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Lassri D, Gewirtz-Meydan A, Nolte T. Transdiagnostic factors in the COVID-19 pandemic: Examining the role of childhood abuse and neglect in establishing latent profiles of risk and resilience. Child Abuse Negl 2024:106808. [PMID: 38693009 DOI: 10.1016/j.chiabu.2024.106808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 04/01/2024] [Accepted: 04/18/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Ample studies have focused on the negative consequences of COVID-19 on mental well-being, but fewer have explored the specific role of childhood abuse and neglect in the context of risk and resilience during this unprecedented crisis. OBJECTIVE We aimed to identify distinct profiles of individuals based on their experiences of childhood abuse and neglect, coping strategies, and psycho-social transdiagnostic risk and protective factors, using a person-centered approach. PARTICIPANTS AND SETTING A convenience sample of 914 Israelis completed self-report questionnaires during the second wave of COVID-19. METHODS Latent Profile Analysis was employed based on levels of childhood abuse and neglect, coping strategies, and established factors underpinning risk and resilience in mental health: dissociation, self-criticism, self-efficacy, self-compassion, attachment insecurity, psychological resilience, mentalizing, distress disclosure, psychopathology, and relationship satisfaction. Profiles were compared in COVID-19-related distress and well-being using ANOVAs. RESULTS A four-profile solution was found to be optimal for describing individuals with different profiles of risk and resilience: "risk" (5.1 %)-individuals with meaningfully high levels of childhood abuse and neglect and dissociation; "vulnerable" (14.2 %)-individuals high in risk factors and low in protective factors; "moderately resilient" (47.6 %)-those with moderate levels of protective and risk factors; "highly resilient" (33.1 %)-individuals high in protective factors and low in risk factors; groups differed in mental well-being and COVID-19-related distress. CONCLUSIONS Results highlight the importance of childhood abuse and neglect in differentiating between the two distinct profiles of at-risk individuals. Implications for risk assessment and treatment in the context of potential traumatic stress are discussed.
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Affiliation(s)
- Dana Lassri
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel; Research Department of Clinical, Educational, and Health Psychology, University College London (UCL), United Kingdom.
| | - Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare & Health Sciences, University of Haifa, Israel. agewirtz-@univ.haifa.ac.il
| | - Tobias Nolte
- Research Department of Clinical, Educational, and Health Psychology, University College London (UCL), United Kingdom; Anna Freud, United Kingdom.
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2
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Wang Y, Gao Y, Liu J, Bai R, Liu X. Reciprocal associations between early maladaptive schemas and depression in adolescence: long-term effects of childhood abuse and neglect. Child Adolesc Psychiatry Ment Health 2023; 17:134. [PMID: 38037149 PMCID: PMC10688108 DOI: 10.1186/s13034-023-00682-z] [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: 07/11/2023] [Accepted: 11/22/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Adolescent depression has grown to be a major social concern in China. During the coronavirus pandemic, the incidence of depression among Chinese adolescents increased substantially. More research is required to inform the prevention and intervention of adolescent depression in China. Depression is associated with Early Maladaptive Schemas (EMSs). Childhood abuse and neglect are distal antecedents of adolescent depression. It is not known how depression and EMSs interact in adolescence and how childhood abuse and neglect contribute to this relationship. This study aimed to examine the reciprocal relationships between depression and EMSs, as well as the long-term effects of childhood abuse and neglect on depression and EMSs during adolescence. The work also investigates gender differences in these mechanisms. METHODS Using a two-wave longitudinal design, we recruited 3,485 Chinese adolescents (Mage = 13.2; 43.2% females) from three Shanxi Province, China middle schools. All participants completed self-report questionnaires addressing childhood abuse and neglect, depression, and EMSs. Structural equation models examined reciprocal relationships between depression and EMS, as well as the effect of childhood abuse and neglect on depression and EMSs. Multi-group analysis addressed gender differences. RESULTS Results indicated that greater depression predicted more EMSs measured later, but EMSs did not predict subsequent depression. Childhood abuse and neglect had different effects on depression and EMSs during adolescence. Specifically, exposure to childhood abuse related to more severe depression and EMSs in adolescence and contributed to the perpetuation of EMSs by increasing depression. Exposure to childhood neglect showed a direct effect on depression and indirectly reinforced subsequent EMSs through depression. There were no gender differences. CONCLUSION These findings contribute to a better understanding of the emergence and course of depression in early adolescence, suggesting that childhood abuse and neglect are critical early risk factors. Additionally, depression plays a key role in promoting schema perpetuation among adolescents exposed to childhood maltreatment, providing important implications for relevant prevention and intervention in early adolescence.
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Affiliation(s)
- Yumeng Wang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, China
| | - Yemiao Gao
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, China
| | - Jinmeng Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, China
| | - Rong Bai
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, China.
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3
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Köhler-Dauner F, Peter L, Fegert JM, Ziegenhain U, Buchheim A. The role of attachment representation in the relationship between childhood maltreatment, mental health and parental load: A mediation analysis. Child Abuse Negl 2023; 144:106334. [PMID: 37454555 DOI: 10.1016/j.chiabu.2023.106334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/15/2023] [Accepted: 06/22/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Franziska Köhler-Dauner
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
| | - Lena Peter
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Anna Buchheim
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
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Barton BB, Reinhard MA, Goerigk S, Wüstenberg T, Musil R, Ehring T, Jobst A, Dewald-Kaufmann J, Padberg F. Association between the behavioral response during social exclusion and recalled childhood maltreatment. Behav Res Ther 2023; 160:104232. [PMID: 36459815 DOI: 10.1016/j.brat.2022.104232] [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] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 10/15/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022]
Abstract
Social exclusion is a critical event for mental health. Patients with interpersonal dysfunction, e.g., with borderline personality disorder (BPD) or persistent depressive disorder (PDD), are particularly vulnerable, often based on their experiences of early adversity in life. The etiological pathways from childhood maltreatment (CM) to current behavior during social exclusion are still underexplored. This cross-diagnostic study investigated the relationship between self-reported CM and behavioral reaction to social exclusion in an experimental paradigm (Cyberball). Data from 140 subjects including patients with BPD and PDD as well as healthy controls were analyzed. The effect of CM (Childhood Trauma Questionnaire, CTQ) on behavior to social exclusion during Cyberball (ball tossing behavior) was analyzed including rejection sensitivity (RS) as a mediator. In the whole sample, the CTQ score (B = -.004, p < .05) as well as the emotional neglect subscore (B = -.016, p < .01) were associated with a reduced ball tossing behavior towards the excluder. There were no significant indirect effects involving RS. These current findings support the relationship between CM and an altered interpersonal response in critical interpersonal situations. Larger cohorts with multidimensional data in social domains are warranted to further investigate the link between CM and current interpersonal dysfunction.
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Affiliation(s)
- Barbara B Barton
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Nussbaumstraße 7, 80336, Munich, Germany.
| | - Matthias A Reinhard
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Nussbaumstraße 7, 80336, Munich, Germany.
| | - Stephan Goerigk
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Nussbaumstraße 7, 80336, Munich, Germany; Charlotte Fresenius Hochschule, Infanteriestraße 11a, 80797 Munich, Germany; Department of Psychological Methodology and Assessment, Ludwig-Maximilians-University, Leopoldstraße 13, 80802, Munich, Germany.
| | - Torsten Wüstenberg
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin, Bonhoefferweg 3, 10117, Berlin, Germany.
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Nussbaumstraße 7, 80336, Munich, Germany.
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Leopoldstraße 13, 80802, Munich, Germany.
| | - Andrea Jobst
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Nussbaumstraße 7, 80336, Munich, Germany.
| | - Julia Dewald-Kaufmann
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Nussbaumstraße 7, 80336, Munich, Germany.
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Nussbaumstraße 7, 80336, Munich, Germany.
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Levin RY, Liu RT. Life stress, early maltreatment, and prospective associations with depression and anxiety in preadolescent children: A six-year, multi-wave study. J Affect Disord 2021; 278:276-9. [PMID: 32977265 DOI: 10.1016/j.jad.2020.09.072] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/28/2020] [Accepted: 09/11/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND The relationship between life stress and depression and anxiety is well characterized in adolescents and adults. Further, research has shown that adolescents and adults with a history of childhood maltreatment are more likely to develop depression and anxiety after being exposed to stress than those without this history. However, the processes underlying risk for depression and anxiety in maltreated preadolescent children are unclear. The current study sought to identify these processes in at-risk preadolescents. METHODS This study analyzed data from the Longitudinal Studies of Child Abuse and Neglect and evaluated interpersonal and non-interpersonal life stress as predictors of depression and anxiety specifically, and internalizing symptoms more generally, in a sample of children vulnerable or exposed to maltreatment (n = 1,049). Participants were assessed repeatedly over a six-year period of early-to-mid childhood. RESULTS Interpersonal life stress prospectively predicted greater depression and anxiety, but not general internalizing symptoms after emotional and behavioral problems, as well as child's sex, family income and baseline maternal depressive symptoms, were covaried. Non-interpersonal life stress was not prospectively predictive of depression and anxiety or general internalizing symptoms. LIMITATIONS The study was unable to identify specific types of interpersonal stress most relevant to risk for depression and anxiety in preadolescent children. CONCLUSIONS These findings lend support for the importance of interpersonal stress when screening for risk for depression and anxiety among preadolescent children vulnerable or exposed to maltreatment. Early intervention to decrease the occurrence and impact of these stressors could have long-lasting impacts on this vulnerable population.
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Marie-Mitchell A, Watkins HBR, Copado IA, Distelberg B. Use of the Whole Child Assessment to identify children at risk of poor outcomes. Child Abuse Negl 2020; 104:104489. [PMID: 32289566 DOI: 10.1016/j.chiabu.2020.104489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 11/22/2019] [Revised: 03/23/2020] [Accepted: 03/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Screening for Adverse Childhood Experiences (ACEs) in pediatric patients has the potential to prevent poor health outcomes associated with ACEs. Only a limited number of tools screen for all ten ACEs in all pediatric age groups, and none of these have demonstrated robust validity to date. OBJECTIVE In order to evaluate the validity of the Whole Child Assessment, we examined associations between poor outcomes in pediatric patients and responses to questions about exposure to and risk of ACEs. METHODS This cross-sectional study used medical record data from 499 children ages 5-11 years old who received care at one of two university-affiliated clinics in California. All Child-ACE measures were included on the Whole Child Assessment, which caregivers completed when they brought their child to a well-child visit. Medical charts were reviewed for current diagnoses and problems, current or past history of any developmental delay, and health care utilization. RESULTS Compared to lower risk patients (0-1 reported ACE exposure), patients with 2 or more reported exposures were statistically significantly more likely to experience sadness, anger, sleep problems, bullying, school problems, and enuresis. The directionality of effects and the number of statistically significant associations improved when adding questions about risk of ACEs to the total Child-ACE score. CONCLUSION We found strong relationships between Child-ACEs reported on the Whole Child Assessment and odds of poor child health and psychosocial outcomes in pediatric patients age 5-11 years old, which supports the validity of using the Whole Child Assessment at well-child visits.
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Affiliation(s)
- Ariane Marie-Mitchell
- Loma Linda University Preventive Medicine & Pediatrics Departments, Loma Linda, CA, United States.
| | | | - Ivan A Copado
- Loma Linda University Preventive Medicine & Pediatrics Departments, Loma Linda, CA, United States
| | - Brian Distelberg
- Loma Linda University Behavioral Medicine Center, Loma Linda, CA, United States
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Dovran A, Winje D, Arefjord K, Tobiassen S, Stokke K, Skogen JC, Øverland S. Associations between adverse childhood experiences and adversities later in life. Survey data from a high-risk Norwegian sample. Child Abuse Negl 2019; 98:104234. [PMID: 31689619 DOI: 10.1016/j.chiabu.2019.104234] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 06/28/2019] [Revised: 09/15/2019] [Accepted: 10/14/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND A history of childhood abuse and neglect (CAN) is associated with exposure to later negative life events. CAN at an early age, multiple cooccurring exposures (cumulative events), and a high severity and frequency of exposure have potential detrimental long-term effects. OBJECTIVE The present study examines the relationship between the severity of CAN and the prevalence of school difficulties and hardship at school, adult adversity and mental health. PARTICIPANTS AND SETTINGS Participants were recruited from in- and outpatient mental health or substance abuse treatment facilities, child protective services (CPS), and prisons (N = 809, age range = 13-66, mean age = 27.62, SD = 10.47). METHODS Exposure to childhood maltreatment was assessed by the Childhood Trauma Questionnaire Short Form (CTQ-SF). After adjusting for gender and age, we conducted a risk ratio regression analysis to investigate associations between severity of child abuse and neglect and hardship at school, adult adversity and adult mental health. RESULTS The moderate and severe level groups of CAN had statistically significant higher risk ratios for experiences of school difficulties, hardship at school, adult adversity and mental health problems. A robust dose-response was found between severity levels. CONCLUSION At an individual level the findings highlight the association between exposure to abuse and adult adversity, underscoring the importance of targeting individuals with high risk of exposure to CAN to reduce the negative long-term risk for Polyvictimization.
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Affiliation(s)
- Anders Dovran
- Stine Sofies Foundation & Stine Sofie Centre, Grimstad, Norway; Department of Psychosocial Health, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway; Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway.
| | - Dagfinn Winje
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Kjersti Arefjord
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Stian Tobiassen
- Stine Sofies Foundation & Stine Sofie Centre, Grimstad, Norway
| | - Kristin Stokke
- Stine Sofies Foundation & Stine Sofie Centre, Grimstad, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway; Alcohol & Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway; Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Simon Øverland
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway; Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
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8
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Simonelli A, Sacchi C, Cantoni L, Brown M, Frewen P. Italian translation and cross-cultural comparison with the Childhood Attachment and Relational Trauma Screen (CARTS). Eur J Psychotraumatol 2017; 8:1375839. [PMID: 29163857 PMCID: PMC5687796 DOI: 10.1080/20008198.2017.1375839] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/18/2017] [Indexed: 01/17/2023] Open
Abstract
Background: The Childhood Attachment and Relational Trauma Screen (CARTS) is a computer-administered survey designed to assess retrospectively the socio-ecological context in which instances of child abuse may have occurred. To date, studies supporting the validity of the CARTS have only been undertaken in English-speaking North American populations. Validation projects in other countries and cross-cultural comparisons are therefore warranted. Objective: Develop and preliminarily evaluate the psychometric properties of an Italian version of the CARTS on college students and compare such observations to data acquired from Canadian students. Method: Seventy-nine undergraduate students from the University of Padua (Italy) completed an Italian translation of the CARTS as well as measures of childhood experiences, mental health and attachment, responses to which were compared to those obtained in 288 Canadian students who completed the CARTS in English. Results: Internal consistency and convergent validity with the Childhood Trauma Questionnaire and Parental Bonding Instrument were found to be acceptable for the Italian translation. Within the Italian sample, correlation analyses suggested that CARTS Mother ratings referring to attachment and abuse were associated with romantic attachment, whereas CARTS Father ratings were significantly correlated to PTSD symptoms and other symptoms of psychopathology-distress. Significant differences between Italian and Canadian students across the relationship types for the CARTS abuse and attachment scales were found, indicating that Italian students rated their mothers and fathers as simultaneously less abusive, but also less as a source of secure attachment. Conclusions: The results of this preliminary study seem to suggest convergent validity of the Italian CARTS and the association between childhood attachment-related experiences and romantic attachment. Cultural variations were identified between Canadian and Italian students in both attachment and abuse scales. Future studies to investigate cross-cultural variations in the relational context of childhood abuse and in order to boost Italian CARTS psychometric features are warranted.
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Affiliation(s)
- A Simonelli
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - C Sacchi
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - L Cantoni
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - M Brown
- Department of Psychology, Western University, London, Canada
| | - P Frewen
- Department of Psychology, Western University, London, Canada.,Department of Psychiatry, Western University, London, Canada.,Imaging Division, Lawson Health Research Institute, London, Canada
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Frewen P, Brown M, DePierro J, D'Andrea W, Schore A. Assessing the family dynamics of childhood maltreatment history with the Childhood Attachment and Relational Trauma Screen (CARTS). Eur J Psychotraumatol 2015; 6:27792. [PMID: 26243548 PMCID: PMC4524890 DOI: 10.3402/ejpt.v6.27792] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 06/22/2015] [Accepted: 06/25/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Existing survey measures of childhood trauma history generally fail to take into account the relational-socioecological environment in which childhood maltreatment occurs. Variables such as the relationship between the perpetrator and the victim, the emotional availability of caregivers, witnessing the abuse of others, and the respondent's own thoughts, feelings, and actions in response to maltreatment are rarely assessed by current measures. METHODS To address these concerns, the current study further investigated the family dynamics of childhood maltreatment using the Childhood Attachment and Relational Trauma Screen (CARTS) in 1,782 persons assessed online. RESULTS Paired differences in means between item-rated descriptiveness of self, mothers, and fathers suggested that respondents' relationship with their biological fathers was less positive and secure than their relationship with their biological mothers, and that biological fathers were more often the perpetrator of emotional, physical, and sexual abuse than biological mothers. However, results further suggested that ratings between self, mothers, and fathers were positively correlated such that, for example, reports of a mother's or a respondent's own abusive behavior were more likely in the presence of reports of a father's abusive behavior. In addition, analyses evaluating witnessing violence demonstrated that fathers were rated as more often violent toward mothers than the reverse, although intimate partner violence was also frequently bidirectional. Analyses of sibling ratings further demonstrated that older brothers were either as or more frequently abusive when compared with parents. Finally, results suggested that childhood emotional, physical, and sexual abuse were much more often perpetrated by family members than extra-familial and non-family members. CONCLUSIONS In so far as these findings are consistent with the prior childhood trauma and attachment literature, the current study further supports the utility of the CARTS as a means of assessing the family dynamics of childhood attachment and maltreatment within a relational-socioecological framework.
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Affiliation(s)
- Paul Frewen
- Departments of Psychiatry, Psychology, and Graduate Program in Neuroscience, Western University Canada, London, Ontario, Canada;
| | - Matthew Brown
- Department of Psychology, Western University, London, Ontario, Canada
| | - Jonathan DePierro
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Wendy D'Andrea
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Allan Schore
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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La Flair LN, Reboussin BA, Storr CL, Letourneau E, Green KM, Mojtabai R, Pacek LR, Alvanzo AA, Cullen B, Crum RM. Childhood abuse and neglect and transitions in stages of alcohol involvement among women: a latent transition analysis approach. Drug Alcohol Depend 2013; 132:491-8. [PMID: 23639389 PMCID: PMC3770786 DOI: 10.1016/j.drugalcdep.2013.03.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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: 12/18/2012] [Revised: 03/13/2013] [Accepted: 03/14/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Childhood abuse and neglect have been linked with alcohol disorders in adulthood yet less is known about the potential of early trauma to influence transitions in stages of alcohol involvement among women. Study aims were to (1) identify stages of women's alcohol involvement, (2) examine the probability of transitions between stages, and (3) investigate the influence of four domains of childhood abuse and neglect (sexual abuse, physical abuse, neglect, and witness to domestic violence), assessed individually and as poly-victimization, on transitions. METHODS The sample consisted of 11,750 adult female current drinkers identified in Wave 1 (2001-2002) and re-interviewed in Wave 2 (2004-2005) of the National Epidemiological Survey on Alcohol and Related Conditions. RESULTS Three stages of alcohol involvement emerged from latent class analysis of 11 DSM-IV abuse/dependence criteria: severe (1.5% at Wave 1, 1.9% at Wave 2), hazardous (13.6% at Wave 1, 16.0% at Wave 2), and non-problem drinking (82.1% at Wave 1, 84.5% at Wave 2). Adjusted latent transition analyses determined transition probabilities between stages across waves. Women reporting any childhood abuse and neglect were more likely to advance from the non-problem drinking class at Wave 1 to severe (AOR=3.90, 95% CI=1.78-8.53) and hazardous (AOR=1.56, 95% CI=1.22-2.01) drinking classes at Wave 2 relative to women without this history. Associations were also observed between individual domains and transition from no problems to severe alcohol stage. CONCLUSIONS Results suggest a long-term impact of childhood abuse and neglect as drivers of progression in women's alcohol involvement.
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Affiliation(s)
- Lareina N. La Flair
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 894, Baltimore, MD 21205, USA,Corresponding author. Tel.: +1 410 302 3899; fax: +1 410 614 7469. (LN. La Flair)
| | - Beth A. Reboussin
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Carla L. Storr
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Elizabeth Letourneau
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Kerry M. Green
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Lauren R. Pacek
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Anika A.H. Alvanzo
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Room 8047a, Baltimore, MD 21205, USA
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Rosa M. Crum
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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