)
- Ricki M de Koning
- Amsterdam UMC location Vrije University Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, The Netherlands, Amsterdam Public Health (Mental Health program) and Amsterdam Neuroscience (Mood, Anxiety, Psychosis, Stress & Sleep program) research institutes, Amsterdam, the Netherlands.
| | - Erika Kuzminskaite
- Amsterdam UMC location Vrije University Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, The Netherlands, Amsterdam Public Health (Mental Health program) and Amsterdam Neuroscience (Mood, Anxiety, Psychosis, Stress & Sleep program) research institutes, Amsterdam, the Netherlands.
| | - Christiaan H Vinkers
- Amsterdam UMC location Vrije University Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, The Netherlands, Amsterdam Public Health (Mental Health program) and Amsterdam Neuroscience (Mood, Anxiety, Psychosis, Stress & Sleep program) research institutes, Amsterdam, the Netherlands; GGZ inGeest Mental Health Care, Amsterdam, The Netherlands.
| | - Erik J Giltay
- Leiden University Medical Center, Department of Psychiatry, Leiden, The Netherlands.
| | - Brenda W J H Penninx
- Amsterdam UMC location Vrije University Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, The Netherlands, Amsterdam Public Health (Mental Health program) and Amsterdam Neuroscience (Mood, Anxiety, Psychosis, Stress & Sleep program) research institutes, Amsterdam, the Netherlands.
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Affiliation(s)
- Natalia E Fares-Otero
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic Barcelona, Institute of Neurosciences, University of Barcelona, Biomedical Research Networking Centre for Mental Health Network (CIBERSAM), August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Catalonia, Spain.
| | - Anabel Martinez-Aran
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic Barcelona, Institute of Neurosciences, University of Barcelona, Biomedical Research Networking Centre for Mental Health Network (CIBERSAM), August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Catalonia, Spain
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Castellini G, Rossi E, Ricca V. Are There Common Pathways for Eating Disorders and Female Sexual Dysfunction? J Sex Med 2021; 19:8-11. [PMID: 34848138 DOI: 10.1016/j.jsxm.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 01/19/2023]
Affiliation(s)
- Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy.
| | - Eleonora Rossi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
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Stout DM, Powell S, Kangavary A, Acheson DT, Nievergelt CM, Kash T, Simmons AN, Baker DG, Risbrough VB. Dissociable impact of childhood trauma and deployment trauma on affective modulation of startle. Neurobiol Stress 2021; 15:100362. [PMID: 34258336 PMCID: PMC8259305 DOI: 10.1016/j.ynstr.2021.100362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/26/2022] Open
Abstract
Trauma disorders are often associated with alterations in aversive anticipation and disruptions in emotion/fear circuits. Heightened or blunted anticipatory responding to negative cues in adulthood may be due to differential trauma exposure during development, and previous trauma exposure in childhood may also modify effects of subsequent trauma in adulthood. The aim of the current investigation was to examine the contributions of childhood trauma on affective modulation of startle before and after trauma exposure in adulthood (a combat deployment). Adult male participants from the Marine Resilience Study with (n = 1145) and without (n = 1312) a history of reported childhood trauma completed an affective modulation of startle task to assess aversive anticipation. Affective startle response was operationalized by electromyography (EMG) recording of the orbicularis oculi muscle in response to acoustic stimuli when anticipating positive and negative affective images. Startle responses to affective images were also assessed. Testing occurred over three time-points; before going on a 7 month combat deployment and 3 and 6 months after returning from deployment. Startle response when anticipating negative images was greater compared to pleasant images across all three test periods. Across all 3 time points, childhood trauma was consistently associated with significantly blunted startle when anticipating negative images, suggesting reliable effects of childhood trauma on aversive anticipation. Conversely, deployment trauma was associated with increased startle reactivity post-deployment compared to pre-deployment, which was independent of childhood trauma and image valence. These results support the hypothesis that trauma exposure during development vs. adulthood may have dissociable effects on aversive anticipation and arousal mechanisms. Further study in women and across more refined age groups is needed to test generalizability and identify potential developmental windows for these differential effects.
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Affiliation(s)
- Daniel M. Stout
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Susan Powell
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | | | - Dean T. Acheson
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Caroline M. Nievergelt
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | | | - Alan N. Simmons
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Dewleen G. Baker
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Victoria B. Risbrough
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
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Terock J, Weihs A, Teumer A, Klinger-König J, Janowitz D, Grabe HJ. Associations and interactions of the serotonin receptor genes 5-HT1A, 5-HT2A, and childhood trauma with alexithymia in two independent general-population samples. Psychiatry Res 2021; 298:113783. [PMID: 33567384 DOI: 10.1016/j.psychres.2021.113783] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/11/2020] [Accepted: 01/31/2021] [Indexed: 12/18/2022]
Abstract
Previous studies suggested that childhood trauma and a disturbed serotonergic neurotransmission are involved in the pathogenesis of alexithymia. Specifically, genetic polymorphisms of the serotonin receptors 5-HT1A and 5-HT2A were found to be associated with alexithymia. However, it is unclear whether these factors show main or interaction effects with childhood trauma on alexithymia. Data from two independent general-population cohorts of the Study of Health in Pomerania (SHIP-Trend: N=3,706, Age: range=20-83, 51.6% female, SHIP-LEGEND: N=2,162, Age: range=20-80, 52.5% female) were used. The Toronto Alexithymia Scale-20 (TAS-20) and the Childhood Trauma Questionnaire (CTQ) were applied. Genotypes of rs6295 of 5-HT1A and rs6311 of 5-HT2A were determined. Ordinary least-squared regression models with robust standard errors were applied to investigate associations of the main and interaction effects of childhood maltreatment and the polymorphisms with alexithymia. Childhood trauma, but none of the investigated polymorphisms showed main effects on alexithymia. However, childhood trauma showed significant CTQ sum score x rs6295 interactions in male subjects in both samples such that the presence of the G-allele diminished the CTQ associated increase in the TAS-20 sum scores. Our results support a strong role of early life stress and interactions with rs6295 on alexithymic personality features at least in male subjects.
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Affiliation(s)
- Jan Terock
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany; Department of Psychiatry and Psychotherapy, HELIOS Hanseklinikum Stralsund, Stralsund, Germany.
| | - Antoine Weihs
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Deborah Janowitz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany; German Center for Neurodegenerative Diseases DZNE, Site Rostock/ Greifswald, Germany
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Azoulay M, Reuveni I, Dan R, Goelman G, Segman R, Kalla C, Bonne O, Canetti L. Childhood Trauma and Premenstrual Symptoms: The Role of Emotion Regulation. Child Abuse Negl 2020; 108:104637. [PMID: 32768748 DOI: 10.1016/j.chiabu.2020.104637] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/05/2020] [Accepted: 07/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Women with Premenstrual Dysphoric Disorder (PMDD) are more likely to have a history of childhood trauma, and may experience more severe premenstrual symptomatology. However, the pathway in which childhood trauma affects the prevalence and severity of premenstrual symptoms remains largely unclear. OBJECTIVE To determine whether childhood trauma is associated with increased premenstrual symptoms, and if so, whether emotional dysregulation mediates or moderates this relationship. PARTICIPANTS AND SETTINGS A total of 112 women were recruited for the study among students at the Hebrew University of Jerusalem. METHODS Participants completed the Premenstrual Symptoms Screening Tool (PSST), the Childhood Trauma Questionnaire (CTQ) and the Difficulties in Emotion Regulation Scale (DERS). To test the mediation hypothesis, direct and indirect effects of childhood trauma on premenstrual symptoms were calculated. To test moderation, we performed multiple regression, including the interaction term between childhood trauma and emotion dysregulation RESULTS: Twenty-two women (18.6%) met criteria for premenstrual syndrome (PMS) and sixteen (13.6 %) for PMDD. The number and severity of premenstrual symptoms increased with more childhood trauma (r = .282), and this relationship was completely mediated by emotion regulation difficulties. Specifically, exposure to Sexual abuse (r = .243) and Emotional neglect (r = .198) were significantly associated with premenstrual symptoms. Abuse predicted greater emotion dysregulation (r = .33), whereas, neglect did not. CONCLUSIONS This study contributes to the current knowledge on the long-term effects of childhood trauma. Promoting use of adaptive emotion regulation strategies for women with a history of childhood trauma, could improve their capability to confront and adapt to premenstrual changes.
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Affiliation(s)
- M Azoulay
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - I Reuveni
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - R Dan
- Edmond and Lily Safra Center for Brain Sciences (ELSC), The Hebrew University of Jerusalem, Israel; Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - G Goelman
- Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - R Segman
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - C Kalla
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - O Bonne
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - L Canetti
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
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Vrijsen JN, Tendolkar I, Onnink M, Hoogman M, Schene AH, Fernández G, van Oostrom I, Franke B. ADHD symptoms in healthy adults are associated with stressful life events and negative memory bias. ACTA ACUST UNITED AC 2018; 10:151-60. [PMID: 29081022 DOI: 10.1007/s12402-017-0241-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 10/09/2017] [Indexed: 11/08/2022]
Abstract
Stressful life events, especially Childhood Trauma, predict ADHD symptoms. Childhood Trauma and negatively biased memory are risk factors for affective disorders. The association of life events and bias with ADHD symptoms may inform about the etiology of ADHD. Memory bias was tested using a computer task in N = 675 healthy adults. Life events and ADHD symptoms were assessed using questionnaires. The mediation of the association between life events and ADHD symptoms by memory bias was examined. We explored the roles of different types of life events and of ADHD symptom clusters. Life events and memory bias were associated with overall ADHD symptoms as well as inattention and hyperactivity/impulsivity symptom clusters. Memory bias mediated the association of Lifetime Life Events, specifically Childhood Trauma, with ADHD symptoms. Negatively biased memory may be a cognitive marker of the effects of Childhood Trauma on the development and/or persistence of ADHD symptoms.
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Abstract
PURPOSE OF REVIEW Paranoid Personality Disorder (PPD) has historically been neglected by science out of proportion to its prevalence or its association with negative clinical outcomes. This review provides an update on what is known about PPD regarding its prevalence, demographics, comorbidity, biological mechanism, risk factors, and relationship to psychotic disorders. RECENT FINDINGS PPD has long been the subject of a rich and prescient theoretical literature which has provided a surprisingly coherent account of the psychological mechanism of non-delusional paranoia. Available data indicate that PPD has a close relationship with childhood trauma and social stress. Descriptive data on a sample of 115 individuals with Paranoid Personality Disorder is examined in comparison with a group of individuals with Borderline Personality Disorder. The descriptive data largely confirm previously identified relationships between Paranoid Personality Disorder and childhood trauma, violence, and race. We identify important similarities to and differences from Borderline Personality Disorder. SUMMARY PPD continues to be an important construct in the clinic and the laboratory. Available data lead to a reconsideration of the disorder as more closely related to trauma than to schizophrenia.
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Affiliation(s)
- Royce Lee
- Associate Professor of Psychiatry and Behavioral Neuroscience, The University of Chicago, Department of Psychiatry and Behavioral Neuroscience, , 773-834-5673, MC 3077, 5841 S. Maryland Ave, Chicago, IL 60637
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Vaughn-Coaxum RA, Wang Y, Kiely J, Weisz JR, Dunn EC. Associations Between Trauma Type, Timing, and Accumulation on Current Coping Behaviors in Adolescents: Results from a Large, Population-based Sample. J Youth Adolesc 2018; 47:842-58. [PMID: 28555292 DOI: 10.1007/s10964-017-0693-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 05/05/2017] [Indexed: 10/19/2022]
Abstract
The development of adolescents' coping in response to stress is critical for adaptive functioning; these coping strategies may be shaped by numerous environmental factors during childhood, including experiences such as exposure to trauma. Childhood trauma has been shown to undermine contemporaneous coping, but how does a history of exposure to trauma and the characteristics of that trauma (type, timing, and accumulation) relate to current coping among adolescents? We addressed this question using a nationally-representative sample of 9427 adolescents (ages 13-18; 48.9% female; 66% White). Adolescents reported on their lifetime exposure to 18 different traumas, including witnessing or experiencing interpersonal violence, accidents, disasters, and violent or accidental loss of loved ones, as well as their current use of coping behaviors when under stress (problem-focused, positive emotion-focused, and negative emotion-focused coping strategies). The study's results highlight that exposure to nearly all forms of trauma was unrelated to problem-focused and positive emotion-focused coping behaviors, but strongly associated with increased negative emotion-focused coping. Use of each coping style did not vary with age at first exposure to trauma, but increased with the number of lifetime traumatic events experienced. The findings suggest that the extent of prior exposure to trauma, including variations across type and timing, may be related to a particular form of coping that has been linked to increased risk for mental health problems. Study results highlight coping strategies as a potential target for prevention and treatment efforts, and indicate a need to better understand the malleability and trajectory of coping responses to stress for promoting healthy youth development.
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Schultz D, Jaycox LH, Ayer L, Setodji CM, Mahmud A, Kofner A, Barnes-Proby D. Improving Outcomes for Children Exposed to Violence: Safe Start Promising Approaches. Rand Health Q 2017; 7:6. [PMID: 29057156 PMCID: PMC5644772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Children's exposure to violence is common and can lead to mental health problems and delinquent behaviors. Because many interventions have focused on specific violence types or symptoms and been difficult to implement in real-world settings, the evidence base is still emerging. The Office of Juvenile Justice and Delinquency Prevention's Safe Start Promising Approaches (SSPA) initiative focused on preventing and reducing the impact of children's exposure to violence through interventions in ten diverse communities. The evaluation examined the effectiveness of the SSPA interventions to address issues for children and families exposed to violence. The ten sites were diverse in their intervention approaches, types of violence exposure targeted, and implementation settings. To evaluate each approach's effectiveness in reducing violence's harmful effects, RAND researchers partnered with the community-based sites to develop a rigorous controlled evaluation design for each intervention, with either a randomized control group or a comparison group selected on similar characteristics. The longitudinal analyses found that families in both the intervention and comparison groups had positive gains on many outcomes, but there was no evidence that the intervention groups improved more. Among those who received Safe Start services, one site produced large, significant improvements in posttraumatic stress disorder symptoms, and another site produced medium, significant effects on several outcomes (child self-control, posttraumatic stress disorder, and behavior; caregiver depression; and family conflict). Although the initiative added to knowledge about how to address the problem, there was no clear case for using a particular intervention to help these children and their families.
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Beutel TF, Zwerenz R, Michal M. [Retrospectively reported childhood trauma and health behavior in adult psychosomatic patients]. Z Psychosom Med Psychother 2016; 62:306-21. [PMID: 27924696 DOI: 10.13109/zptm.2016.62.4.306] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lotzin A, Haupt L, von Schönfels J, Wingenfeld K, Schäfer I. Profiles of Childhood Trauma in Patients with Alcohol Dependence and Their Associations with Addiction-Related Problems. Alcohol Clin Exp Res 2016; 40:543-52. [PMID: 26876715 DOI: 10.1111/acer.12990] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [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: 08/19/2015] [Accepted: 12/14/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND The high occurrence of childhood trauma in individuals with alcohol dependence is well-recognized. Nevertheless, researchers have rarely studied which types of childhood trauma often co-occur and how these combinations of different types and severities of childhood trauma are related to the patients' current addiction-related problems. We aimed to identify childhood trauma profiles in patients with alcohol dependence and examined relations of these trauma profiles with the patients' current addiction-related problems. METHODS In 347 alcohol-dependent patients, 5 types of childhood trauma (sexual abuse, physical abuse, emotional abuse, emotional neglect, and physical neglect) were measured using the Childhood Trauma Questionnaire. Childhood trauma profiles were identified using cluster analysis. The patients' current severity of addiction-related problems was assessed using the European Addiction Severity Index. RESULTS We identified 6 profiles that comprised different types and severities of childhood trauma. The patients' trauma profiles predicted the severity of addiction-related problems in the domains of psychiatric symptoms, family relationships, social relationships, and drug use. CONCLUSIONS Childhood trauma profiles may provide more useful information about the patient's risk of current addiction-related problems than the common distinction between traumatized versus nontraumatized patients.
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Affiliation(s)
- Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
| | - Lena Haupt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
| | - Julia von Schönfels
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
| | - Katja Wingenfeld
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
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Ruby E, Polito S, McMahon K, Gorovitz M, Corcoran C, Malaspina D. Pathways Associating Childhood Trauma to the Neurobiology of Schizophrenia. Front Psychol Behav Sci 2014; 3:1-17. [PMID: 25419548 PMCID: PMC4236311] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
While researchers have for decades considered the role of social factors, endocrinology, neural function, hippocampal integrity, and cognition in the development of schizophrenia, there has been a relative paucity of studies considering the participation of the stress cascade in the interplay of these elements. As described in this review, stressful exposures and stress sensitivity may plausibly be argued to play a role in the etiology, neurobiology, and course of schizophrenia and related psychotic disorders. Notably, research conducted over the last decade has made it increasingly clear that childhood traumatic experiences represent a prominent risk factor for the development of psychotic disorders, including schizophrenia. Accumulating evidence suggests that this relationship is mediated by the development of a neuropathological stress response, involving HPA axis dysregulation, aberrant functioning of different neurotransmitter systems, hippocampal damage, and memory deficits. However, it remains difficult to identify exact causal pathways linking early trauma to schizophrenia, including to the individual symptoms associated with the disorder. In addition to the strong association among early trauma, stress sensitization, and positive symptoms in schizophrenia, there is also evidence indicating that the negative and cognitive symptoms are related to these factors. However, the emergence of these symptoms may lie on a distinct and non-interacting pathway in relation to the development of the positive symptoms. The natural increases in stress sensitivity and HPA axis activity during adolescence may act on already maladaptive stress circuitry resulting from early trauma and/or a genetic predisposition to produce full blown stress sensitization and cause epigenetic effects, such as the altered methylation of different genes, that lead to schizophrenia or other psychiatric illnesses.
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Affiliation(s)
- Eugene Ruby
- Institute for Social and Psychiatric Initiatives - Research, Education, and Services (InSPIRES), Department of Psychiatry, New York University School of Medicine, 462 First Avenue, OBV A-Building, Rm 857, New York, NY 10016, USA
| | - Stephanie Polito
- New York State Psychiatric Institute at Columbia University, 1051 Riverside Drive, New York, NY 10032, USA
| | - Kevin McMahon
- Creedmoor Psychiatric Center, New York State Office of Mental Health, 79-25 Winchester Boulevard, Queens Village, New York, 11427, USA
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