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Karakaş M, Çingöl N. The relationship of childhood trauma experiences with cognitive distortions and sense of coherence in nursing students. Perspect Psychiatr Care 2022; 58:1546-1553. [PMID: 34634143 DOI: 10.1111/ppc.12962] [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: 08/10/2021] [Revised: 09/21/2021] [Accepted: 10/03/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study aimed to determine the relationship of childhood trauma experiences with cognitive distortions and sense of coherence in nursing students. DESIGN AND METHODS This descriptive, correlational, and cross-sectional study was conducted with 359 nursing students. Data were collected using the Sociodemographic Information Form, Childhood Trauma Questionnaire (CTQ), Cognitive Distortions Scale (CDS), and Sense of Coherence (SOC). FINDINGS A positive correlation between CTQ and CDS and a negative correlation between CTQ and SOC were determined (p < 0.05). It was concluded that the CTQ sexual abuse variable had a significant (p = 0.008) effect on the SOC meaningfulness subscale. PRACTICE IMPLICATIONS It is thought that it is essential to strengthen nursing students in terms of childhood traumatic experiences, and the sense of coherence will contribute positively to this situation.
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Affiliation(s)
- Mehmet Karakaş
- Department of Nursing, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Nurhan Çingöl
- Department of Nursing, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey
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Rai T, Mainali P, Raza A, Rashid J, Rutkofsky I. Exploring the Link Between Emotional Child Abuse and Anorexia Nervosa: A Psychopathological Correlation. Cureus 2019; 11:e5318. [PMID: 31598427 PMCID: PMC6777933 DOI: 10.7759/cureus.5318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 08/04/2019] [Indexed: 01/08/2023] Open
Abstract
Eating disorders (ED) are well known psychiatric disorders associated with dysregulated eating behaviors and related thoughts and emotions. Common eating disorders are bulimia nervosa (BN), anorexia nervosa (AN), and binge eating disorders (BED). There is an active link between child abuse and eating disorders, emotional child abuse being the important subtype of CA and has a strong comorbid psychopathological relationship with EDs, including AN. The PubMed database was searched for the related articles about child abuse, including emotional childhood maltreatment and their psychopathology associated with EDs, especially AN. No filters were used for the date of publication and article types. Childhood abuse, including physical, sexual, and emotional maltreatment, has an active link with psychopathology associated with dysregulated eating behaviors. However, emotional childhood maltreatment including emotional abuse, neglect, and/or exposure to intimate partner violence (IPV) has been least studied, but studies have shown a strong relationship with the symptoms of anorexia nervosa such as weight concern, negative self-image, and maladaptive emotional response. Emotional dysregulation is the crucial psychopathological factor involved in mediating the effects of emotional childhood maltreatment and symptoms of anorexia nervosa and is strongly associated with long-term morbidity in patients with AN. Conducting more clinical studies in the future would help explore the temporal causation, and this association may help the practitioners to develop new diagnostic and therapeutic strategies in the management of AN.
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Affiliation(s)
- Tehrima Rai
- Pediatrics, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Pranita Mainali
- Psychiatry, Washington DC VA Medical Center, Washington DC, USA
| | - Ali Raza
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Junaid Rashid
- Medicine and Histopathology, California Instititute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Ian Rutkofsky
- Psychiatry, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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Abstract
CONTEXT Psychosocial factors can impact lung transplant outcomes. However, it is currently unknown whether abuse survivorship influences lung transplant survival. OBJECTIVE To characterize the abuse history of adult lung transplant patients and determine whether such history is associated with mortality. PATIENTS AND OTHER PARTICIPANTS Adult lung transplant recipients evaluated from 2000 to 2004. MAIN OUTCOME MEASURES The main outcome was post-lung transplantation survival. The secondary outcomes included demographic, transplantation, or psychological assessment differences between those with a history of abuse survivorship and those without. RESULTS Thirty-three lung transplant recipients (35.5% male, median age: 55 years) were included. A history of abuse survivorship was common (24.2%) and was associated with decreased survival following lung transplantation (P = .003). There was no difference in sex, marital status, or smoking history between abuse survivors and those who denied being the victim of abuse. Abuse survivors had a higher Personality Assessment Screener total score, a measure of maladaptive personality traits (P = .02). CONCLUSION Abuse survivorship is common in lung transplant patients and associated with increased posttransplant mortality and increased maladaptive personality traits. This preliminary evidence suggests that lung transplant patients should be screened for abuse history and provided with appropriate treatment of survivorship issues to potentially improve their health outcomes from transplantation.
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Affiliation(s)
- Cassie C Kennedy
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Adeel Zubair
- Mayo Medical School, Mayo Clinic, Rochester, MN, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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Nazarov A, Walaszczyk V, Frewen P, Oremus C, Lanius R, McKinnon MC. Moral reasoning in women with posttraumatic stress disorder related to childhood abuse. Eur J Psychotraumatol 2016; 7:31028. [PMID: 27837580 PMCID: PMC5106867 DOI: 10.3402/ejpt.v7.31028] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 08/28/2016] [Accepted: 09/05/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Preliminary evidence suggests that relative to healthy controls, patients with posttraumatic stress disorder (PTSD) show deficits on several inter-related social cognitive tasks, including theory of mind, and emotion comprehension. Systematic investigations examining other aspects of social cognition, including moral reasoning, have not been conducted in PTSD stemming from childhood trauma. OBJECTIVE To conduct a comprehensive assessment of moral reasoning performance in individuals with PTSD stemming from childhood abuse. METHOD Moral reasoning performance was assessed in 28 women with PTSD related to prolonged childhood trauma and 19 matched healthy controls. Performance was assessed using 12 modified moral dilemmas and was queried in three domains: utilitarian/deontological sacrificial dilemmas (personal and impersonal), social order vs. compassion, and altruism vs. self-interest. Participants were asked whether a proposed action was morally acceptable or unacceptable and whether or not they would perform this action under the circumstances described. RESULTS Women with PTSD were less likely to carry out utilitarian actions in personal, sacrificial moral dilemmas, a choice driven primarily by consequential intrapersonal disapproval. Increased concern regarding intrapersonal disapproval was related to higher symptoms of guilt in the PTSD group. Patients with PTSD demonstrated less altruistic moral reasoning, primarily associated with decreased empathic role-taking for beneficiaries. CONCLUSIONS Women with PTSD due to childhood trauma show alterations in moral reasoning marked by decreased utilitarian judgment and decreased altruism. Childhood trauma may continue to impact moral choices made into adulthood.
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Affiliation(s)
- Anthony Nazarov
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Victoria Walaszczyk
- Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Paul Frewen
- Department of Psychiatry, Western University, London, ON, Canada.,Department of Psychology, Western University, London, ON, Canada.,Department of Neuroscience, Western University, London, ON, Canada.,Homewood Research Institute, Guelph, ON, Canada
| | - Carolina Oremus
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Ruth Lanius
- Department of Psychiatry, Western University, London, ON, Canada.,Department of Neuroscience, Western University, London, ON, Canada.,Homewood Research Institute, Guelph, ON, Canada.,Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Margaret C McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Homewood Research Institute, Guelph, ON, Canada;
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Tursich M, Ros T, Frewen PA, Kluetsch RC, Calhoun VD, Lanius RA. Distinct intrinsic network connectivity patterns of post-traumatic stress disorder symptom clusters. Acta Psychiatr Scand 2015; 132:29-38. [PMID: 25572430 DOI: 10.1111/acps.12387] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [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] [Accepted: 12/09/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Post-traumatic stress disorder (PTSD) is considered a multidimensional disorder, with distinct symptom clusters including re-experiencing, avoidance/numbing, hyperarousal, and most recently depersonalization/derealization. However, the extent of differing intrinsic network connectivity underlying these symptoms has not been fully investigated. We therefore investigated the degree of association between resting connectivity of the salience (SN), default mode (DMN), and central executive (CEN) networks and PTSD symptom severity. METHOD Using resting-state functional MRI data from PTSD participants (n = 21), we conducted multivariate analyses to test whether connectivity of extracted independent components varied as a function of re-experiencing, avoidance/numbing, hyperarousal, and depersonalization/derealization. RESULTS Hyperarousal symptoms were associated with reduced connectivity of posterior insula/superior temporal gyrus within SN [peak Montréal Neurological Institute (MNI): -44, -8, 0, t = -4.2512, k = 40]. Depersonalization/derealization severity was associated with decreased connectivity of perigenual anterior cingulate/ventromedial prefrontal cortex within ventral anterior DMN (peak MNI: 8, 40, -4; t = -3.8501; k = 15) and altered synchrony between two DMN components and between DMN and CEN. CONCLUSION Our results are consistent with prior research showing intrinsic network disruptions in PTSD and imply heterogeneous connectivity patterns underlying PTSD symptom dimensions. These findings suggest possible biomarkers for PTSD and its dissociative subtype.
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Affiliation(s)
- M Tursich
- Department of Psychiatry, The University of Western Ontario, London, ON, Canada
| | - T Ros
- Department of Fundamental Neurosciences, The University of Geneva, Geneva, Switzerland
| | - P A Frewen
- Department of Psychiatry, The University of Western Ontario, London, ON, Canada.,Department of Psychology, The University of Western Ontario, London, ON, Canada.,Department of Neuroscience, The University of Western Ontario, London, ON, Canada
| | - R C Kluetsch
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
| | - V D Calhoun
- Department of Electrical and Computer Engineering, The University of New Mexico, Albuquerque, NM, USA.,The Mind Research Network, Albuquerque, NM, USA
| | - R A Lanius
- Department of Psychiatry, The University of Western Ontario, London, ON, Canada.,Department of Neuroscience, The University of Western Ontario, London, ON, Canada
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Nazarov A, Frewen P, Oremus C, Schellenberg EG, McKinnon MC, Lanius R. Comprehension of affective prosody in women with post-traumatic stress disorder related to childhood abuse. Acta Psychiatr Scand 2015; 131:342-9. [PMID: 25401486 DOI: 10.1111/acps.12364] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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] [Accepted: 10/14/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Although deficits in memory and cognitive processing are evident in post-traumatic stress disorder (PTSD), difficulties with social cognition and the impact of such difficulties on interpersonal functioning are poorly understood. Here, we examined the ability of women diagnosed with PTSD related to childhood abuse to discriminate affective prosody, a central component of social cognition. METHOD Women with PTSD and healthy controls (HCs) completed two computer-based tasks assessing affective prosody: (i) recognition (categorizing foreign-language excerpts as angry, fearful, sad, or happy) and (ii) discrimination (identifying whether two excerpts played consecutively had the 'same' or 'different' emotion). The association of performance with symptom presentation, trauma history, and interpersonal functioning was also explored. RESULTS Women with PTSD were slower than HCs at identifying happiness, sadness, and fear, but not anger in the speech excerpts. The presence of dissociative symptoms was related to reduced accuracy on the discrimination task. An increased severity of childhood trauma was associated with reduced accuracy on the discrimination task and with slower identification of emotional prosody. CONCLUSION Exposure to childhood trauma is associated with long-term, atypical development in the interpretation of prosodic cues in speech. The findings have implications for the intergenerational transmission of trauma.
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Affiliation(s)
- A Nazarov
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada; Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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Nazarov A, Frewen P, Parlar M, Oremus C, MacQueen G, McKinnon M, Lanius R. Theory of mind performance in women with posttraumatic stress disorder related to childhood abuse. Acta Psychiatr Scand 2014; 129:193-201. [PMID: 23662597 DOI: 10.1111/acps.12142] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [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] [Accepted: 04/03/2013] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Key questions remain unaddressed concerning the nature of interpersonal functioning in trauma survivors, including the ability to understand and interpret other people's thoughts and feelings. Here, we investigate theory of mind (ToM) performance of women with PTSD related to childhood abuse in comparison to healthy controls. METHOD Participants completed two ToM tasks, the Interpersonal Perception Task-15 (IPT-15) and the Reading the Mind in the Eyes Task - Revised (RMET). RESULTS Relative to controls, women with a history of childhood trauma had difficulty recognizing familial relationships depicted in the IPT-15 (P = 0.005). No other category of the IPT-15 showed significant group differences. In addition, while healthy women displayed faster RMET reaction times to emotionally valenced mental states (positive: P = 0.003; negative: P = 0.016) compared with neutral mental states, the PTSD group showed similar reaction times across all valences. The presence of dissociative symptoms (e.g., disengagement, amnesia, identity dissociation) was strongly associated with hindered accuracy of complex mental state identification and altered perception of kinship interactions. CONCLUSION Women with PTSD stemming from childhood trauma show changes in ToM abilities particularly those often involved in the interpretation of family interactions. In addition, individuals with PTSD showed slower reaction times during the recognition of complex mental states from emotionally salient facial/eye expressions in comparison with healthy subjects.
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Affiliation(s)
- A Nazarov
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada; Mood Disorders Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada
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Dorrepaal E, Thomaes K, Hoogendoorn AW, Veltman DJ, Draijer N, van Balkom AJLM. Evidence-based treatment for adult women with child abuse-related Complex PTSD: a quantitative review. Eur J Psychotraumatol 2014; 5:23613. [PMID: 25563302 PMCID: PMC4199330 DOI: 10.3402/ejpt.v5.23613] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 07/14/2014] [Accepted: 08/19/2014] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Effective first-line treatments for posttraumatic stress disorder (PTSD) are well established, but their generalizability to child abuse (CA)-related Complex PTSD is largely unknown. METHOD A quantitative review of the literature was performed, identifying seven studies, with treatments specifically targeting CA-related PTSD or Complex PTSD, which were meta-analyzed, including variables such as effect size, drop-out, recovery, and improvement rates. RESULTS Only six studies with one or more cognitive behavior therapy (CBT) treatment conditions and one with a present centered therapy condition could be meta-analyzed. RESULTS indicate that CA-related PTSD patients profit with large effect sizes and modest recovery and improvement rates. Treatments which include exposure showed greater effect sizes especially in completers' analyses, although no differential results were found in recovery and improvement rates. However, results in the subgroup of CA-related Complex PTSD studies were least favorable. Within the Complex PTSD subgroup, no superior effect size was found for exposure, and affect management resulted in more favorable recovery and improvement rates and less drop-out, as compared to exposure, especially in intention-to-treat analyses. CONCLUSION Limited evidence suggests that predominantly CBT treatments are effective, but do not suffice to achieve satisfactory end states, especially in Complex PTSD populations. Moreover, we propose that future research should focus on direct comparisons between types of treatment for Complex PTSD patients, thereby increasing generalizability of results.
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Affiliation(s)
- Ethy Dorrepaal
- GGZ inGeest, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands; EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands; PsyQ, Parnassia Groep, The Hague, The Netherlands;
| | - Kathleen Thomaes
- GGZ inGeest, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Dick J Veltman
- GGZ inGeest, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Nel Draijer
- GGZ inGeest, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands; EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Anton J L M van Balkom
- GGZ inGeest, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands; EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands
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Zalewski M, Cyranowski JM, Cheng Y, Swartz HA. Role of maternal childhood trauma on parenting among depressed mothers of psychiatrically ill children. Depress Anxiety 2013; 30:792-9. [PMID: 23649503 PMCID: PMC4536924 DOI: 10.1002/da.22116] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [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: 01/18/2013] [Revised: 03/20/2013] [Accepted: 03/22/2013] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Independently, maternal depression and maternal history of childhood abuse confer risk for impaired parenting. These associations may be compounded when depressed mothers with histories of childhood abuse are faced with the challenge of parenting offspring who themselves struggle with mental health problems. This study examined the relationships among maternal history of childhood abuse, maternal depression, and parenting style in the context of parenting a psychiatrically ill child, with an emphasis on examining maternal emotional abuse and neglect. We hypothesized that maternal childhood emotional abuse would be associated with maladaptive parenting strategies (lower levels of maternal acceptance and higher levels of psychological control), independent of maternal depression severity and other psychosocial risk factors. METHOD Ninety-five mother-child dyads (children ages 7-18) were recruited from child mental health centers where children were receiving treatment for at least one internalizing disorder. Participating mothers met DSM-IV criteria for major depressive disorder. Mothers reported on their own childhood abuse histories and children reported on their mothers' parenting. RESULTS Regression analyses demonstrated that maternal childhood emotional abuse was associated with child reports of lower maternal acceptance and greater psychological control, controlling for maternal depression severity, and other psychosocial risk factors. CONCLUSIONS When treating psychiatrically ill children, it is important for a child's clinician to consider mothers' childhood abuse histories in addition to their history of depression. These mothers appear to have additional barriers to effective parenting.
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Affiliation(s)
- Maureen Zalewski
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jill M. Cyranowski
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Yu Cheng
- Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Holly A. Swartz
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania,Correspondence to: Holly A. Swartz, M.D., University of Pittsburgh; 3811 O’Hara Street, Pittsburgh, PA 15213.
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Cort NA, Gamble SA, Smith PN, Chaudron LH, Lu N, He H, Talbot NL. Predictors of treatment outcomes among depressed women with childhood sexual abuse histories. Depress Anxiety 2012; 29:479-86. [PMID: 22570264 PMCID: PMC3383394 DOI: 10.1002/da.21942] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [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: 12/06/2011] [Revised: 02/15/2012] [Accepted: 03/04/2012] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND A notable portion (21%) of female patients receiving treatment for depression in community mental health centers (CMHC) has childhood sexual abuse (CSA) histories. Treatment outcomes in this population are heterogeneous; identifying factors associated with differential outcomes could inform treatment development. This exploratory study begins to address the gap in what is known about predictors of treatment outcomes among depressed women with sexual abuse histories. METHOD Seventy women with major depressive disorder and CSA histories in a CMHC were randomly assigned to interpersonal psychotherapy (n = 37) or usual care (n = 33). Using generalized estimating equations, we examined four pretreatment predictor domains (i.e. sociodemographic characteristics, clinical features, social and physical functioning, and trauma features) potentially related to depression treatment outcomes. RESULTS Among sociodemographic characteristics, Black race/ethnicity, public assistance income, and unemployment were associated with less depressive symptom reduction over the course of treatment. Two clinical features, chronic depression and borderline personality disorder, were also related to less reduction in depressive symptoms across the treatment period. CONCLUSION Our results demonstrate the clinical relevance of attending to predictors of depressed women with CSA histories being treated in public sector mental health centers. Particular sociodemographic characteristics and clinical features among these women may be significant indicators of risk for relatively poorer treatment outcomes.
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Affiliation(s)
- Natalie A. Cort
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
| | - Stephanie A. Gamble
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
| | - Phillip N. Smith
- Department of Psychology, University of South Alabama, Mobile, AL, United States
| | - Linda H. Chaudron
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
| | - Naiji Lu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, United States
| | - Hua He
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, United States
| | - Nancy L. Talbot
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
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Ritchie K, Jaussent I, Stewart R, Dupuy AM, Courtet P, Ancelin ML, Malafosse A. Association of adverse childhood environment and 5-HTTLPR Genotype with late-life depression. J Clin Psychiatry 2009; 70:1281-8. [PMID: 19573496 PMCID: PMC3078522 DOI: 10.4088/jcp.08m04510] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [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: 07/01/2008] [Accepted: 09/15/2008] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Neurobiological and clinical studies suggest that childhood maltreatment may result in functional and structural nervous system changes that predispose the individual to depression. This vulnerability appears to be modulated by a polymorphism in the serotonin gene-linked promoter region (5-HTTLPR). Little is known, however, about the persistence of this vulnerability across the life span, although clinical studies of adult populations suggest that gene-environment interaction may diminish with aging. METHOD Depressive symptomatology and adverse and protective childhood events were examined in a population of 942 persons aged 65 years and older, taking into account sociodemographic characteristics and proximal competing causes of depression (widowhood, recent life events, vascular and neurologic disorder, and disability). Subjects were recruited between March 1999 and February 2001 and were diagnosed as depressed if they met 1 of 3 criteria: a diagnosis of major depression on the Mini-International Neuropsychiatric Interview, a score higher than 16 on the Center for Epidemiologic Studies-Depression Scale, or current treatment with an antidepressant. RESULTS Exposure to traumatic events in childhood doubled the risk of late-life depression and increased the risk of repeated episodes. Not all events were found to be pathogenic; significant risk was associated with excessive sharing of parental problems, poverty or financial difficulties, mental disorder in parents, excessive physical punishment, verbal abuse from parents, humiliation, and mistreatment by an adult outside the family. Interactions were observed between the 5-HTTLPR long (L) allele, poverty, and excessive sharing of parental problems. CONCLUSIONS Certain types of childhood trauma continue to constitute risk factors for depression in old age, outweighing more proximal causes. Gene environment vulnerability interaction is linked in older age to the L-carrying genotype, modulating the effects of general environmental conditions rather than aggressive acts on the individual, perhaps due to increased cardiac reactivity.
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Affiliation(s)
| | - Isabelle Jaussent
- Pathologies du système nerveux : recherche épidémiologique et clinique
INSERM : U888IFR76Université Montpellier IHôpital la colombiere 39, avenue charles flahault BP 34493 -pav 42 calixte cavalier 34093 MONTPELLIER CEDEX 5,FR
| | - Robert Stewart
- Pathologies du système nerveux : recherche épidémiologique et clinique
INSERM : U888IFR76Université Montpellier IHôpital la colombiere 39, avenue charles flahault BP 34493 -pav 42 calixte cavalier 34093 MONTPELLIER CEDEX 5,FR,Institute of Psychiatry
University of LondonDe crespigny park, King's College London, SE5 8AF,GB
| | - Anne-Marie Dupuy
- Pathologies du système nerveux : recherche épidémiologique et clinique
INSERM : U888IFR76Université Montpellier IHôpital la colombiere 39, avenue charles flahault BP 34493 -pav 42 calixte cavalier 34093 MONTPELLIER CEDEX 5,FR,Laboratoire de biochimie
CHRU MontpellierHôpital Lapeyronie34295 Montpellier Cedex 5,FR
| | - Philippe Courtet
- Pathologies du système nerveux : recherche épidémiologique et clinique
INSERM : U888IFR76Université Montpellier IHôpital la colombiere 39, avenue charles flahault BP 34493 -pav 42 calixte cavalier 34093 MONTPELLIER CEDEX 5,FR,Service de psychologie médicale et psychiatrie
CHRU MontpellierMontpellier, FR
| | - Marie-Laure Ancelin
- Pathologies du système nerveux : recherche épidémiologique et clinique
INSERM : U888IFR76Université Montpellier IHôpital la colombiere 39, avenue charles flahault BP 34493 -pav 42 calixte cavalier 34093 MONTPELLIER CEDEX 5,FR
| | - Alain Malafosse
- Pathologies du système nerveux : recherche épidémiologique et clinique
INSERM : U888IFR76Université Montpellier IHôpital la colombiere 39, avenue charles flahault BP 34493 -pav 42 calixte cavalier 34093 MONTPELLIER CEDEX 5,FR,Département de psychiatrie
Hôpital Universitaire de GenèveCH
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