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Jing Z, Ding F. Interaction between anxiety symptoms and decreased meaning in life: One possible pathway linking childhood trauma and depression- evidence from the network analysis. J Affect Disord 2024; 355:440-449. [PMID: 38580034 DOI: 10.1016/j.jad.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/26/2024] [Accepted: 04/01/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Robust evidence suggests that individuals exposed to childhood trauma are more vulnerable to suffering from later depression. However, the pathway connecting the experience of childhood trauma and depression remains unclear. PARTICIPANTS AND SETTINGS A total of 3663 participants from six colleges in China completed the Childhood Trauma Questionnaire-Short Form, Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7, and Multidimensional Existential Meaning Scale. Among all participants, 3115 (Mage = 19.20, SDage = 1.38, males = 1384) participants met the selective standard of suffering from childhood trauma and were divided into the traumatized depressed group (the DT group) (n = 1432, Mage = 19.26, males = 700) and traumatized non-depressed group (the UDT group) (n = 1683, Mage = 19.15, males = 684). METHODS In the present study, we examined the comorbidity of anxiety and the facets of meaning in the life network model. We then calculated the bridge symptoms and compared the networks of the DT group and the UDT group. RESULTS The results of the t-test showed that the DT group scored significantly higher on all symptoms of anxiety and significantly lower on all dimensions of meaning in life compared to the UDT group. Meanwhile, the strongest bridge exists between "Mattering" and "Restlessness" in the symptom network of the DT group, while there is no bridge in the symptom network of the UDT group. The result of NCT indicates that the global strength and the EI value of "Mattering" are significantly higher in the symptom network of the DT group than in the UDT group. CONCLUSION Intervention targeting improving the self-esteem of individuals suffering from childhood trauma may help to alleviate their depression and anxiety symptoms.
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Affiliation(s)
- Zhi Jing
- Department of Psychology, College of Teacher Education, Ningxia University, Yinchuan, 750021, China; Department of Mental Health Education, Office of Student Affairs, Ordos Institute of Technology, Ordos, 017000, China.
| | - Fengqin Ding
- Department of Psychology, College of Teacher Education, Ningxia University, Yinchuan, 750021, China.
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Cotter G, Morreale K, Valdegas A, Fish M, Beebe R, Grasso D, Stover C, Tseng WL. Associations between trauma exposure and irritability within the family unit: a network approach. J Child Psychol Psychiatry 2024. [PMID: 38710637 DOI: 10.1111/jcpp.13998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Pediatric irritability is a pervasive psychiatric symptom, yet its etiology remains elusive. While trauma exposure may contribute to the development of irritability, empirical research is limited. This study examined the prevalence of irritability among trauma-exposed children, identified factors that differentiate trauma-exposed children with and without irritability, and employed a network analysis to uncover associations between irritability and trauma exposure in the family unit. METHODS Sample included 676 children (56.3% male, mean age = 9.67 ± 3.7 years) and their parents referred by the Connecticut Department of Children and Families to Fathers for Change - a psychotherapy intervention designed to reduce intimate partner violence (IPV) and child maltreatment. Child's trauma exposure, post-traumatic stress disorder (PTSD) symptoms, and irritability were assessed pre-intervention using self- and caregiver-report. Parents self-reported their childhood and adulthood trauma exposures, PTSD symptoms, irritability, psychopathology, and IPV. RESULTS Across caregiver- and child-reports, 16%-17% of children exhibited irritability. Irritable children experienced greater trauma exposure, interpersonal violence, emotional abuse, and PTSD severity. They had caregivers, particularly mothers, with greater trauma histories, IPV, and psychopathology. Network analysis revealed 10 nodes directly correlated to child's irritability including child's PTSD severity, parental IPV (specifically psychological violence), and parental psychopathology. CONCLUSIONS Results provide initial empirical evidence that pediatric irritability is linked to trauma exposure, suggesting trauma histories be considered in the diagnosis and treatment of irritability. Interventions addressing caregiver trauma, IPV, and psychopathology may ameliorate pediatric irritability. Future studies could benefit from adopting network approaches with longitudinal or time series data to elucidate causality and points of intervention.
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Affiliation(s)
- Grace Cotter
- Yale School of Medicine, Yale Child Study Center, New Haven, CT, USA
- Northeastern University, Boston, MA, USA
| | - Kristina Morreale
- Yale School of Medicine, Yale Child Study Center, New Haven, CT, USA
- Veterans Affairs Boston Healthcare System, Boston, MA, USA
| | | | - Meghan Fish
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Rebecca Beebe
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Damion Grasso
- University of Connecticut School of Medicine, Farmington, CT, USA
| | - Carla Stover
- Yale School of Medicine, Yale Child Study Center, New Haven, CT, USA
| | - Wan-Ling Tseng
- Yale School of Medicine, Yale Child Study Center, New Haven, CT, USA
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Frank P, Batty GD, Pentti J, Jokela M, Ervasti J, Steptoe A, Lewis G, Kivimäki M. Impact of physical and sexual abuse on risk of hospitalisations for physical and mental illnesses: insights from two large prospective cohort studies. THE LANCET REGIONAL HEALTH. EUROPE 2024; 40:100883. [PMID: 38495556 PMCID: PMC10944261 DOI: 10.1016/j.lanepe.2024.100883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 03/19/2024]
Abstract
Background Physical abuse can lead to severe health consequences that extend beyond immediate harm. We explored the associations of physical abuse experienced during childhood and adulthood with a wide range of adult health conditions requiring hospital treatment. Methods We utilised data from a sub-cohort of 157,366 UK Biobank participants (46.4% of the baseline population; age range 45-81; 89,101 women) and repeated analyses in an independent population of 85,929 adults from the Finnish Public Sector (FPS) study (age range 17-78; 68,544 women). Participants in both cohorts reported instances of physical and sexual abuse at study baseline. Follow-up included 77 common health conditions ascertained from linkage data to national hospital and mortality registries. Findings Mean follow-up duration was 4.6 years (SD 0.14) in UK Biobank and 10.6 years (4.3) in FPS. Physical and sexual abuse was associated with 22 mental and physical health conditions. After multivariable adjustments, participants who experienced abuse during both early and later stages of life had a 2.12- (95% confidence interval 1.39-3.23) to 3.37-fold (1.52-7.45) increased risk of mental and behavioural disorders, a 1.46 (1.20-1.79) to 1.83 (1.05-3.20) times increased risk of metabolic, haematologic, and respiratory diseases, and a 1.24 (1.07-1.45) times higher risk of inflammatory diseases compared with non-exposed participants. The absolute risk difference between these groups was greatest for metabolic and haematologic conditions (rate 381 and risk difference 160 per 100,000 person-years). Frailty, comorbidities, and competing risk of death did not modify these associations, but the possibility of bias or residual confounding cannot be excluded. Interpretation Repeated exposure to physical and sexual abuse amplifies the risk of hospitalisations from mental disorders and physical diseases spanning diverse organ systems. Addressing this issue may necessitate multifaceted strategies, including shifts in societal norms, legal measures, and increased healthcare provision for affected individuals and their families. Funding Wellcome Trust, UK Medical Research Council, U.S. National Institute on Aging, Academy of Finland.
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Affiliation(s)
- Philipp Frank
- UCL Brain Sciences, University College London, 149 Tottenham Court Rd, London, W1T 7BN, UK
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - G. David Batty
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Jaana Pentti
- Clinicum, Faculty of Medicine, University of Helsinki, Tukholmankatu 8 B, Helsinki, FI-00014, Finland
- Department of Public Health, University of Turku, Turku, Finland
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 B, Helsinki, FI-00250, Finland
| | - Markus Jokela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, Helsinki, 00290, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 B, Helsinki, FI-00250, Finland
| | - Andrew Steptoe
- Research Department of Behavioural Science and Health, University College, London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Glyn Lewis
- UCL Brain Sciences, University College London, 149 Tottenham Court Rd, London, W1T 7BN, UK
| | - Mika Kivimäki
- UCL Brain Sciences, University College London, 149 Tottenham Court Rd, London, W1T 7BN, UK
- Clinicum, Faculty of Medicine, University of Helsinki, Tukholmankatu 8 B, Helsinki, FI-00014, Finland
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 B, Helsinki, FI-00250, Finland
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Rostam-Abadi Y, Stefanovics EA, Zhai ZW, Potenza MN. An exploratory study of the prevalence and adverse associations of in-school traditional bullying and cyberbullying among adolescents in Connecticut. J Psychiatr Res 2024; 173:372-380. [PMID: 38593696 DOI: 10.1016/j.jpsychires.2024.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 10/25/2023] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
Bullying, traditional or cyber, among adolescents, is a public health concern. In this study, we explored frequencies and correlates of different forms of bullying among Connecticut high-school students. Youth Risk Behavior Survey data from 2019 from Connecticut adolescents (N = 1814) were used. χ2 tests and survey-weighted logistic regressions examined relationships between bullying subgroups (in-school traditional bullying (ISTB) only, cyberbullying only, and both) and mental concerns, risk behaviors, academic performance, physical health, and receipt of social support, with the logistic regressions adjusted for demographics. The past-12-month frequency of having experienced only cyberbullying was 5.6%, only ISTB was 9.1%, and both forms was 8.7%. Between-group differences were observed by bullying status in terms of sex and race/ethnicity. In adjusted models, bullying status was associated with suicide attempts, suicidal ideation, self-harm, depression/dysphoria, mental health, use of alcohol, marijuana, injection drugs, tobacco, and e-vapor, gambling, driving under influence of alcohol, high-risk sexual behavior, physical fights, weapon-carrying, injuries/threats at school, feeling unsafe at school, dating violence, obesity, poor general health, insecure housing, less perceived family support, and poor academic performance. People experiencing both types of bullying were typically more likely to report adverse measures. High-school students commonly report bullying. The findings that both forms (traditional and cyber) were more robustly linked to negative experiences highlight the need for examining further relationships between types and patterns of bullying and mental health and functioning. Better understanding may help improve preventive anti-bullying interventions.
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Affiliation(s)
- Yasna Rostam-Abadi
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Elina A Stefanovics
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center (MIRECC), West Haven, CT, USA; National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, FL, USA
| | - Zu Wei Zhai
- Program in Neuroscience, Middlebury College, Middlebury, VT, 05753, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Wu Tsai Institute, Yale University, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Department of Neuroscience, Yale University, New Haven, CT, USA.
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Erga AH, Ushakova A, Elstad M, Fodstad EC, Belfrage A. The Relationship Between Self-Reported Childhood Maltreatment and Mental Health in Substance Use Disorders: A 6-Year Retrospective Analysis. J Dual Diagn 2024:1-13. [PMID: 38648609 DOI: 10.1080/15504263.2024.2338799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE This longitudinal cohort study aims to investigate the relationship between self-reported childhood maltreatment (CM) and the retrospective trajectory of substance use, mental health, and satisfaction with life in individuals with substance use disorders. METHODS One hundred eleven treatment-seeking individuals with substance use disorder were recruited from clinical settings and monitored prospectively for 6 years. The participants' substance use, mental health, and satisfaction with life were assessed using standardized measures. Cluster analysis divided the cohort into two groups-low CM and high CM-based on their scores on the Childhood Trauma Questionnaire Short Form at year 6. Mixed-effects linear models were fitted to assess the association between longitudinal scores on drug use, mental health, and satisfaction with life and CM group. RESULTS Most participants (92%) reported at least 1 CM. Out of all participants, 36% were categorized into the high-CM group, while 59% were categorized into the low-CM group. CM group was not associated with the amount of substance or alcohol use. CM group was significantly associated with the longitudinal course of mental health and life satisfaction. CONCLUSIONS This study underscores the association between self-reported CM and mental health and life satisfaction in patients with substance use disorder. Our results may imply an increased risk of adverse outcomes in patients with high levels of CM, while bearing in mind that both current and retrospective mental health and substance use problems can influence the accuracy of recalling CM.
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Affiliation(s)
- Aleksander H Erga
- Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
- Department of Social Studies, University of Stavanger, Stavanger, Norway
- The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway
| | - Anastasia Ushakova
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway
| | - Maria Elstad
- Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Elise Constance Fodstad
- Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Anna Belfrage
- Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
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Goh KK, Kanahara N, Chiu YH, Lu ML. The impact of childhood trauma exposure on social functioning in schizophrenia: the moderated mediation role of oxytocin and oxytocin receptor gene polymorphisms. Psychol Med 2024; 54:980-992. [PMID: 37721215 DOI: 10.1017/s003329172300274x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND Childhood trauma has been linked to increased risk of schizophrenia and social dysfunction, and oxytocin and its receptor gene have been implicated in regulating social behavior. This study investigated the potential role of oxytocin and oxytocin receptor gene (OXTR) in mediating the effects of childhood trauma on social functioning in schizophrenia. METHODS The study consisted of 382 patients with schizophrenia and 178 healthy controls who were assessed using the Taiwanese version of the Childhood Trauma Questionnaire (CTQ-SF), the Social Functioning Scale (SFS), and plasma oxytocin levels. DNA was extracted to genotype the OXTR and ten single-nucleotide polymorphisms (SNPs; rs2254298, rs237885, rs237887, rs237899, rs53576, rs9840864, rs13316193, rs7632287, rs1042778, and rs237895) were selected. RESULTS Patients with schizophrenia showed higher CTQ-SF scores (t = 12.549, p < 0.001), lower SFS scores (t = -46.951, p < 0.001), and lower plasma oxytocin levels (t = -5.448, p < 0.001) compared to healthy controls. The study also found significant differences in OXTR SNPs between both groups, with risk alleles being more prevalent in patients with schizophrenia (t = 2.734, p = 0.006). Results indicated a significant moderated mediation effect, with oxytocin and the OXTR SNPs partially mediating the relationship between childhood trauma exposure and social functioning in patients with schizophrenia (index of mediation = 0.038, 95% CI [0.033-0.044]). CONCLUSIONS The findings suggest that oxytocin and its receptor gene may be promising targets for interventions aimed at improving social functioning in patients with a history of childhood trauma and schizophrenia. However, further research is needed to fully understand these effects and the potential of oxytocin-based interventions in this population.
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Affiliation(s)
- Kah Kheng Goh
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
- The Innovative and Translational Research Center of Brain Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Nobuhisa Kanahara
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Yi-Hang Chiu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Parvin MR, Johra FT, Akter F, Wahiduzzaman M, Akter K, Das M, Mondal S, Debnath M, Ullah M, Rony MKK. The long-term effects of childhood circumstances on older individuals: A systematic review. Aging Med (Milton) 2024; 7:239-251. [PMID: 38725695 PMCID: PMC11077334 DOI: 10.1002/agm2.12299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 02/27/2024] [Accepted: 03/28/2024] [Indexed: 05/12/2024] Open
Abstract
Childhood experiences are known to shape individuals' development and can influence various aspects of life later on. Understanding the long-term effects is crucial for informing interventions and policies aimed at promoting healthy aging. This review aimed to explore the long-term effects of childhood experiences on older individuals. This systematic review comprised three distinct phases. Firstly, a systematic review was conducted, exploring databases such as Google Scholar, PubMed, EMBASE, PsycINFO, and the Web of Science. Out of the 2116 studies initially identified, 24 studies were selected based on the inclusion criteria. Secondly, these inclusion criteria were applied to ensure that the chosen studies specifically delved into the connection between childhood experiences and outcomes in older individuals. Finally, data extraction and synthesis techniques were employed to analyze findings, facilitating the drawing of conclusions concerning the enduring impacts of childhood experiences on the well-being of older individuals. The review's findings revealed how negative experiences in childhood continue to affect older individuals in various ways. These early-life events have far-reaching consequences, profoundly impacting their physical health, making them more susceptible to chronic diseases and weakening their immune system. Additionally, they affect mental health, leading to conditions like depression, anxiety, and substance abuse. Cognitive function is also affected, resulting in memory problems and cognitive decline. Furthermore, these experiences impact social relationships, affecting trust, emotional control, and social isolation in later life. This review highlighted the enduring influence of childhood circumstances on the health and well-being of older individuals. Policymakers and health care practitioners should consider these findings when developing strategies to support healthy aging and mitigate the long-term effects of adverse childhood experiences.
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Affiliation(s)
- Mst. Rina Parvin
- Major at Bangladesh Army (AFNS Officer), Combined Military Hospital DhakaDhakaBangladesh
- School of Medical SciencesShahjalal University of Science and TechnologySylhetBangladesh
| | - Fateha Tuj Johra
- Masters in Disaster ManagementUniversity of DhakaDhakaBangladesh
| | - Fazila Akter
- Dhaka Nursing College, affiliated with the University of DhakaDhakaBangladesh
| | - Md. Wahiduzzaman
- School of Medical SciencesShahjalal University of Science and TechnologySylhetBangladesh
| | - Khadiza Akter
- Master of Public HealthDaffodil International UniversityDhakaBangladesh
| | - Mousumi Das
- Master of Public HealthLeading UniversitySylhetBangladesh
| | - Sujit Mondal
- Master of Science in NursingNational Institute of Advanced Nursing Education and Research MugdaDhakaBangladesh
| | - Mitun Debnath
- Master of Public HealthNational Institute of Preventive and Social MedicineDhakaBangladesh
| | - Mohammad Ullah
- College of NursingInternational University of Business Agriculture and Technology (IUBAT)DhakaBangladesh
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Veronese G, Mahamid F, Obaid H, Bdier D, Cavazzoni F. Positive and negative effects of child's agency on trauma symptoms and psychological difficulties in war-like conditions. The mediating role of hope and life satisfaction. J Ment Health 2024:1-10. [PMID: 38526328 DOI: 10.1080/09638237.2024.2332801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 12/13/2023] [Indexed: 03/26/2024]
Abstract
BACKGROUND Children affected by war and political violence deploy agentic competencies to cope with trauma symptoms and psychological difficulties. However, it does not always act as a protective factor to help them adjust to potentially traumatic events. AIMS We expected to explore the association between agency, trauma symptoms and psychological difficulties and the mediating role of hope and life satisfaction in a group of child victims of military violence in Palestine. METHODS 965 children aged 8 to 14 were assessed with self-reported measures, War Child Agency Assessment Scale, Children Revised Impact of events scale, Strengths and difficulties scale, Child Hope Scale and Brief Multidimensional Students Life Satisfaction Scale. Structural Equation Modelling was performed having Agency as a predictor, trauma symptoms, psychological difficulties as an outcome variable and life satisfaction and hope as a mediator. RESULTS We found a direct and positive effect of agency on trauma symptoms, psychological difficulties, and life satisfaction and hope on the two dependent variables. Life satisfaction and hope mediated the association between agency and the outcome variables. CONCLUSION Agency can help defend children from trauma and psychological maladaptation when it acts on life satisfaction and hope. At the same time, it might worsen psychological dysfunctions when working directly on trauma symptoms and difficulties. Clinical interventions must help children to foster agentic resources in activating hope and life satisfaction.
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Affiliation(s)
- Guido Veronese
- Department of Human Sciences and Education, University of Milano-Bicocca, Milan, Italy
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Fayez Mahamid
- Department of Psychology & Counselling, An-Najah National University, Nablus, Palestinian territory
| | - Hania Obaid
- Department of Human Sciences and Education, University of Milano-Bicocca, Milan, Italy
| | - Dana Bdier
- Department of Human Sciences and Education, University of Milano-Bicocca, Milan, Italy
- Department of Psychology & Counselling, An-Najah National University, Nablus, Palestinian territory
| | - Federica Cavazzoni
- Department of Human Sciences and Education, University of Milano-Bicocca, Milan, Italy
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Presseau C, Carney JR, Kline NK, Grimshaw AA, DeMoss L, Gunderson C, Portnoy GA. Child Maltreatment, Adult Trauma, and Mental Health Symptoms Among Women Veterans: A Scoping Review of Published Quantitative Research. TRAUMA, VIOLENCE & ABUSE 2024:15248380241234345. [PMID: 38468375 DOI: 10.1177/15248380241234345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
The objective of this scoping review was to describe and synthesize the measures, methods, and key findings of published quantitative research examining the influence of child maltreatment (i.e., abuse and/or neglect) and adult trauma exposure on mental health symptoms among women Veterans. A systematic search from database inception to June 2023 generated 18,861 unique articles retrieved and independently screened for eligibility. A total of 21 articles met pre-established inclusion criteria: (a) quantitative data and results within a sample or subsample of U.S. women veterans, (b) published in a peer-reviewed journal, and (c) examining variables of interest simultaneously (i.e., child maltreatment, adult trauma exposure, mental health symptom) in quantitative analyses. Reviewed literature showed a lack of uniformity in measurement and methodologies to evaluate women veterans' lifetime trauma exposure in relation to mental health. Studies most frequently used self-report survey data to evaluate exposure to child maltreatment and/or adult trauma with convenience samples of women veterans (52.4%, n = 11) and examined depressive and/or posttraumatic stress symptomatology. Findings demonstrate the need for additional research attending to the interplay between child maltreatment and adult trauma exposures in relation to women veterans' mental health using comprehensive assessment, longitudinal methods, and understudied as well as more representative samples.
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Affiliation(s)
- Candice Presseau
- VA Connecticut Healthcare System, West Haven, USA
- Yale School of Medicine, New Haven, CT, USA
| | | | | | | | | | - Craig Gunderson
- VA Connecticut Healthcare System, West Haven, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Galina A Portnoy
- VA Connecticut Healthcare System, West Haven, USA
- Yale School of Medicine, New Haven, CT, USA
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Rojnic Kuzman M, Padberg F, Amann BL, Schouler-Ocak M, Bajic Z, Melartin T, James A, Beezhold J, Artigue Gómez J, Arango C, Jendricko T, Ismayilov J, Flannery W, Chumakov E, Başar K, Vahip S, Dudek D, Samochowiec J, Mihajlovic G, Rota F, Stoppe G, Dom G, Catthoor K, Chkonia E, Heitor Dos Santos MJ, Telles D, Falkai P, Courtet P, Patarák M, Izakova L, Skugarevski O, Barjaktarov S, Babic D, Racetovic G, Fiorillo A, Carpiniello B, Taube M, Melamed Y, Chihai J, Cozman DCM, Mohr P, Szekeres G, Delic M, Mazaliauskienė R, Tomcuk A, Maruta N, Gorwood P. Clinician treatment choices for post-traumatic stress disorder: ambassadors survey of psychiatrists in 39 European countries. Eur Psychiatry 2024; 67:e24. [PMID: 38450651 PMCID: PMC10988156 DOI: 10.1192/j.eurpsy.2024.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/23/2023] [Accepted: 12/29/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians' treatment choices for post-traumatic stress disorder (PTSD). METHODS The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148). RESULTS About 82% woulduse antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct "profiles" of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines. CONCLUSIONS Clinicians' decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.
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Affiliation(s)
- Martina Rojnic Kuzman
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University (LMU), Munich, Germany
| | - Benedikt L. Amann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University (LMU), Munich, Germany
- Mental Health Institute Hospital del Mar and Hospital del Mar Research Institute, Barcelona, CIBERSAM, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Meryam Schouler-Ocak
- Psychiatric University Clinic of Charité at St. Hedwig Hospital Berlin, Berlin, Germany
| | - Zarko Bajic
- Research Unit “Dr. Mirko Grmek”, Psychiatric Clinic “Sveti Ivan”, Zagreb, Croatia
| | - Tarja Melartin
- Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | | | - Julian Beezhold
- Great Yarmouth Acute Service, Northgate Hospital/Norfolk & Suffolk NHS Foundation Trust, Great Yarmouth, UK
| | | | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
| | | | | | - William Flannery
- Department of Adult Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Egor Chumakov
- Department of Psychiatry and Addiction, Saint-Petersburg State University, Saint-Petersburg, Russia
| | - Koray Başar
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Simavi Vahip
- Affective Disorders Unit, Department of Psychiatry, Ege University Medicine Faculty, Izmir, Turkey
| | - Dominika Dudek
- Psychiatry and Department of Adult Psychiatry, Collegium Medicum Jagiellonian University, Cracow, Poland
| | | | - Goran Mihajlovic
- Clinic for Psychiatry, University of Kragujevac, Kragujevac, Serbia
| | - Fulvia Rota
- Swiss Society for Psychiatry and Psychotherapy, Switzerland
| | | | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UAntwerp), Antwerp, Belgium
| | - Kirsten Catthoor
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UAntwerp), Antwerp, Belgium
| | - Eka Chkonia
- Department of Psychiatry, Tbilisi State Medical University, Tbilisi, Georgia
| | - Maria João Heitor Dos Santos
- Psychiatry and Mental Health Department, Hospital Beatriz Ângelo, Loures, Portugal
- Centro de Investigação Interdisciplinar em Saúde (CIIS), Universidade Católica Portuguesa, Lisbon, Portugal
- Faculdade de Medicina, Universidade Católica Portuguesa, Lisbon, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Diogo Telles
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University (LMU), Munich, Germany
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post Acute Care, Hôspital Lapeyronie, CHU Montpellier,Montpellier, France
| | - Michal Patarák
- Department of Psychiatry, Slovak Medical University, Bratislava, Slovakia
- Roosevelt Teaching Hospital, Banská Bystrica, Slovakia
| | - Lubomira Izakova
- Department of Psychiatry, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
| | - Oleg Skugarevski
- Department of Psychiatry and Medical Psychology, Belarusian State Medical University, Minsk, Belarus
| | - Stojan Barjaktarov
- University Clinic of Psychiatry, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Dragan Babic
- Psychiatry Clinic, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Goran Racetovic
- Community Mental Health Center, Health Center Prijedor, Prijedor, Bosnia and Herzegovina
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Bernardo Carpiniello
- University of Cagliari and Psychiatry Unit, Section of Psychiatry, Department of Medical Sciences and Public Health, University Hospital, Cagliari, Italy
| | - Maris Taube
- Department of Psychiatry and Narcology, Riga Stradiņš University, Riga Centre of Psychiatry and Narcology, Riga, Latvia
| | | | - Jana Chihai
- Department of Mental Health, Medical Psychology and Psychotherapy, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova, Kishinev, Moldova
| | | | - Pavel Mohr
- Clinical Department, National Institute of Mental Health, Klecany, Czechia
- Third School of Medicine, Charles University, Prague, Czech Republic
| | | | | | - Ramunė Mazaliauskienė
- Psychiatric Clinic, Lithuanian Health Sciences University Kaunas Hospital, Kaunas, Lithuania
| | | | - Nataliya Maruta
- Institute of Neurology, Psychiatry and Narcology, National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
| | - Philip Gorwood
- Université Paris Cité, INSERM UMR1266, Paris, France
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
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11
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Daníelsdóttir HB, Aspelund T, Shen Q, Halldorsdottir T, Jakobsdóttir J, Song H, Lu D, Kuja-Halkola R, Larsson H, Fall K, Magnusson PKE, Fang F, Bergstedt J, Valdimarsdóttir UA. Adverse Childhood Experiences and Adult Mental Health Outcomes. JAMA Psychiatry 2024:2815834. [PMID: 38446452 PMCID: PMC10918580 DOI: 10.1001/jamapsychiatry.2024.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/31/2023] [Indexed: 03/07/2024]
Abstract
Importance Exposure to adverse childhood experiences (ACEs) has consistently been associated with multiple negative mental health outcomes extending into adulthood. However, given that ACEs and psychiatric disorders cluster within families, it remains to be comprehensively assessed to what extent familial confounding contributes to associations between ACEs and clinically confirmed adult psychiatric disorders. Objective To investigate whether associations between ACEs and adult mental health outcomes remain after adjusting for familial (genetic and environmental) confounding. Design, Setting, and Participants This Swedish twin cohort study used a discordant twin pair design based on monozygotic (MZ) and dizygotic (DZ) twins. A total of 25 252 adult twins (aged 18-47 years) from the Swedish Twin Registry born between 1959 and 1998 were followed up from age 19 years until 2016, with a maximum follow-up time of 39 years. Data were analyzed from April 2022 to November 2023. Exposures A total of 7 ACEs, including family violence, emotional abuse or neglect, physical neglect, physical abuse, sexual abuse, rape, and hate crime, were assessed with items from the Life Stressor Checklist-Revised in a web-based survey. Main Outcomes and Measures Adult (ages >18 years) clinical diagnosis of psychiatric disorders (ie, depressive, anxiety, alcohol or drug misuse, or stress-related disorders) were obtained from the Swedish National Patient Register. Results Of 25 252 twins included in the study (15 038 female [59.6%]; mean [SD] age at ACE assessment, 29.9 [8.7] years), 9751 individuals (38.6%) reported exposure to at least 1 ACE. A greater number of ACEs was associated with increased odds of any psychiatric disorder in the full cohort (odds ratio [OR] per additional ACE, 1.52; 95% CI, 1.48-1.57). The association remained but ORs per additional ACE were attenuated in DZ (1.29; 95% CI, 1.14-1.47) and MZ (1.20; 95% CI, 1.02-1.40) twin pairs. Individuals who were exposed to sexual abuse compared with those who were not exposed had increased odds of any clinically confirmed psychiatric disorder in all comparisons: full cohort (OR, 3.09; 95% CI, 2.68-3.56), DZ twin pairs (OR, 2.10; 95% CI, 1.33-3.32), and MZ twin pairs (1.80; 95% CI, 1.04-3.11). Conclusions and relevance This study found that associations between ACEs and adult mental health outcomes remained after controlling for shared genetic and environmental factors, which was particularly evident after multiple ACEs or sexual abuse. These findings suggest that targeted interventions may be associated with reduced risks of future psychopathology.
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Affiliation(s)
- Hilda Björk Daníelsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Qing Shen
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
- Institute for Advanced Study, Tongji University, Shanghai, China
| | | | - Jóhanna Jakobsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Huan Song
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Donghao Lu
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Katja Fall
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Patrik K. E. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jacob Bergstedt
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Unnur Anna Valdimarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts
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12
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Ng MHS, Zainal NH, Newman MG. Positive reappraisal coping mediates the relationship between parental abuse and lack of affection on adulthood generalized anxiety severity. J Anxiety Disord 2024; 102:102826. [PMID: 38244467 PMCID: PMC10993168 DOI: 10.1016/j.janxdis.2024.102826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/23/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024]
Abstract
Exposure to parental abuse and lack of parental affection during childhood are risk factors for adulthood psychopathology. Tendency to engage in positive reappraisal may be a plausible mechanism underlying this relationship. The current study examined if positive reappraisal coping mediated the relationship between maternal/paternal abuse/affection and adulthood generalized anxiety disorder (GAD) symptoms. Participant data (N = 3294) from the Midlife Development in the United States study was collected in three waves, spaced nine years apart. Longitudinal structural equation mediation modeling examined whether positive reappraisal coping at Time 2 mediated the relationship between maternal/paternal abuse/affection at Time 1 and GAD symptoms at Time 3, controlling for GAD symptoms at Time 1. Positive reappraisal coping mediated maternal/paternal childhood abuse - GAD symptom severity and maternal/paternal childhood affection - GAD severity relations. Maternal and paternal abuse was associated with lower positive reappraisal tendencies, predicting increased GAD symptom severity. Conversely, higher maternal/paternal affection was associated with increased positive reappraisal, predicting lower GAD severity. Incremental prediction revealed that childhood abuse to GAD severity via positive reappraisal path was significant for maternal but not paternal abuse, whereas affection from both parents remained significant. Positive reappraisal coping may be a possible mechanism linking childhood experiences to adulthood GAD severity.
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Affiliation(s)
- Matthew H S Ng
- Rehabilitation Research Institute of Singapore, Nanyang Technological University, Singapore.
| | - Nur Hani Zainal
- Department of Health Care Policy, Harvard Medical School, USA; Department of Psychology, National University of Singapore, Singapore
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13
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Soran D. A practical guide to the trauma-informed physical examination. JAAPA 2024; 37:42-45. [PMID: 38386932 DOI: 10.1097/01.jaa.0000997712.61508.4d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
ABSTRACT About two-thirds of patients have a trauma history, such as experiencing abuse or community violence. Clinicians must be knowledgeable about trauma because of its high prevalence and long-lasting effect on patients. The medical encounter can be triggering for patients with a history of trauma, especially when power differentials are intensified, such as during the physical examination. Clinicians can improve the interaction by incorporating simple trauma-informed techniques, such as adjusting communication, positioning, and contact during the physical examination. These modifications foster a sense of patient safety and collaborative decision-making. This article describes the background of trauma-informed care and outlines trauma-informed techniques for physical examinations.
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Affiliation(s)
- Diana Soran
- Diana Soran practices at Boynton Health-University of Minnesota, in Minneapolis, Minn. The author has disclosed no potential conflicts of interest, financial or otherwise
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14
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Kamis C, Lynch S, Copeland WE. Associations Between Configurations of Childhood Adversity and Adult Mental Health Disorder Outcomes. SOCIETY AND MENTAL HEALTH 2024; 14:23-38. [PMID: 38500789 PMCID: PMC10947149 DOI: 10.1177/21568693231197746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
The life course perspective and cumulative inequality theory suggest that childhood adversity, occurring during a sensitive period of the life course, can have long-term consequences for adult mental health and well-being. Yet, the long-term influence of adversity on adult outcomes may depend on both the features of adverse childhood experiences (e.g., the number, type, and co-occurrence of adversities) as well as the outcome assessed. Using latent class analysis applied to several waves of prospective data from the Great Smoky Mountain Study (GSMS; N=1,420) we identify subpopulations that are similar in their adversity experiences before age 18. We then predict adult internalizing and substance use disorder diagnoses by adversity experience. Results reveal five distinct classes of adversity, with unique risks for specific diagnoses in adulthood.
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Affiliation(s)
- Christina Kamis
- Center for Demography of Health and Aging, University of Wisconsin-Madison
| | | | - William E Copeland
- Department of Psychiatry, University of Vermont Larner College of Medicine
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15
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Lawrence-Sidebottom D, Huffman LG, Beam AB, Guerra R, Parikh A, Roots M, Huberty J. Rates of Trauma Exposure and Posttraumatic Stress in a Pediatric Digital Mental Health Intervention: Retrospective Analysis of Associations With Anxiety and Depressive Symptom Improvement Over Time. JMIR Pediatr Parent 2024; 7:e55560. [PMID: 38412001 PMCID: PMC10933721 DOI: 10.2196/55560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND More than 2 out of 3 children and adolescents in the United States experience trauma by the age of 16 years. Exposure to trauma in early life is linked to a range of negative mental health outcomes throughout the lifespan, particularly co-occurring symptoms of posttraumatic stress (PTS), anxiety, and depression. There has been an increasing uptake of digital mental health interventions (DMHIs) among youths, particularly for anxiety and depression. However, little is known regarding the incidence of trauma exposure and PTS symptoms among youths participating in DMHIs and whether PTS symptoms impact anxiety and depressive symptom treatment response. Moreover, it is unclear whether participation in a DMHI for anxiety and depressive symptoms is associated with secondary effects on PTS symptoms among trauma-exposed youths. OBJECTIVE This study aims to use retrospective data from youths participating in a DMHI to (1) characterize rates of trauma, PTS, and comorbid anxiety and depressive symptoms; (2) determine whether trauma exposure and elevated PTS symptoms impact the improvement of comorbid anxiety and depressive symptoms throughout participation in care; and (3) determine whether participation in a non-posttraumatic DMHI is linked to reductions in PTS symptoms. METHODS This study was conducted using retrospective data from members (children ages 6 to 12 years) involved in a pediatric collaborative care DMHI. Participating caregivers reported their children's trauma exposure. PTS, anxiety, and depressive symptom severity were measured monthly using validated assessments. RESULTS Among eligible participants (n=966), 30.2% (n=292) reported at least 1 traumatic event. Of those with trauma exposure and elevated symptoms of PTS (n=119), 73% (n=87) exhibited elevated anxiety symptoms and 50% (n=59) exhibited elevated depressive symptoms. Compared to children with no trauma, children with elevated PTS symptoms showed smaller reductions per month in anxiety but not depressive symptoms (anxiety: F2,287=26.11; P<.001). PTS symptoms also decreased significantly throughout care, with 96% (n=79) of participants showing symptom reductions. CONCLUSIONS This study provides preliminary evidence for the frequency of trauma exposure and comorbid psychiatric symptoms, as well as variations in treatment response between trauma-exposed and nontrauma-exposed youths, among participants in a pediatric collaborative care DMHI. Youths with traumatic experiences may show increased psychiatric comorbidities and slower treatment responses than their peers with no history of trauma. These findings deliver compelling evidence that collaborative care DMHIs may be well-suited to address mental health symptoms in children with a history of trauma while also highlighting the critical need to assess symptoms of PTS in children seeking treatment.
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Affiliation(s)
| | | | | | | | | | | | - Jennifer Huberty
- Bend Health Inc, Madison, WI, United States
- FitMinded Inc LLC, Phoenix, AZ, United States
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16
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Noel ES, Chen A, Peña YA, Honeycutt JA. Early life adversity drives sex-dependent changes in 5-mC DNA methylation of parvalbumin cells in the prefrontal cortex in rats. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.31.578313. [PMID: 38352518 PMCID: PMC10862911 DOI: 10.1101/2024.01.31.578313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Early life adversity (ELA) can result in increased risk for developing affective disorders, such as anxiety or depression, later in life, with women showing increased risk. Interactions between an individual's genes and their environment play key roles in producing, as well as mitigating, later life neuropathology. Our current understanding of the underlying epigenomic drivers of ELA associated anxiety and depression are limited, and this stems in part from the complexity of underlying biochemical processes associated with how early experiences shapes later life behavior. Epigenetic alterations, or experience-driven modifications to DNA, can be leveraged to understand the interplay between genes and the environment. The present study characterized DNA methylation patterning, assessed via evaluation of 5-methylcytosine (5-mC), following ELA in a Sprague Dawley rat model of ELA induced by early caregiver deprivation. This study utilized maternal separation to investigate sex- and age-specific outcomes of ELA on epigenetic patterning in parvalbumin (PV)-containing interneurons in the prefrontal cortex (PFC), a subpopulation of inhibitory neurons which are associated with ELA and affective dysfunction. While global analysis of 5-mC methylation and CpG site specific pyrosequencing of the PV promoter, Pvalb, showed no obvious effects of ELA, when analyses were restricted to assessing 5-mC intensity in colocalized PV cells, there were significant sex and age dependent effects. We found that ELA leads sex-specific changes in PV cell counts, and that cell counts can be predicted by 5-mC intensity, with males and females showing distinct patterns of methylation and PV outcomes. ELA also produced sex-specific effects in corticosterone reactivity, with juvenile females showing a blunted stress hormone response compared to controls. Overall, ELA led to a sex-specific developmental shift in PV profile, which is comparable to profiles that are seen at a later developmental timepoint, and this shift may be mediated in part by epigenomic alterations driven by altered DNA methylation.
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Affiliation(s)
- Emma S Noel
- Program in Biochemistry, Brunswick, ME 04011 USA
| | - Alissa Chen
- Program in Neuroscience, Brunswick, ME 04011 USA
| | | | - Jennifer A Honeycutt
- Program in Neuroscience, Brunswick, ME 04011 USA
- Department of Psychology Bowdoin College, Brunswick, ME 04011 USA
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17
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Rónai L, Hann F, Kéri S, Ettinger U, Polner B. Emotions under control? Better cognitive control is associated with reduced negative emotionality but increased negative emotional reactivity within individuals. Behav Res Ther 2024; 173:104462. [PMID: 38159416 DOI: 10.1016/j.brat.2023.104462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/27/2023] [Accepted: 12/10/2023] [Indexed: 01/03/2024]
Abstract
Associations between impaired cognitive control and maladaptive emotion regulation have been extensively studied between individuals. However, it remains unclear if this relationship holds within individuals. In this study, we tested the assumption that momentary within-person fluctuation in cognitive control (working memory updating and response inhibition) is associated with emotional reactivity in everyday life. We conducted an experience sampling study (eight two-hourly prompts daily) where participants repeatedly performed short 2-back and Go/no-go tasks in daily life. We assessed negative and positive affective states, and unpleasantness of a recent event to capture emotional reactivity. We analyzed two overlapping samples: a Go/no-go and a 2-back dataset (N = 161/158). Our results showed that better momentary working memory updating was associated with decreased negative affect if the recent event was on average unpleasant for the given individual. However, better-than-average working memory updating in interaction with higher event-unpleasantness predicted higher negative affect levels (i.e., higher negative emotional reactivity). These findings may challenge the account of better cognitive control being universally related to adaptive emotion regulation. Although it is unlikely that emotional reactivity boosts working memory, future studies should establish the direction of causality.
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Affiliation(s)
- Levente Rónai
- Department of Cognitive Science, Faculty of Natural Sciences, University of Technology and Economics, Budapest, Hungary; Institute of Psychology, University of Szeged, Szeged, Hungary; Institute of Psychology, ELTE, Eötvös Loránd University, Budapest, Hungary
| | - Flóra Hann
- Department of Cognitive Science, Faculty of Natural Sciences, University of Technology and Economics, Budapest, Hungary
| | - Szabolcs Kéri
- Department of Cognitive Science, Faculty of Natural Sciences, University of Technology and Economics, Budapest, Hungary; National Institute of Mental Health, Neurology and Neurosurgery - Nyírő Gyula Hospital, Budapest, Hungary
| | | | - Bertalan Polner
- Institute of Psychology, ELTE, Eötvös Loránd University, Budapest, Hungary; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.
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18
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Gelkopf M, Berger R, Dicker-Oren SD, Lapid Pickman L, Greene T. Trauma history predicts depression and posttraumatic stress symptoms better than a psychiatric diagnosis: Comparing wartime, routine time, and early COVID-19 in Israel. Stress Health 2024; 40:e3254. [PMID: 37165573 DOI: 10.1002/smi.3254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 03/14/2023] [Accepted: 04/17/2023] [Indexed: 05/12/2023]
Abstract
Individuals with a psychiatric diagnosis and those with a history of trauma are at high risk for depression and posttraumatic stress symptoms (PTSS) following exposure to new traumatic events. Nevertheless, research is scarce on how having both a psychiatric diagnosis and a trauma history affect reactions to new traumatic events, and how different trauma types may affect individuals with a psychiatric diagnosis. We thus examined whether different stressful contexts (War and COVID-19) affected individuals with and without a psychiatric diagnosis differentially and whether results might be explained by prior trauma exposure. In the same cohort, we assessed depression and PTSS during wartime (2014), routine time (2016), and during the COVID-19 pandemic (2020) in a sample with (n = 89) and without (n = 104) a self-reported psychiatric diagnosis. This cohort was recruited during the 2014 Israel-Gaza War using social media, snowballing and outreach to mental health rehabilitation centres. We used a linear mixed modelling approach on data from the entire sample, as well as on the two study groups separately. We found that trauma history predicted PTSS and depression whereas a history of psychiatric diagnosis did not. Regarding trauma types, we found that individuals in the psychiatric diagnosis group relative to themselves had more symptoms during COVID-19 compared to war and routine time, while those without diagnosis had more PTSS and depression symptoms during wartime compared to routine time and COVID-19. In conclusion, a traumatic past may have an important influence on reactions to different types of traumatic events. Distinct traumatic events may affect individuals with or without a psychiatric diagnosis differentially.
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Affiliation(s)
- Marc Gelkopf
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Rony Berger
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv-Yafo, Israel
- Center for Compassionate and Mindful Education, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Sheila Daniela Dicker-Oren
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Liron Lapid Pickman
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Talya Greene
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Clinical, Educational and Health Psychology, University College London, London, UK
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19
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Jin Y, Xu S, Shao Z, Luo X, Wang Y, Yu Y, Wang Y. Discovery of depression-associated factors among childhood trauma victims from a large sample size: Using machine learning and network analysis. J Affect Disord 2024; 345:300-310. [PMID: 37865343 DOI: 10.1016/j.jad.2023.10.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 09/25/2023] [Accepted: 10/15/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Experiences of childhood trauma (CT) would lead to serious mental problems, especially depression. Therefore, it becomes crucial to identify influential factors related to depression and explore their associations. The objectives were to 1) identify critical depression-related factors using the extreme gradient boosting (XGBoost) method from a large-scale survey data; 2) explore associations between these factors for targeted interventions and treatments. METHODS A large-scale epidemiological study covering 63 universities was conducted in Jilin Province, China. The XGBoost model was trained and tested to classify young adults with CT experiences who had or did not have depression (N = 27,671). The essential factors were selected by SHapley Additive exPlanations (SHAP) value. Multiple logistic regression analyses were conducted for validation. The associations between these depression-related factors were further explored using network analysis. RESULTS The XGBoost model selected the top 10 features associated with depression with satisfactory performance (AUC = 0.91; sensitivity = 0.88 and specificity = 0.76). These factors significantly differed between depression and non-depression groups (p < 0.001). There are strong positive associations between anxiety and obsessive-compulsive disorder (OCD), anxiety and post-traumatic stress disorder (PTSD), social anxiety disorder (SAD) and appearance anxiety, and negative associations between sleep quality and anxiety, sleep quality and PTSD among CT participants with depression. LIMITATIONS The cross-sectional design cannot draw causality, and biases in self-report measurements cannot be ignored. CONCLUSIONS XGBoost model and network analysis were useful methods for discovering and understanding depression-related factors in this epidemiological study. Moreover, these essential factors could offer insights into future interventions and treatments for depressed young adults with CT experiences.
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Affiliation(s)
- Yu Jin
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China; Department of Population, Resources and Environment, Northeast Asian Studies College, Jilin University, Changchun, China; China Center for Aging Studies and Social-Economic Development, Jilin University, Changchun, China
| | - Zhixian Shao
- School of Statistics, Beijing Normal University, Beijing, China
| | - Xianyu Luo
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Yinzhe Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yi Yu
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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Janiri D, Di Luzio M, Montanari S, Hirsch D, Simonetti A, Moccia L, Conte E, Contaldo I, Veredice C, Mercuri E, Sani G. Childhood Trauma and Self-harm in Youths with Bipolar Disorders. Curr Neuropharmacol 2024; 22:152-158. [PMID: 36788693 DOI: 10.2174/1570159x21666230213155249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/03/2022] [Accepted: 08/04/2022] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Bipolar disorders (BD) in youth are associated with a high risk of self-harm behaviors. Childhood trauma (CT) is a relevant environmental stressor that is related to both BD diagnosis and self-harm in adulthood. It is not yet established whether CT may impact self-harm risk in youth. Therefore, the aim of this study was to investigate the distribution patterns of CT in youth BD with and without self-harm. METHODS We assessed 273 participants (aged 13-25 years), 96 youths with BD according to DSM-5 criteria and 177 healthy controls (HC). History of CT was obtained using the Childhood Trauma Questionnaire (CTQ). The association between CT and self-harm was tested using multivariate statistical models. RESULTS Over 45% of participants with BD reported lifetime self-harm. The BD Self-harm group reported more emotional abuse, emotional neglect, sexual abuse, and physical abuse than HC. The BD No-Self-harm group reported more emotional abuse than HC. The BD Self-harm group reported more emotional abuse and neglect than the BD No-Self-harm group. The BD Self-harm group also reported separated parents, hospitalizations, smoking, use of antiepileptics, antipsychotics and lithium. Emotional abuse was an independent predictor of self-harm in youths with BD. CONCLUSION Findings support the importance of assessing CT, in particular emotional abuse, in youth with BD at risk for self-harm.
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Affiliation(s)
- Delfina Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy
| | - Michelangelo Di Luzio
- Department of Neuroscience, Child and Adolescence Neuropsychiatry Unit, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy
| | - Silvia Montanari
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniele Hirsch
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessio Simonetti
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Lorenzo Moccia
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eliana Conte
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
- Early Intervention Unit, ASL Roma 3, Rome, 00152, Italy
| | - Ilaria Contaldo
- Pediatric Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Chiara Veredice
- Pediatric Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Eugenio Mercuri
- Pediatric Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Pediatric Neurology, Department of Woman and Child Health and Public Health, Università Cattolica del Sacro Cuore, Child Health Area, Rome, Italy
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
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21
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Berger E, O'Donohue K, Jeanes R, Alfrey L. Trauma-Informed Practice in Physical Activity Programs for Young People: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023:15248380231218293. [PMID: 38153107 DOI: 10.1177/15248380231218293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Physical activity, sport, and physical education share many similar qualities with trauma-informed practice, including promoting relationships, inclusion, and physical and mental well-being. There is growing research and programs that incorporate trauma-informed practices into physical activity programs for young people. The aim of this systematic review was to explore current evidence-based, Trauma-Informed Physical Activity programs for young people. Four databases were searched using the Preferred Reporting Items of Systematic Review and Meta-Analyses guidelines for systematic reviews. The search identified 19 studies that highlighted most Trauma-Informed Physical Activity programs reviewed resulted in positive social, emotional, behavioral, and academic outcomes for children and adolescents. However, further research and randomized control trials are required to understand the longitudinal outcomes of Trauma-Informed Physical Activity programs for children and adolescents. Program facilitators reported on the benefits of support and professional development opportunities for trauma awareness to administer Trauma-Informed Physical Activity programs with children and young people. Implications from this study emphasize the importance of the continued design, delivery, and research of Trauma-Informed Physical Activity programs for young people exposed to trauma.
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Affiliation(s)
- Emily Berger
- Faculty of Education, School of Educational Psychology and Counselling, Monash University, Clayton, VIC, Australia
- Faculty of Medicine, Nursing and Health Sciences, School of Rural Health, Monash University, Clayton, VIC, Australia
| | - Katelyn O'Donohue
- Faculty of Education, School of Educational Psychology and Counselling, Monash University, Clayton, VIC, Australia
| | - Ruth Jeanes
- Faculty of Education, School of Curriculum, Teaching, and Inclusive Education, Monash University, Clayton, VIC, Australia
| | - Laura Alfrey
- Faculty of Education, School of Curriculum, Teaching, and Inclusive Education, Monash University, Clayton, VIC, Australia
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22
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Marusak HA, Evanski J, Desai S, Rabinak CA. Impact of Childhood Trauma Exposure, Genetic Variation in Endocannabinoid Signaling, and Anxiety on Frontolimbic Pathways in Children. Cannabis Cannabinoid Res 2023; 8:1079-1089. [PMID: 35944262 PMCID: PMC10714120 DOI: 10.1089/can.2022.0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: The endocannabinoid (eCB) system plays a key role in modulating brain development, including myelination processes. Recent studies link a common variant (C385A, rs324420) in the fatty acid amide hydrolase (FAAH) gene to higher circulating eCB levels, lower anxiety, and altered frontolimbic development. Frontolimbic pathways, which demonstrate a protracted maturational course across childhood and adolescence, are associated with anxiety, and are vulnerable to environmental stressors such as trauma exposure. Here, we examined the impact of trauma exposure, FAAH genotype, and anxiety on frontolimbic white matter microstructure in children. Materials and Methods: We leveraged baseline data from the Adolescent Brain Cognitive Development (ABCD) study (n=9969; mean±standard deviation age=9.92±0.62 years; 47.1% female). Saliva samples were used for genotyping, and caregivers reported on their child's anxiety symptoms and trauma exposure. Fractional anisotropy (FA), a nonspecific measure of white matter integrity, was estimated for frontolimbic tracts. Results: Thirty-six percent of youth experienced one or more potentially traumatic events according to DSM-5 Criterion A (64% controls), and 45% were FAAH A-allele carriers (55% noncarriers). Relative to controls, trauma-exposed youth demonstrated higher anxiety and higher FA of the left uncinate. The FAAH A-allele (vs. CC) was associated with lower FA in the left fornix and left parahippocampal cingulum, and there was an indirect effect of FAAH genotype on anxiety through FA of the left fornix. Moreover, genotype moderated the association between FA of the left cingulum and anxiety. Conclusions: Our findings demonstrate distinct effects of trauma exposure and the FAAH C385A variant on frontolimbic pathways and subsequent anxiety risk in preadolescent children. This line of work may provide important insights into neurodevelopmental mechanisms leading to anxiety risk, and potential targets for intervention.
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Affiliation(s)
- Hilary A. Marusak
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA
- Translational Neuroscience Graduate Program, Wayne State University School of Medicine, Detroit, Michigan, USA
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, Michigan, USA
| | - Julia Evanski
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Shreya Desai
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Christine A. Rabinak
- Translational Neuroscience Graduate Program, Wayne State University School of Medicine, Detroit, Michigan, USA
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, Michigan, USA
- Department of Pharmacy Practice and Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
- Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
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23
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Cruz D. Childhood Trauma Questionnaire-Short Form: Evaluation of Factor Structure and Measurement Invariance. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:1099-1108. [PMID: 38045834 PMCID: PMC10689687 DOI: 10.1007/s40653-023-00556-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 12/05/2023]
Abstract
Childhood trauma is known to put individuals at risk for mental and physical challenges later in life. Retrospective assessment of early abuse and neglect is critical for prevention and intervention efforts targeted at reducing the negative impacts of childhood trauma. The Childhood Trauma Questionnaire-Short Form (CTQ-SF) is a widely used measure to assess trauma among adolescents and adults, though there are some inconsistencies with regard to its factor structure and psychometric properties. The purpose of the current study was twofold: (1) to evaluate the hypothesized five-factor structure of CTQ-SF and (2) to test measurement invariance (equivalence) of the instrument across gender and race in a large, nationally representative sample of US adults (N = 863). Confirmatory factor analysis results indicate that the five-factor model fit the data well. The results also show that the five-factor model is generally invariant by gender and racial/ethnic groups and that the form's subscales positively correlate with depression, anxiety, and abnormal inflammatory biomarker activity. Assessment is critical for the advocacy and treatment of individuals who have experienced abuse and neglect as children and adolescents. Our findings suggest that the CTQ-SF is a valuable tool for assessing childhood trauma and can be used in advocacy and treatment efforts.
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Affiliation(s)
- Daniel Cruz
- The Institute for Trauma-Informed Research, Evaluation, and Training, LLC, Morris Plains, NJ 07950 United States
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24
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Cossette-Côté F, Daigneault I, Lecomte T, Francoeur A, Brassard A. Explaining the Association Between Childhood Maltreatment and Psychological Adjustment in Youth in a Romantic Relationship. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:1119-1132. [PMID: 38045837 PMCID: PMC10689713 DOI: 10.1007/s40653-023-00562-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Flavie Cossette-Côté
- Psychology Department, Université de Montréal, 90 Vincent D’Indy Ave, Outremont, Montréal, QC H2V 2S9 Canada
| | - Isabelle Daigneault
- Psychology Department, Université de Montréal, 90 Vincent D’Indy Ave, Outremont, Montréal, QC H2V 2S9 Canada
| | - Tania Lecomte
- Psychology Department, Université de Montréal, 90 Vincent D’Indy Ave, Outremont, Montréal, QC H2V 2S9 Canada
| | - Audrey Francoeur
- Psychology Department, Université de Montréal, 90 Vincent D’Indy Ave, Outremont, Montréal, QC H2V 2S9 Canada
| | - Audrey Brassard
- Psychology Department, Université de Sherbrooke, 2500, boulevard de l’Université Sherbrooke, Sherbrooke, Québec J1K 2R1 Canada
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25
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Copeland WE, Halvorson-Phelan J, McGinnis E, Shanahan L. Adult Mental Health, Substance Use Disorders, and Functional Outcomes of Children Resilient to Early Adversity. Am J Psychiatry 2023; 180:906-913. [PMID: 37941330 DOI: 10.1176/appi.ajp.20230038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
OBJECTIVE Some children are unaffected by mental illness despite exposure to childhood adversity. These children are typically considered resilient. The objective of this study was to follow up such resilient children in adulthood to characterize mental health status, substance use, and functional outcomes. METHODS The analysis was based on the prospective, representative Great Smoky Mountains Study (N=1,420). Participants were assessed for psychiatric disorders and exposure to adversity with the structured Child and Adolescent Psychiatric Assessment interview up to eight times in childhood (ages 9-16; 6,674 observations). In total, 1,266 participants (86.3%) were followed up in adulthood at ages 25 and 30 to assess psychiatric disorders, substance use disorders, and functional outcomes. RESULTS Seventy-five percent of the sample had met criteria for a psychiatric disorder or displayed subthreshold psychiatric problems by age 16. The number of adverse childhood experiences was strongly associated with childhood psychiatric status. Of children exposed to multiple adversities (N=650), 12.2% (N=63) did not display psychiatric problems. This group meets common definitions of childhood resilience. In adulthood, these individuals showing childhood resilience had greater risk of anxiety (risk ratio=2.9, 95% CI=1.0-9.1) and depressive (risk ratio=4.5, 95% CI=1.1-16.7) disorders, as well as worse physical health (means ratio=0.7, 95% CI=0.5-0.9) and financial or educational functioning (means ratio=0.6, 95% CI=0.5-0.7), compared with individuals exposed to fewer childhood adversities. These individuals showing childhood resilience did not have elevated risk for substance use disorders. CONCLUSIONS Resilience to childhood adversity was uncommon. Individuals who appeared resilient in childhood were at risk for delayed poorer outcomes in adulthood. Public health efforts should prioritize minimizing early adversity exposure over promoting resilience.
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Affiliation(s)
- William E Copeland
- Department of Psychiatry, Larner College of Medicine, University of Vermont, Burlington (Copeland, Halvorson-Phelan); Department of Public Health Sciences, Wake Forest University, Winston-Salem, N.C. (McGinnis); Jacobs Center for Productive Youth Development and Department of Psychology, University of Zurich, Zurich (Shanahan)
| | - Julia Halvorson-Phelan
- Department of Psychiatry, Larner College of Medicine, University of Vermont, Burlington (Copeland, Halvorson-Phelan); Department of Public Health Sciences, Wake Forest University, Winston-Salem, N.C. (McGinnis); Jacobs Center for Productive Youth Development and Department of Psychology, University of Zurich, Zurich (Shanahan)
| | - Ellen McGinnis
- Department of Psychiatry, Larner College of Medicine, University of Vermont, Burlington (Copeland, Halvorson-Phelan); Department of Public Health Sciences, Wake Forest University, Winston-Salem, N.C. (McGinnis); Jacobs Center for Productive Youth Development and Department of Psychology, University of Zurich, Zurich (Shanahan)
| | - Lilly Shanahan
- Department of Psychiatry, Larner College of Medicine, University of Vermont, Burlington (Copeland, Halvorson-Phelan); Department of Public Health Sciences, Wake Forest University, Winston-Salem, N.C. (McGinnis); Jacobs Center for Productive Youth Development and Department of Psychology, University of Zurich, Zurich (Shanahan)
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26
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Spencer CN, Khalil M, Herbert M, Aravkin AY, Arrieta A, Baeza MJ, Bustreo F, Cagney J, Calderon-Anyosa RJC, Carr S, Chandan JK, Coll CVN, de Andrade FMD, de Andrade GN, Debure AN, Flor LS, Hammond B, Hay SI, Knaul FN, Lim RQH, McLaughlin SA, Minhas S, Mohr JK, Mullany EC, Murray CJL, O'Connell EM, Patwardhan V, Reinach S, Scott D, Sorenson RJD, Stein C, Stöckl H, Twalibu A, Vasconcelos N, Zheng P, Metheny N, Chandan JS, Gakidou E. Health effects associated with exposure to intimate partner violence against women and childhood sexual abuse: a burden of proof study. Nat Med 2023; 29:3243-3258. [PMID: 38081957 PMCID: PMC10719101 DOI: 10.1038/s41591-023-02629-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/04/2023] [Indexed: 12/17/2023]
Abstract
The health impacts of intimate partner violence against women and childhood sexual abuse are not fully understood. Here we conducted a systematic review by comprehensively searching seven electronic databases for literature on intimate partner violence-associated and childhood sexual abuse-associated health effects. Following the burden of proof methodology, we evaluated the evidence strength linking intimate partner violence and/or childhood sexual abuse to health outcomes supported by at least three studies. Results indicated a moderate association of intimate partner violence with major depressive disorder and with maternal abortion and miscarriage (63% and 35% increased risk, respectively). HIV/AIDS, anxiety disorders and self-harm exhibited weak associations with intimate partner violence. Fifteen outcomes were evaluated for their relationship to childhood sexual abuse, which was shown to be moderately associated with alcohol use disorders and with self-harm (45% and 35% increased risk, respectively). Associations between childhood sexual abuse and 11 additional health outcomes, such as asthma and type 2 diabetes mellitus, were found to be weak. Although our understanding remains limited by data scarcity, these health impacts are larger in magnitude and more extensive than previously reported. Renewed efforts on violence prevention and evidence-based approaches that promote healing and ensure access to care are necessary.
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Affiliation(s)
- Cory N Spencer
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Mariam Khalil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Molly Herbert
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Aleksandr Y Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Applied Mathematics, University of Washington, Seattle, WA, USA
| | - Alejandra Arrieta
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - María Jose Baeza
- School of Medicine, The Pontifical Catholic University of Chile, Santiago, Chile
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Flavia Bustreo
- Fondation Botnar, Basel, Switzerland
- Partnership for Maternal, Newborn and Child Health, Geneva, Switzerland
| | - Jack Cagney
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Sinclair Carr
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jaidev Kaur Chandan
- Warwick Medical School, University of Warwick, Coventry, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Carolina V N Coll
- Department of Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Human Development and Violence Research Center, Federal University of Pelotas, Pelotas, Brazil
| | | | | | - Alexandra N Debure
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Luisa S Flor
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ben Hammond
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Felicia N Knaul
- Institute for the Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA
| | - Rachel Q H Lim
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Susan A McLaughlin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Sonica Minhas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jasleen K Mohr
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Erin C Mullany
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Erin M O'Connell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Vedavati Patwardhan
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Center on Gender Equity and Health, UC San Diego School of Medicine, San Diego, CA, USA
| | | | - Dalton Scott
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Reed J D Sorenson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Caroline Stein
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Heidi Stöckl
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany
| | - Aisha Twalibu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | | | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Nicholas Metheny
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Emmanuela Gakidou
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
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27
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Bränn E, Vaina A, Daníelsdóttir HB, Thordardottir EB, Yang Q, Jakobsdóttir J, Aspelund T, Hauksdóttir A, Valdimarsdóttir UA, Lu D. Association between adverse childhood experiences and perinatal depressive symptoms: a cross-sectional analysis of 16,831 women in Iceland. Arch Womens Ment Health 2023; 26:839-849. [PMID: 37726573 PMCID: PMC10632282 DOI: 10.1007/s00737-023-01369-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023]
Abstract
Emerging data suggest that certain adverse childhood experiences (ACEs) are associated with perinatal depression (PND). However, few studies have comprehensively assessed the cumulative number and types of ACEs and their association to PND. We conducted a cross-sectional analysis among 16,831 female participants from the Stress-And-Gene-Analysis (SAGA) cohort in Iceland, 2018. ACEs were surveyed with the World Health Organization ACE-International questionnaire, while PND symptoms were assessed using the Edinburgh Postnatal Depression Scale (lifetime version). We, while adjusting for confounding factors, estimated the prevalence ratio (PR) of PND in relation to total number of ACEs using the Poisson quasi-likelihood model and further performed analyses for type-specific ACEs. At a mean age of 44 years (SD ± 11.1), 6,201 (36.8%) participants had experienced probable PND. Total number of ACEs was positively associated with PND (PR 1.11 per ACE, 95% CI: 1.10-1.11), also among women without any psychiatric comorbidities (PR 1.13, 95% CI: 1.11-1.14). PRs increased in a dose-response manner with the number of ACEs (P for trend < 0.001); women that endorsed 5 or more ACEs were twice as likely to have experienced PND (PR 2.24, 95% CI: 2.09-2.41). All ACE types (n = 13) were associated with PND, with most pronounced association for emotional neglect by a guardian (PR 1.53, 95% CI: 1.47-1.59). Our findings suggest a positive association between number of ACEs and PND symptoms. If our results are confirmed with prospective data, healthcare providers need to be alert of the risk of PND among expecting mothers with history of ACEs.
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Affiliation(s)
- Emma Bränn
- Institute of Environmental Medicine, Unit of Integrative Epidemiology, Karolinska Institutet, Stockholm, Sweden.
| | - Alexandra Vaina
- Institute of Environmental Medicine, Unit of Integrative Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | | | - Edda Bjork Thordardottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Mental Health Services, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Qian Yang
- Department of Medicine, Unit of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Jóhanna Jakobsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Arna Hauksdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Unnur A Valdimarsdóttir
- Institute of Environmental Medicine, Unit of Integrative Epidemiology, Karolinska Institutet, Stockholm, Sweden
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Donghao Lu
- Institute of Environmental Medicine, Unit of Integrative Epidemiology, Karolinska Institutet, Stockholm, Sweden
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28
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Bürgin D, Witt A, Seker S, d'Huart D, Meier M, Jenkel N, Boonmann C, Schmeck K, Fegert JM, Schmid M. Childhood maltreatment and mental health problems in a 10-year follow-up study of adolescents in youth residential care: A latent transition analysis. Dev Psychopathol 2023:1-16. [PMID: 37990404 DOI: 10.1017/s0954579423001426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
Childhood maltreatment and mental health problems are common among young people placed out-of-home. However, evidence on the impact of maltreatment on the course of mental health problems in at-risk populations is sparse. The aim of this longitudinal study is twofold: (a) describe the course of mental health problems and the shift in symptom patterns among adolescents in youth residential care into young adulthood and (b) assess how childhood maltreatment is related to the course of mental health problems. One hundred and sixty-six adolescents in Swiss youth residential care were followed up into young adulthood (36.1% women; MAge-Baseline = 16.1 years; MAge-Follow-Up = 26.4 years). Latent transition analysis was employed to analyze transitions of symptom patterns and their association with maltreatment exposure. We found three latent classes of mental health problems: a "multiproblem"-class (51.8% baseline; 33.7% follow-up), a "low symptom"-class (39.2% baseline; 60.2% follow-up), and an "externalizing"-class (9.0% baseline; 6.0% follow-up). Individuals in the "multiproblem"-class were likely to transition towards less-complex symptom patterns. Higher severity of self-reported childhood maltreatment was associated with more complex and persistent mental health problems. Our study underlines the need for collaboration between residential and psychiatric care systems within and after care placements, with a specialized focus on trauma-informed interventions and care.
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Affiliation(s)
- David Bürgin
- Child and Adolescent Psychiatric Research Department (UPKKJ), University Psychiatric Hospitals, University of Basel, Basel, Switzerland
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Andreas Witt
- Department of Child and Adolescent Psychiatry, University Psychiatric Services Berne, Berne, Switzerland
| | - Süheyla Seker
- Child and Adolescent Psychiatric Research Department (UPKKJ), University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Delfine d'Huart
- Child and Adolescent Psychiatric Research Department (UPKKJ), University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Maria Meier
- Child and Adolescent Psychiatric Research Department (UPKKJ), University Psychiatric Hospitals, University of Basel, Basel, Switzerland
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Constance, Germany
| | - Nils Jenkel
- Child and Adolescent Psychiatric Research Department (UPKKJ), University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Cyril Boonmann
- Child and Adolescent Psychiatric Research Department (UPKKJ), University Psychiatric Hospitals, University of Basel, Basel, Switzerland
- Department of Child and Adolescent Psychiatry - LUMC Curium, Leiden University Medical Center, Leiden, The Netherlands
| | - Klaus Schmeck
- Child and Adolescent Psychiatric Research Department (UPKKJ), University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany
| | - Marc Schmid
- Child and Adolescent Psychiatric Research Department (UPKKJ), University Psychiatric Hospitals, University of Basel, Basel, Switzerland
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Hanson RF, Zhu V, Are F, Espeleta H, Wallis E, Heider P, Kautz M, Lenert L. Initial development of tools to identify child abuse and neglect in pediatric primary care. BMC Med Inform Decis Mak 2023; 23:266. [PMID: 37978498 PMCID: PMC10656827 DOI: 10.1186/s12911-023-02361-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/02/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Child abuse and neglect (CAN) is prevalent, associated with long-term adversities, and often undetected. Primary care settings offer a unique opportunity to identify CAN and facilitate referrals, when warranted. Electronic health records (EHR) contain extensive information to support healthcare decisions, yet time constraints preclude most providers from thorough EHR reviews that could indicate CAN. Strategies that summarize EHR data to identify CAN and convey this to providers has potential to mitigate CAN-related sequelae. This study used expert review/consensus and Natural Language Processing (NLP) to develop and test a lexicon to characterize children who have experienced or are at risk for CAN and compared machine learning methods to the lexicon + NLP approach to determine the algorithm's performance for identifying CAN. METHODS Study investigators identified 90 CAN terms and invited an interdisciplinary group of child abuse experts for review and validation. We then used NLP to develop pipelines to finalize the CAN lexicon. Data for pipeline development and refinement were drawn from a randomly selected sample of EHR from patients seen at pediatric primary care clinics within a U.S. academic health center. To explore a machine learning approach for CAN identification, we used Support Vector Machine algorithms. RESULTS The investigator-generated list of 90 CAN terms were reviewed and validated by 25 invited experts, resulting in a final pool of 133 terms. NLP utilized a randomly selected sample of 14,393 clinical notes from 153 patients to test the lexicon, and .03% of notes were identified as CAN positive. CAN identification varied by clinical note type, with few differences found by provider type (physicians versus nurses, social workers, etc.). An evaluation of the final NLP pipelines indicated 93.8% positive CAN rate for the training set and 71.4% for the test set, with decreased precision attributed primarily to false positives. For the machine learning approach, SVM pipeline performance was 92% for CAN + and 100% for non-CAN, indicating higher sensitivity than specificity. CONCLUSIONS The NLP algorithm's development and refinement suggest that innovative tools can identify youth at risk for CAN. The next key step is to refine the NLP algorithm to eventually funnel this information to care providers to guide clinical decision making.
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Affiliation(s)
| | - Vivienne Zhu
- Medical University of South Carolina, Charleston, SC, USA
| | | | | | | | - Paul Heider
- Medical University of South Carolina, Charleston, SC, USA
| | - Marin Kautz
- Medical University of South Carolina, Charleston, SC, USA
| | - Leslie Lenert
- Medical University of South Carolina, Charleston, SC, USA
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Davis RS, Meiser-Stedman R, Afzal N, Devaney J, Halligan SL, Lofthouse K, Smith P, Stallard P, Ye S, Hiller RM. Systematic Review and Meta-analysis: Group-Based Interventions for Treating Posttraumatic Stress Symptoms in Children and Adolescents. J Am Acad Child Adolesc Psychiatry 2023; 62:1217-1232. [PMID: 36948393 DOI: 10.1016/j.jaac.2023.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 01/30/2023] [Accepted: 03/13/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVE Trauma exposure in childhood is common and can lead to a range of negative mental health outcomes, including posttraumatic stress disorder (PTSD). In many settings, resources to address this distress are scarce. Group-based interventions require minimal resources and training, can be delivered by non-mental health specialists, and target larger numbers of children and adolescents. This meta-analysis sought to establish whether such an approach is an effective method for targeting PTSD symptoms and to identify potential moderators of effectiveness. METHOD PubMed, PsycNET, and PTSDPubs were searched for randomized controlled trials that used a group-based PTSD intervention with children and adolescents aged 6 to 18 years. Data were extracted for PTSD symptoms and depression symptoms. A random-effects meta-analysis was conducted to obtain between-group pooled effect size estimates. This study was registered on PROSPERO (CRD42020187214). RESULTS The initial search identified 9,650 studies, of which 42 were eligible for inclusion (N = 5,998). Children randomized to a group-based intervention had significantly lower PTSD symptoms after treatment compared with a control group, with a medium pooled effect (g = -0.55, 95% CI [-0.76, -0.35]). Group interventions were superior when compared with either active or passive controls, at follow-up, and for depression symptoms. There was a large amount of heterogeneity, but no evidence that this was explained by whether the intervention was delivered in a low- and middle-income or high-income country, included caregivers, or was universal or targeted. CONCLUSION Group PTSD interventions, particularly cognitive-behavioral therapy-based interventions, are effective at targeting posttrauma distress in children and adolescents. There was evidence of effectiveness when delivered in highly complex and resource-scarce settings and to a range of trauma-exposed groups, including groups exposed to war/conflict, natural disasters, and abuse.
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Affiliation(s)
| | | | | | - John Devaney
- School of Social and Political Science, University of Edinburgh, United Kingdom
| | - Sarah L Halligan
- University of Bath, United Kingdom; University of Cape Town, South Africa
| | | | - Patrick Smith
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | | | - Siyan Ye
- University of Bath, United Kingdom
| | - Rachel M Hiller
- Division of Psychology and Language Sciences, University College London, United Kingdom; Anna Freud National Centre for Children & Families, United Kingdom.
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Ayawvi G, Berglund AM, James SH, Luther L, Walker EF, Mittal VA, Strauss GP. The association between early traumatic experiences and the five domains of negative symptoms in participants at clinical high risk for psychosis. Early Interv Psychiatry 2023; 17:1131-1135. [PMID: 37041742 PMCID: PMC10564962 DOI: 10.1111/eip.13418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/02/2023] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
AIM Youth at clinical high risk (CHR) for psychosis have high rates of early life trauma, but it is unclear how trauma exposure impacts later negative symptom severity in CHR. The current study examined the association between early childhood trauma and the five domains of negative symptoms (anhedonia, avolition, asociality, blunted affect, alogia). METHOD Eighty nine participants completed interviewer-rated measures of childhood trauma and abuse experienced before age 16, psychosis risk, and negative symptoms. RESULTS Higher global negative symptom severity was associated with greater exposure to childhood psychological bullying, physical bullying, emotional neglect, psychological abuse, and physical abuse. Greater severity of avolition and asociality was associated with physical bullying. Greater severity of avolition was associated with emotional neglect. CONCLUSION Early adversity and childhood trauma is associated with negative symptoms during adolescence and early adulthood among participants at CHR for psychosis.
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Affiliation(s)
- Gifty Ayawvi
- Department of Psychology, University of Georgia, Athens, GA, USA
| | | | - Sydney H. James
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Lauren Luther
- Department of Psychology, University of Georgia, Athens, GA, USA
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32
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Clark SL, Dodd CG, Taylor L, Stewart S, Yang N, Shahidullah JD, Guzick AG, Richmond R, Aksan N, Rathouz PJ, Rousseau JF, Newport DJ, Wagner KD, Nemeroff CB. Characterizing patterns of substance use in trauma exposed youth. J Psychiatr Res 2023; 167:1-9. [PMID: 37778242 DOI: 10.1016/j.jpsychires.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/17/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Previous work investigating the impact of childhood trauma on substance use and co-occurring psychiatric disorders has primarily been conducted in adults or on specific trauma types. This limits understanding of traumas impact in childhood and how different types of traumas play a role. We sought to characterize substance use in a sample of trauma-exposed youth in the context of psychiatric comorbidities. METHOD 1152 youth from the Texas Childhood Trauma Research Network (TX-CTRN) that were exposed to at least one trauma meeting DSM-5 Criterion A were assessed for current substance use and psychiatric diagnoses. Latent class analysis was used to identify patterns of substance use. To characterize these patterns, we examined if demographics, number of trauma types experienced, or childhood psychiatric disorders predicted class membership. RESULTS We identified four primary patterns of substance use: Non-use (66.1%), predominantly alcohol use (19.7%), predominantly cannabis use (4.5%), and polysubstance use (9.7%). Compared to the non-users, polysubstance users tended to be older, Non-Hispanic White, have experienced more types of trauma. They were also more likely to have fulfilled diagnostic criteria for suicidality and ADHD. Comparisons among the substance using classes were more nuanced. CONCLUSION The findings highlight the need for universal assessments of trauma, substance misuse, and mental health symptoms in youth as the presence or absence of their co-occurrence has implications for treatment.
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Affiliation(s)
| | - Cody G Dodd
- University of Texas Medical Branch, United States
| | - Leslie Taylor
- University of Texas Health Science Center, United States
| | | | | | | | | | - Robyn Richmond
- Texas Tech University Health Sciences Center, United States
| | - Nazan Aksan
- University of Texas at Austin, United States
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Tsheole P, Makhado L, Maphula A. Childhood Trauma and Exposure to Violence Interventions: The Need for Effective and Feasible Evidence-Based Interventions. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1760. [PMID: 38002851 PMCID: PMC10670457 DOI: 10.3390/children10111760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/11/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023]
Abstract
Several crimes in South Africa cause physical, economic, and mental problems. Xenophobic attacks, mob justice, and other violent conduct directly traumatise children. Service delivery riots and physical and sexual abuse are examples. This evaluation evaluates childhood trauma and exposure to violence interventions. The review describes the therapeutic methods for traumatised children exposed to violence, the healthcare professionals administering them, and the strategies used to tailor the interventions. The researcher systematically searched PsycINFO, Google Scholar, PubMed, Science Direct, and EBSCOhost. Literature from 2011 to 31 July 2023 was searched, and 19 papers were chosen for further review after the systematic search. The authors conducted an eligibility evaluation according to PRISMA guidelines. A thorough review of article texts identified 19 papers that met eligibility standards. Only nineteen studies have validated trauma and violence therapies for children. An effective multi-phased intervention that is feasible and adaptable to varied socioeconomic backgrounds is needed. Further studies on the mental health benefits of brief trauma intervention treatment are needed.
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Affiliation(s)
- Petunia Tsheole
- Department of Psychology, Faculty of Health Sciences, University of Venda, Thohoyandou 0950, South Africa
| | - Lufuno Makhado
- Public Health, Faculty of Health Care Sciences, University of Venda, Thohoyandou 0950, South Africa; (L.M.); (A.M.)
| | - Angelina Maphula
- Public Health, Faculty of Health Care Sciences, University of Venda, Thohoyandou 0950, South Africa; (L.M.); (A.M.)
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Barton BB, Ehring T, Reinhard MA, Goerigk S, Wüstenberg T, Musil R, Amann BL, Jobst A, Dewald-Kaufmann J, Padberg F. Effects of resilience and timing of adverse and adaptive experiences on interpersonal behavior: a transdiagnostic study in a clinical sample. Sci Rep 2023; 13:18131. [PMID: 37875505 PMCID: PMC10598007 DOI: 10.1038/s41598-023-44555-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023] Open
Abstract
Adverse childhood experiences (ACE) have been linked to less prosocial behavior during social exclusion in vulnerable groups. However, little is known about the impact of the timing of ACE and the roles of protective factors. Therefore, this study investigated the association of the behavioral response to experimental partial social exclusion with adverse and adaptive experiences across age groups and resilience in clinical groups with persistent depressive disorder and borderline personality disorder, i.e., groups with high ACE, and in healthy controls (HC) (N = 140). Adverse and adaptive experiences during childhood, youth, and adulthood were assessed with the Traumatic Antecedents Questionnaire, and resilience was measured with the Connor Davidson Resilience Scale. A modified version of the Cyberball paradigm was used to assess the direct behavioral response to partial social exclusion. In patients, adverse events during youth (B = - 0.12, p = 0.016) and adulthood (B = - 0.14, p = 0.013) were negatively associated with prosocial behavior, whereas in the HC sample, adaptive experiences during youth were positively associated with prosocial behavior (B = 0.25, p = 0.041). Resilience did not mediate these effects. The findings indicate that critical events during youth may be particularly relevant for interpersonal dysfunction in adulthood.
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Affiliation(s)
- Barbara B Barton
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany.
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Munich, Germany
| | - Matthias A Reinhard
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Stephan Goerigk
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
- Charlotte Fresenius Hochschule, Infanteriestrasse 11A, 80797, Munich, Germany
- Department of Psychological Methodology and Assessment, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Torsten Wüstenberg
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Benedikt L Amann
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
- Centre Fòrum Research Unit, Hospital Del Mar Research Institute, Barcelona, Spain
- Mental Health Institute, Hospital Del Mar, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Andrea Jobst
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Julia Dewald-Kaufmann
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
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Liu Y, Hatch SL, Patalay P, Schott JM, Richards M. A lifecourse approach in examining the association between accumulation of adversity and mental health in older adulthood. J Affect Disord 2023; 339:211-218. [PMID: 37442442 DOI: 10.1016/j.jad.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/01/2023] [Accepted: 07/08/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND There is evidence for a cumulative effect of adversities on mental health, however, less is known on the accumulating duration of exposure to adversity across the lifecourse on mental health in older adults. METHODS Using data from the 1946 British birth cohort study (N = 2745), we examined associations between the accumulation of adversity (birth-63 years) and mental health (emotional symptom, life satisfaction, affective wellbeing) in older adults (63-69 years). Accumulation of adversity was assessed as the number of adversities and duration of exposure (number of lifecourse stages exposed to any, economic, psychosocial, or physical adversity). Linear regression tested their association with mental health, adjusted for sex, childhood cognition and emotional problems, and educational attainment. RESULTS Increased number of adversities was associated with increased emotional symptoms (β = 0.08 [0.06, 0.10]), decreased life satisfaction (β = -0.14 [-0.16, -0.12]) and decreased affective wellbeing (β = -0.08 [-0.10, -0.06]). Each additional duration of exposure was associated with a 0.38 [0.12, 0.65] standard deviation (SD) increase in emotional symptoms, and a - 0.68 [-0.96, -0.39] and -0.43 SD [-0.68, -0.18] decrease in life satisfaction and affective wellbeing, respectively. Life satisfaction showed stronger associations with economic and psychosocial compared to physical adversity. LIMITATIONS Some limitations include selective drop-out and lack of ethnic diversity. CONCLUSIONS Efforts to improve mental health in older adults should focus on reducing the number of adversities, as well as considering previous exposure across different lifecourse stages, to prevent adversities from becoming chronic. Future research should also consider the clustering and co-occurrence of different adversities across the lifecourse.
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Affiliation(s)
- Yiwen Liu
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK.
| | - Stephani L Hatch
- Department of Psychological Medicine, King's College London, London, UK; ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Praveetha Patalay
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK; Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
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Bürgin D, Clemens V, Witt A, Sachser C, Jud A, Brähler E, Strauß B, Petrowski K, Schmid M, Fegert JM. Adverse childhood experiences increase the risk for low perceived social participation and health-related quality of life in a large-scale population-based study in Germany. CHILD ABUSE & NEGLECT 2023; 144:106382. [PMID: 37527561 DOI: 10.1016/j.chiabu.2023.106382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 05/17/2023] [Accepted: 07/25/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are highly prevalent and increase the risk for long-term adverse health outcomes. Next to well-known ACE-associated risks for morbidity, recent research is increasingly invested in exploring pathways towards health, overall functioning, and partaking in society following early adversity. OBJECTIVES Thus, this study aims to assess the association between latent classes of ACEs with perceived social participation and health-related Quality of Life (QoL) in a large population-based sample and to explore potential moderators of these associations. METHOD A representative sample of the German population (N = 2531; Mage = 48.7; 51 % women) was cross-sectionally investigated for ACEs, social participation (KsT-5), and health-related QoL (EuroQol-5D-5L). Latent Class Analysis (LCA) was performed to derive groups with similar ACE patterns. Multiple regression analyses were used to investigate the association of latent classes of ACEs with social participation and health-related QoL and to explore potential moderators. RESULTS Four distinct latent classes of ACEs were identified; "no/low ACEs" (N = 1968, 77.8 %); "household-dysfunction" (N = 259, 10.2 %), "child abuse and neglect" (N = 188, 7.4 %), and "polyadversity" (N = 116, 4.6 %). Compared to participants in the no/low ACE class, those in the ACE-exposed classes showed overall lower levels of perceived social participation and health-related QoL. The polyadversity class showed lower levels of social participation compared to the two other ACE-exposed classes. Chronic stress, living with a partner, education, current job/educational involvement, and gender were found to moderate these associations in exploratory analyses. CONCLUSIONS This study shows people exposed to ACEs to have a higher risk for lower perceived social participation and lower health-related QoL - an increased risk, however, is not a deterministic uninventable fortune. Reduction of chronic stress, fostering of social support, and educational and vocational paths as interventional targets are discussed to enable those with precarious starting conditions to partake in society.
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Affiliation(s)
- David Bürgin
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; University Psychiatric Hospitals, Child and Adolescent Psychiatric Research Department (UPKKJ), University of Basel, Basel, Switzerland.
| | - Vera Clemens
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany
| | - Andreas Witt
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany
| | - Andreas Jud
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; Competence Center Child Abuse and Neglect in Medicine Baden-Wurttemberg com.can, Ulm, Germany
| | - Elmar Brähler
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Mainz, Germany; Integrated Research and Treatment Center (IFB) Adiposity Diseases-Behavioral Medicine, Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Bernhard Strauß
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Jena, Germany
| | - Katja Petrowski
- Medical Psychology and Medical Sociology, Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Marc Schmid
- University Psychiatric Hospitals, Child and Adolescent Psychiatric Research Department (UPKKJ), University of Basel, Basel, Switzerland
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; Competence Center Child Abuse and Neglect in Medicine Baden-Wurttemberg com.can, Ulm, Germany
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Shanahan L, Copeland WE. A Deadly Drop in Rankings: How the United States Was Left Behind in Global Life Expectancy Trends. Am J Public Health 2023; 113:961-963. [PMID: 37471674 PMCID: PMC10413746 DOI: 10.2105/ajph.2023.307367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 07/22/2023]
Affiliation(s)
- Lilly Shanahan
- Lilly Shanahan is with the Department of Psychology and the Jacobs Center for Productive Youth Development at the University of Zurich in Zurich, Switzerland. William E. Copeland is with the Department of Psychiatry at the University of Vermont, Burlington
| | - William E Copeland
- Lilly Shanahan is with the Department of Psychology and the Jacobs Center for Productive Youth Development at the University of Zurich in Zurich, Switzerland. William E. Copeland is with the Department of Psychiatry at the University of Vermont, Burlington
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Gürsoy MY, Mechmet FC. Correlations between childhood trauma and depression, anxiety, and stress levels in nurses. Arch Psychiatr Nurs 2023; 45:164-168. [PMID: 37544694 DOI: 10.1016/j.apnu.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/19/2023] [Accepted: 06/24/2023] [Indexed: 08/08/2023]
Abstract
AIMS This study aims to determine correlations between childhood trauma and depression, anxiety, and stress levels in nurses. METHODS This cross-sectional study was conducted among nurses in Turkey from August to September 2022. A total of 395 nurses were included in the study. Data were collected through an online survey using a personal information form, the Childhood Trauma Questionnaire (CTQ-28), and the Depression, Anxiety, and Stress Scale (DASS 21). RESULTS The mean score of the CTQ-28 total scale was 51.6, and emotional neglect was the most common type of abuse. The prevalence of moderate-to-extremely severe depression, anxiety, and stress was 34.7 %, 42.2 %, and 18.3 %, respectively. Emotional abuse and emotional neglect subscales of the CTQ were independently related to all three DASS subscale scores. CONCLUSION This study revealed that the emotional abuse and neglect experienced in childhood are related to the nurses' current stress, anxiety, and depression levels.
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Affiliation(s)
- Melike Yalçın Gürsoy
- Canakkale Onsekiz Mart University, Çanakkale Faculty of Health Sciences, Terzioglu Campus, Canakkale/Center, Turkey.
| | - Fatme Chousko Mechmet
- Çanakkale Onsekiz Mart University, School of Graduate Studies, M.Sc. Program in Nursing, Canakkale/Center, Turkey
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Hilberdink CE, van Zuiden M, Olff M, Roseboom TJ, de Rooij SR. The impact of adversities across the lifespan on psychological symptom profiles in late adulthood: a latent profile analysis. J Dev Orig Health Dis 2023; 14:508-522. [PMID: 37477375 DOI: 10.1017/s2040174423000181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
People commonly face adverse circumstances throughout life, which increases risk for psychiatric disorders, such as anxiety, depression, psychosis, and posttraumatic stress disorder (PTSD). Adversities may occur during different periods in life. Especially adversity during early periods has been suggested to put individuals at risk for adverse mental health outcomes. Here, we investigated whether timing of adversity during the prenatal period, childhood, or mid-to-late adulthood differentially impacted classification into late adulthood symptom profiles. We performed sex-stratified Latent Profile Analysis to identify latent profiles regarding anxious, depressive, psychotic, and PTSD symptoms in n = 568 Dutch famine birth cohort members (n = 294 women, n = 274 men, mean age(SD) = 72.9(0.8)). Cross-sectional late adulthood symptomatology, childhood traumatic maltreatment, and adulthood trauma were based on self-report questionnaires. Prenatal adversity was considered present when individuals were prenatally exposed to the 1944-45 Dutch famine. In both men and women we identified one anxious/depressive profile and three profiles with approximately equal severity of all symptom types within each profile, yet differentiating in overall severity (low, mild, high) between profiles. We additionally found a PTSD symptom profile in women. In men, logistic regression models showed significant associations between prenatal, childhood and adulthood adversity, and profile classification, with differential effects depending on timing and most profound effects of child maltreatment. In women, childhood and adulthood adversity significantly increased classification probability into almost all profiles, with no significant effect of prenatal adversity. These findings support a time-dependent and sex-specific impact of adversity during different periods across the lifespan on psychological health, with consequences into late adulthood.
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Affiliation(s)
- C E Hilberdink
- Amsterdam UMC Location University of Amsterdam, Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience Research Institute, Mood, Anxiety, Psychosis, Stress and Sleep, Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, University of Amsterdam, Amsterdam, The Netherlands
| | - M van Zuiden
- Amsterdam UMC Location University of Amsterdam, Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience Research Institute, Mood, Anxiety, Psychosis, Stress and Sleep, Amsterdam, The Netherlands
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - M Olff
- Amsterdam UMC Location University of Amsterdam, Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience Research Institute, Mood, Anxiety, Psychosis, Stress and Sleep, Amsterdam, The Netherlands
- ARQ, National Psychotrauma Centre, Diemen, The Netherlands
| | - T J Roseboom
- Department of Epidemiology and Data Science, University of Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - S R de Rooij
- Department of Epidemiology and Data Science, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Aging and Later Life, Health Behaviors and Chronic Diseases, Amsterdam, The Netherlands
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Rodríguez-Reynaldo M, Rivera-Orraca Z, Ramos Monserrate G, Martínez-González K. Mental health impact of the COVID-19 pandemic in perinatal women living in Puerto Rico. J Reprod Infant Psychol 2023:1-14. [PMID: 37427837 PMCID: PMC10776800 DOI: 10.1080/02646838.2023.2232388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 06/26/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Studies have reported an increase in mental health disorders during the perinatal period as a result of the COVID-19 pandemic and the quarantine restrictions imposed. The effects of untreated maternal mental health have an adverse impact on the mother, the development of the baby, and the family system. Determinants of health, recent natural disasters, and disparities in perinatal care that impact perinatal women in Puerto Rico place them at a higher risk of mental health difficulties. AIM It is therefore, of extreme importance, to evaluate the effect that the COVID-19 pandemic has had on this vulnerable population. DESIGN This is a cross-sectional observational study that interviewed 100 women in the perinatal period during the COVID-19 lockdown measures in Puerto Rico. Participants completed the Spanish version of the COVID-19 Perinatal Experiences (COPE-IS) questionnaire and assessments of clinical depression (PHQ-9) and anxiety (GAD-7). RESULTS The prevalence of moderate to severe risk of depression in this sample is 14%, while 17% showed clinical signs of anxiety. Concerns about social impact and the quarantine mandate were the most common stressors reported. Additionally, our sample reported concerns about the impact the pandemic would have on future employment and finances. CONCLUSION Perinatal women showed significantly higher prevalence of depression and anxiety during the COVID -19 pandemic when compared to the mental health prevalence of the general population pre-pandemic in Puerto Rico. The concerns identified during the pandemic provide information on the importance of a biopsychosocial approach to perinatal mental health care.
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Affiliation(s)
- Marianela Rodríguez-Reynaldo
- Department of Obstetrics and Gynecology, University of Puerto Rico- Conceptualization, Investigation, Methodology, Resources, Writing - Original Draft, Writing - Review & Editing, San Juan, Puerto Rico
| | - Zilkia Rivera-Orraca
- Department of Psychiatry, University of Puerto Rico- Investigation, Methodology, Analysis, Resources, Review & Editing, San Juan, Puerto Rico
| | - Gian Ramos Monserrate
- Department of Psychiatry, University of Puerto Rico- Investigation, Methodology, Analysis, Resources, Review & Editing, San Juan, Puerto Rico
| | - Karen Martínez-González
- Department of Psychiatry, University of Puerto Rico- Investigation, Methodology, Analysis, Resources, Review & Editing, San Juan, Puerto Rico
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Todahl JL, Piper S, Metcalfe RE, Luther SC, Barkhurst PD, Cook K, Ratliff M, Gau JM. How Do Survivor and Mandatory Reporter Status Correlate with Program Outcomes for an Adult-Focused Child Sexual Abuse Prevention Program? JOURNAL OF CHILD SEXUAL ABUSE 2023; 32:979-996. [PMID: 37975619 DOI: 10.1080/10538712.2023.2277325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/10/2023] [Indexed: 11/19/2023]
Abstract
This exploratory study investigated group differences and pre-post changes in knowledge, beliefs, and behavior by mandatory reporters and Child Sexual Abuse (CSA) survivor status for a CSA prevention training designed for the general public. Of the 8,114 study participants, 32% identified as having experienced CSA, and 77% indicated they were mandatory reporters for child abuse and neglect. Mandatory reporters had higher baseline knowledge about CSA than those who were not mandatory reporters and reported more CSA preventative behaviors. Mandatory reporters continued to have higher levels of knowledge following the training. Survivors of CSA also had higher baseline knowledge about CSA and preventative behavior scores than individuals who are not survivors of CSA. Unlike mandatory reporters, they experienced fewer increases in knowledge. At posttest, there was no evidence of a difference in knowledge between CSA survivors and non-CSA survivors. For items related to beliefs, mandatory reporters had higher baseline scores than other participants. However, they had smaller gains, so mandatory reporters and non-mandatory reporters had more similar beliefs related to CSA after the training. There were few differences between CSA survivors and non-survivors on baseline beliefs related to CSA, though CSA survivors reported greater increases in beliefs that CSA prevention is their responsibility and in the idea that they know what to do to prevent CSA. These results have significant results for the development and evaluation of trauma-informed prevention programming.
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Affiliation(s)
- Jeffrey L Todahl
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
| | - Simone Piper
- Center for the Prevention of Abuse and Neglect, University of Oregon, Eugene, OR, United States of America
| | - Robyn E Metcalfe
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
| | - Stephanie C Luther
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
| | - Phyllis D Barkhurst
- Center for the Prevention of Abuse and Neglect, University of Oregon, Eugene, OR, United States of America
| | - Keavy Cook
- The Ford Family Foundation, Roseberg, OR, United States of America
| | - Mary Ratliff
- The Ford Family Foundation, Roseberg, OR, United States of America
| | - Jeff M Gau
- Center on Human Development, University of Oregon, Eugene, OR, United States of America
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Boals A. Illusory posttraumatic growth is common, but genuine posttraumatic growth is rare: A critical review and suggestions for a path forward. Clin Psychol Rev 2023; 103:102301. [PMID: 37331153 DOI: 10.1016/j.cpr.2023.102301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/20/2023]
Abstract
Over the last 2.5 decades, trauma researchers have increasingly become interested in posttraumatic growth (PTG) - the concept that some people experience growth as a result of trauma exposure. I begin by reviewing extant research on PTG, with a focus on measurement and conceptual issues. Expanding on arguments made by others, I distinguish between three forms of PTG, 1) perceived PTG, which is an individual's beliefs about their own PTG, 2) genuine PTG, which is veridical growth following adversity, and 3) illusory PTG, which is motivated fabrications of PTG. Perceived PTG is extremely common, as over half of individuals exposed to a potentially traumatic event (PTE) report moderate or greater levels of PTG. I review evidence that most self-reports of PTG are greatly exaggerated and argue that perceived PTG is mostly illusory PTG. I propose five reasons for the disconnect between perceived PTG and genuine PTG, including design flaws in the current measurements, emotional biases that favor perceived PTG, the inherent appeal of PTG, cultural expectations, and problems of definition. I then review the empirical evidence concerning the prevalence rate of genuine PTG, coming to the bold conclusion that the occurrence of genuine PTG is very rare, contradicting current fundamental beliefs about PTG. I recommend researchers focus on the key areas of measurement and etiology of genuine PTG, which are necessary to create interventions that foster genuine PTG. I conclude by outlining a path to steer the scientific progression of PTG back in the right direction.
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Affiliation(s)
- Adriel Boals
- University of North Texas, United States of America.
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43
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Speranza AM, Liotti M, Spoletini I, Fortunato A. Heterotypic and homotypic continuity in psychopathology: a narrative review. Front Psychol 2023; 14:1194249. [PMID: 37397301 PMCID: PMC10307982 DOI: 10.3389/fpsyg.2023.1194249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/16/2023] [Indexed: 07/04/2023] Open
Abstract
Psychopathology is a process: it unfolds over time and involves several different factors. To extend our knowledge of such process, it is vital to understand the trajectories that lead to developing and maintaining a specific disorder. The construct of continuity appears very useful to this aim. It refers to the consistency, similarity, and predictability of behaviors or internal states across different developmental phases. This paper aims to present a narrative review of the literature on homotypic and heterotypic continuity of psychopathology across the lifespan. A detailed search of the published literature was conducted using the PsycINFO Record and Medline (PubMed) databases. Articles were included in the review based on the following criteria: (1) publication dates ranging from January 1970 to October 2022; and (2) articles being written in the English language. To ensure a thorough investigation, multiple combinations of keywords such as "continuity," "psychopathology," "infancy," "childhood," "adolescence," "adulthood," "homotypic," and "heterotypic" were used. Articles were excluded if exclusively focused on epidemiologic data and if not specifically addressing the topic of psychopathology continuity. The literature yielded a total of 36 longitudinal studies and an additional 190 articles, spanning the research published between 1970 and 2022. Studies on continuity focus on the etiology of different forms of mental disorders and may represent a fundamental resource from both a theoretical and clinical perspective. Enhancing our understanding of the different trajectories beneath psychopathology may allow clinicians to implement more effective strategies, focusing both on prevention and intervention. Since literature highlights the importance of early detection of clinical signs of psychopathology, future research should focus more on infancy and pre-scholar age.
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Affiliation(s)
- Anna Maria Speranza
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Marianna Liotti
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Ilaria Spoletini
- Department of Medical Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Alexandro Fortunato
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
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González-Castro TB, Juárez-Rojop IE, Tovilla-Zárate CA, Ovando-Ricárdez JA, Hernández-Díaz Y, López-Narváez ML, Genis-Mendoza AD, Rodríguez-Pérez C. Gene-environment interaction between HPA-axis genes and trauma exposure in the suicide behavior: A systematic review. J Psychiatr Res 2023; 164:162-170. [PMID: 37352812 DOI: 10.1016/j.jpsychires.2023.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 03/03/2023] [Accepted: 06/15/2023] [Indexed: 06/25/2023]
Abstract
Suicide behavior (SB) emerge from complex interactions among traumatic events and multiple genetic factors. We conducted the first systematic review to assess the evidence of a link among trauma exposure, HPA-axis genes, and SB. A systematic search of PubMed, EBSCO, Science Direct, PsychInfo, and Scopus databases on gene-environment interaction, and susceptibility to SB was carried out until February 2022. Our study was prospectively registered in PROSPERO (CRD42022316141). A total of 13 epidemiological studies (11,756 subjects) were included: eight studies focused on traumatic experiences in the childhood and five studies on lifetime trauma exposure. All studies reported a positive association between the trauma exposure with SB. Gene-environment interaction was reported for CRHR1 (n = 6), CRHR2 (n = 2), FKBP5 (n = 2), and CRHBP (n = 1), however, for CRH, NR3C1, MC2R, and POMC genes no found gene-environment effects on SB. Trauma exposure could be one mechanism that links HPA-axis genes activity with the development of SB.
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Affiliation(s)
- Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, United Mexican States.
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, United Mexican States.
| | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco, United Mexican States.
| | - José Antonio Ovando-Ricárdez
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, United Mexican States.
| | - Yazmin Hernández-Díaz
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, United Mexican States.
| | | | - Alma Delia Genis-Mendoza
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, United Mexican States.
| | - Candelario Rodríguez-Pérez
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, United Mexican States.
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Metcalfe RE, Muentner LD, Reino C, Schweer-Collins ML, Kjellstrand JM, Eddy JM. Witnessing Parental Arrest As a Predictor of Child Internalizing and Externalizing Symptoms During and After Parental Incarceration. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:329-338. [PMID: 36157296 PMCID: PMC9483368 DOI: 10.1007/s40653-022-00490-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 05/26/2023]
Abstract
Purpose One in fourteen children in the United States experiences the incarceration of a parent with whom they have lived. Although prior research has established that witnessing the arrest of a parent is a common occurrence for children of criminal justice-involved parents, child outcomes following such an event are understudied. Little is known about the long-term impacts of witnessing an arrest on children and the extent to which they may vary by child age. Methods Using longitudinal data from the Parent Child Study of mothers and fathers incarcerated in state prison, we examine the witnessing of parental arrest as an acute traumatic event and identify the extent to which this type of trauma predicts externalizing and internalizing symptoms for children during their parents' incarceration and following release. Results Witnessing a parent's arrest predicted greater internalizing behavior concerns while parents were incarcerated, with a greater magnitude of effect for children under eight years of age. Six months post-release of the parent, children younger than age eight who witnessed the arrest showed significantly higher internalizing and externalizing behaviors. No effect was found for children ages eight years or older. Conclusion Implications for future policies to reduce the likelihood of children witnessing parental arrests, as well as the potential benefit of screening for trauma when working with children with incarcerated parents, are discussed.
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Affiliation(s)
- Robyn E. Metcalfe
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, OR Eugene, USA
- Prevention Science Institute, University of Oregon, Eugene, OR USA
| | - Luke D. Muentner
- Department of Pediatrics, University of Minnesota, Minnesota, Minneapolis, USA
| | - Claudia Reino
- Texas Center for Equity Promotion, College of Education, The University of Texas at Austin, Austin, TX USA
| | | | - Jean M. Kjellstrand
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, OR Eugene, USA
- Prevention Science Institute, University of Oregon, Eugene, OR USA
| | - J. Mark Eddy
- Texas Center for Equity Promotion, College of Education, The University of Texas at Austin, Austin, TX USA
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DiGiovanni SS, Hoffmann Frances RJ, Brown RS, Wilkinson BT, Coates GE, Faherty LJ, Craig AK, Andrews ER, Gabrielson SMB. Pediatric Trauma and Posttraumatic Symptom Screening at Well-child Visits. Pediatr Qual Saf 2023; 8:e640. [PMID: 37250613 PMCID: PMC10219716 DOI: 10.1097/pq9.0000000000000640] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 02/15/2023] [Indexed: 05/31/2023] Open
Abstract
Adverse childhood experiences (ACEs), including abuse or neglect, parental substance abuse, mental illness, or separation, are public health crises that require identification and response. We aimed to increase annual rates of trauma screening during well-child visits from 0% to 70%, post-traumatic stress disorder (PTSD) symptom screening for children with identified trauma from 0% to 30%, and connection to behavioral health for children with symptoms from 0% to 60%. Methods Our interdisciplinary behavioral and medical health team implemented 3 plan-do-study-act cycles to improve screening and response to pediatric traumatic experiences. Automated reports and chart reviews measured progress toward goals as we changed screening methods and provider training. Results During plan-do-study-act cycle 1, a chart review of patients with positive trauma screenings identified various trauma types. During cycle 2, a comparison of screening methods demonstrated that written screening identified trauma among more children than verbal screening (8.3% versus 1.7%). During cycle 3, practices completed trauma screenings at 25,287 (89.8%) well-child visits. Among screenings, 2,441 (9.7%) identified trauma. The abbreviated Post Traumatic Stress Disorder Reaction Index was conducted at 907 (37.2%) encounters and identified 520 children (57.3%) with PTSD symptoms. Among a sample of 250, 26.4% were referred to behavioral health, 43.2% were already connected, and 30.4% had no connection. Conclusions It is feasible to screen and respond to trauma during well-child visits. Screening method and training implementation changes can improve screening and response to pediatric trauma and PTSD. Further work is needed to increase rates of PTSD symptomology screening and connection to behavioral health.
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Affiliation(s)
- Stephen S. DiGiovanni
- From the Barbara Bush Children’s Hospital at Maine Medical Center, Department of Pediatrics, Portland, Maine
| | | | | | | | | | - Laura J. Faherty
- From the Barbara Bush Children’s Hospital at Maine Medical Center, Department of Pediatrics, Portland, Maine
- RAND Corporation, Boston, Massachusetts
| | - Alexa K. Craig
- From the Barbara Bush Children’s Hospital at Maine Medical Center, Department of Pediatrics, Portland, Maine
| | - Elizabeth R. Andrews
- From the Barbara Bush Children’s Hospital at Maine Medical Center, Department of Pediatrics, Portland, Maine
| | - Sarah M. B. Gabrielson
- From the Barbara Bush Children’s Hospital at Maine Medical Center, Department of Pediatrics, Portland, Maine
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Fares-Otero NE, De Prisco M, Oliva V, Radua J, Halligan SL, Vieta E, Martinez-Aran A. Association between childhood maltreatment and social functioning in individuals with affective disorders: A systematic review and meta-analysis. Acta Psychiatr Scand 2023. [PMID: 37105552 DOI: 10.1111/acps.13557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE Childhood maltreatment has been linked to impairments in social functioning and social cognition in adults with affective disorders. However, conclusions have been limited by inconsistent findings across different maltreatment subtypes and social domains. We conducted a systematic review and meta-analysis to quantify associations between childhood maltreatment (overall and subtypes - physical, emotional and/or sexual abuse, and/or physical and/or emotional neglect) and different domains of social functioning and social cognition in adults with affective disorders (bipolar disorder or major depressive disorder). We also examined effect moderators and mediators of these associations. METHODS A systematic search was performed on 12.12.2022 which identified 29 studies included in qualitative synthesis (n = 3022 individuals with affective disorders), of which 27 (n = 2957) were pooled in meta-analyses. Across studies, five social functioning and five social cognition domains were examined, of which four domains of social functioning and two domains of social cognition had sufficient data for meta-analysis (PROSPERO CRD42022288976). RESULTS Social functioning: childhood maltreatment was associated with lower global social functioning (r = -0.11 to -0.20), poorer interpersonal relations (r = -0.18 to -0.33), and with aggressive behaviour (r = 0.20-0.29) but was unrelated to vocational functioning. Emotional abuse and emotional neglect showed the largest magnitudes of effect. Social cognition: there was no meta-analytic evidence of associations between maltreatment and social cognition domains. Exploratory moderation analyses did not identify any consistent moderators. Narrative synthesis identified attachment style as possible moderator, and sensory patterns, anxiety, and depressive symptoms as possible mediators between childhood maltreatment and social outcomes. Overall, the available evidence was limited, particularly in relation to social cognition. CONCLUSIONS Adults with affective disorders are at risk of social functioning difficulties after childhood maltreatment exposure, an effect observed across multiple maltreatment subtypes, social functioning domains, and diagnoses. Addressing social functioning problems may benefit maltreated adults with both bipolar disorder and major depressive disorder.
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Affiliation(s)
- Natalia E Fares-Otero
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Michele De Prisco
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Vincenzo Oliva
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Joaquim Radua
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Anabel Martinez-Aran
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
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Ehrlich TJ, Kim H, Ryan KA, Langenecker SA, Duval ER, Yocum AK, Diaz-Byrd C, Wrobel AL, Dean OM, Cotton SM, Berk M, McInnis MG, Marshall DF. Childhood trauma relates to worse memory functioning in bipolar disorder. J Affect Disord 2023; 333:377-383. [PMID: 37084974 DOI: 10.1016/j.jad.2023.04.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 04/01/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Childhood trauma is commonly experienced by individuals diagnosed with bipolar disorder (BP). In BP, childhood trauma is related to a more severe clinical course, but its association with cognition remains unclear. METHODS This study evaluated 405 adult participants diagnosed with BP and 136 controls. Participants completed the Childhood Trauma Questionnaire and a comprehensive neuropsychological battery. High versus low childhood trauma was defined with one standard deviation above the control participant's mean Childhood Trauma Questionnaire score. Neuropsychological data was transformed into eight cognitive factors, including four executive functioning, auditory and visual memory, fine motor, and emotion processing. Multivariate analysis of covariance evaluated group differences in cognition, while adjusting for covariates. RESULTS There were significant differences among the three groups, F(16, 968) = 4.05, p < .001, Wilks' Λ = 0.88, partial η2 = 0.06. Comparing the high and low trauma BP groups, high trauma was related to lower auditory and visual memory factor scores (p < .05). As compared to controls, the BP high trauma group had lower scores on six of eight factors (all p < .01), while the BP low trauma group had lower scores on four of eight factors (all p < .01). LIMITATIONS Analyses of factor score do not address which aspect of the memory process is affected and biomarkers may help guide interventions addressing underlying biological process. CONCLUSIONS Adults diagnosed with BP with higher childhood trauma have worse memory functioning, beyond the lower childhood trauma BP group, highlighting the importance of understanding the long-term cognitive outcomes of childhood trauma.
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Affiliation(s)
- Tobin J Ehrlich
- Heinz C Prechter Bipolar Research Program, Eisenberg Family Depression Center, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Hanjoo Kim
- Heinz C Prechter Bipolar Research Program, Eisenberg Family Depression Center, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Kelly A Ryan
- Heinz C Prechter Bipolar Research Program, Eisenberg Family Depression Center, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Anastasia K Yocum
- Heinz C Prechter Bipolar Research Program, Eisenberg Family Depression Center, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Claudia Diaz-Byrd
- Heinz C Prechter Bipolar Research Program, Eisenberg Family Depression Center, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Anna L Wrobel
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia; Orygen, Parkville, VIC, Australia
| | - Olivia M Dean
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia; Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Sue M Cotton
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia; Orygen, Parkville, VIC, Australia; Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia; Department of Psychiatry, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Melvin G McInnis
- Heinz C Prechter Bipolar Research Program, Eisenberg Family Depression Center, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - David F Marshall
- Heinz C Prechter Bipolar Research Program, Eisenberg Family Depression Center, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
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Erduran Tekin Ö, Şirin A. Rumination Mediates the Relationship Between Childhood Traumas with Cognitive Defusion, Acceptance, and Emotion Regulation: A Qualitative and Quantitative Study. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2023:1-28. [PMID: 37360921 PMCID: PMC10081932 DOI: 10.1007/s10942-023-00503-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 06/28/2023]
Abstract
This study examines the intermediary role of rumination in the relationship between childhood traumas in young adults and cognitive defusion, psychological acceptance, and suppression which is one of the emotion regulation strategies. In the quantitative stage of the study formed according to the explanatory sequential design, the intermediary role of rumination by using a structural equation model while in the qualitative stage, the intermediary role of rumination was analyzed through interviews using the interpretive phenomenology design. Personal Information Form, Childhood Trauma Scale, Short Form Ruminative Response Scale, Acceptance and Action Form II, Drexel Defusion Scale, and Emotion Regulation Scale were used in the research. At the end of the research, it was determined that childhood traumas have a negative effect on cognitive defusion and acceptance, while they have a positive effect on suppression. It was seen that rumination has a partial intermediary role in the relationship of childhood traumas with cognitive defusion, acceptance, and suppression. As a result of the qualitative analysis, twelve themes such as "Constantly thinking about the past, not being able to move away from childhood traumas, not being able to forgive their parents, inability to get rid of negative thoughts, living in the past, moving away from a value-driven life, false expression of emotion, suppression of emotions, emotions reflected in behavior, coping with negative emotions and desired emotion regulation" emerged concerning participants' experiences of cognitive defusion, acceptance, and suppression. Although one of the purposes of using AAQ-II in the study was to support discussions about the scale via qualitative results, this was a limitation for the study. Therefore, although a high rate was obtained, it is not possible to infer that childhood traumas and rumination can explain acceptance behaviors. For this, much more quantitative and qualitative studies are needed. Other qualitative research findings are thought to support quantitative research findings.
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Affiliation(s)
- Özge Erduran Tekin
- Department of Educational Sciences, National Defense University, Air Force Academy, 34149 Yeşilyurt, Istanbul, Turkey
| | - Ahmet Şirin
- Department of Guidance and Psychological Counseling, Marmara University Atatürk Faculty of Education, Istanbul, Turkey
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Dauvermann MR, Costello L, Tronchin G, Holleran L, Mothersill D, Rokita KI, Kane R, Hallahan B, Corvin A, Morris D, McKernan DP, Kelly J, McDonald C, Donohoe G, Cannon DM. Childhood trauma is associated with altered white matter microstructural organization in schizophrenia. Psychiatry Res Neuroimaging 2023; 330:111616. [PMID: 36827958 DOI: 10.1016/j.pscychresns.2023.111616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/02/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023]
Abstract
It has been reported that childhood trauma (CT) is associated with reductions in fractional anisotropy (FA) in individuals with schizophrenia (SZ). Here, we hypothesized that SZ with high levels of CT will show the greatest reductions in FA in frontolimbic and frontoparietal regions compared to healthy controls (HC) with high trauma levels and participants with no/low levels of CT. Thirty-seven SZ and 129 HC with CT experience were dichotomized into groups of 'none/low' or 'high' levels. Participants underwent diffusion-weighted MRI, and Tract-based spatial statistics were employed to assess the main effect of diagnosis, main effect of CT severity irrespective of diagnosis, and interaction between diagnosis and CT severity. SZ showed FA reductions in the corpus callosum and corona radiata compared to HC. Irrespective of a diagnosis, high CT levels (n = 48) were related to FA reductions in frontolimbic and frontoparietal regions compared to those with none/low levels of CT (n = 118). However, no significant interaction between diagnosis and high levels of CT was found (n = 13). Across all participants, we observed effects of CT on late developing frontolimbic and frontoparietal regions, suggesting that the effects of CT severity on white matter organization may be independent of schizophrenia.
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Affiliation(s)
- Maria R Dauvermann
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland; Institute for Mental Health, School of Psychology, University of Birmingham, B15 2TT, United Kingdom.
| | - Laura Costello
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Giulia Tronchin
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Laurena Holleran
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - David Mothersill
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland; Department of Psychology, School of Business, National College of Ireland, Dublin, Ireland; Department of Psychiatry, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
| | - Karolina I Rokita
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Ruán Kane
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Brian Hallahan
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Aiden Corvin
- Department of Psychology, School of Business, National College of Ireland, Dublin, Ireland
| | - Derek Morris
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Declan P McKernan
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - John Kelly
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Colm McDonald
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Gary Donohoe
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Dara M Cannon
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
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