Childhood Trauma Questionnaire – Psychometrische Eigenschaften einer deutschsprachigen Version

Attention to facial emotions in adult women varies by type and severity of childhood maltreatment experience and emotion regulation strategy

Little eye-tracking research has been conducted so far on the association of subtypes of childhood maltreatment and habitual emotion regulation with attention to emotions. To address this issue, gaze behavior of one hundred women with experiences of childhood maltreatment was examined in a free-viewing task in which pairs of faces consisting of an emotional (happy, surprised, angry, disgusted, fearful, and sad) and a neutral face were displayed. Participants' childhood maltreatment experiences, emotion regulation strategies (reappraisal and suppression), anxiety, depression, stress perception, level of alexithymia, and intelligence were assessed. Fixation durations were used to assess attentional bias. A mixed linear model with post-hoc pairwise comparisons was used to investigate research questions. Results indicated that, at high levels of maltreatment severity, attentional preference for positive over other emotional faces was found to be diminished for physical and emotional abuse but not for emotional neglect. At a severe level of emotional abuse, a bias away from disgusted faces was observed. Suppression was linked to reduced and reappraisal was related to heightened attention allocation to facial emotions. Our data indicates that attention to social emotional information in adulthood could depend on the type and severity of childhood trauma and habitual emotion regulation strategy.

Childhood maltreatment and mental health problems in a 10-year follow-up study of adolescents in youth residential care: A latent transition analysis

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.

Emotion regulation use in daily-life and its association with success of emotion-regulation, self-efficacy, stress, and state rumination

Introduction

Investigations on emotion regulation strategies (ERS) primarily focus on the influence of instructed emotion regulation (ER) on outcomes. However, recent work has shown that selection of ERS is dependent on, e.g., situational demands and personal resources.

Methods

In this current investigation, we used an online diary to investigate ERS used by free choice and their association with ER-success, stress and rumination. We identified four factors of ERS: cognitive perspective change, cognitive-behavioral problem-solving, suppression-distraction and body-social ERS. Associations of ERS with stress, state-rumination and ER-success were investigated using multilevel-mixed-models, allowing to separate within- and between-subject effects.

Results

Our results show that, on a within-subject level, all adaptive ERS were positively associated with ER-success, while maladaptive ERS as well as higher stress and state rumination were negatively associated with ER-success. On the other hand, only within-subject cognitive ERS were associated with higher self-efficacy. Maladaptive ERS-use was consequently positively associated with stress and state rumination. Surprisingly, only cognitive perspective change ERS were negatively associated with state rumination. Cognitive-behavioral problem-solving was positively associated with stress and success of emotion regulation.

Discussion

We interpret these results in the light of situational constraints of ERS-use and the importance of the assessment of these in future studies.

Reduced positive attentional bias in patients with borderline personality disorder compared with non-patients: results from a free-viewing eye-tracking study

BACKGROUND

Attentional processes are important for regulating emotional states and coping with stressful events. Orientation of attention acts as filter for subsequent information processing. So far, only few eye-tracking studies have examined attentional processes during emotion perception in borderline personality disorder (BPD). In these studies, gaze behaviour was analysed during simultaneous or delayed evaluation of single stimuli. The objective of the present eye-tracking study was to investigate early and late attention allocation towards emotional facial expressions in patients with BPD and non-patients (NPs) based on a free-viewing paradigm, which allows to examine processes of self-generated attention deployment.

METHODS

In a multiple-stimulus free-viewing task with facial expressions, i.e. happy, angry, sad, and neutral faces, presented simultaneously early and late attentional allocation was analysed in 43 patients with BPD and 43 age- and sex-matched NPs. We assessed study participants' trait anxiety, depressive symptoms, level of alexithymia, traumatic childhood experiences, and borderline symptoms. Entry time was used to measure initial gaze orientation, whereas dwell time was calculated as an index of late attention allocation.

RESULTS

As could be expected, patients with BPD reported more anxiety, depressive symptoms, experiences of childhood maltreatment, and showed higher levels of alexithymia than NPs. Patients differed from NPs in dwell time on happy facial expressions but not in dwell time on angry, sad, and neutral expressions. Contrary to our hypothesis, patients did not differ from NPs concerning entry times on angry facial expressions.

CONCLUSIONS

According to our results, patients with BPD show a reduced attentional preference for happy facial expression during free viewing compared to NPs. A decreased positive attentional bias at a late processing stage could be part of emotion regulation impairments and add to the vulnerability for negative affects in BPD, which represent core symptoms of the disorder. In contrast to previous eye-tracking research in BPD examining attention during evaluative processing, our dwell time data could be more indicative of self-generated, endogenously controlled attentional processes in emotion perception. The present data do not support an early vigilance for threatening social information in BPD.

Childhood trauma is linked to epigenetic age deceleration in young adults with previous youth residential care placements

Background: Early adversity increases the risk for mental and physical disorders as well as premature death. Epigenetic processes, and altered epigenetic aging in particular, might mediate these effects. While the literature that examined links between early adversity and epigenetic aging is growing, results have been heterogeneous.Objective: In the current work, we explored the link between early adversity and epigenetic aging in a sample of formerly out-of-home placed young adults.Method: A total of N = 117 young adults (32% women, age mean = 26.3 years, SD = 3.6 years) with previous youth residential care placements completed the Childhood Trauma Questionnaire (CTQ) and the Life Events Checklist (LEC-R) and provided blood samples for the analysis of DNA methylation using the Illumina Infinium MethylationEPIC BeadChip Microarray. Epigenetic age was estimated using Hovarth's and Hannum's epigenetic clocks. Furthermore, Hovarth's and Hannum's epigenetic age residuals were calculated as a proxy of epigenetic aging by regressing epigenetic age on chronological age. The statistical analysis plan was preregistered (https://osf.io/b9ev8).Results: Childhood trauma (CTQ) was negatively associated with Hannum's epigenetic age residuals, β = -.23, p = .004 when controlling for sex, BMI, smoking status and proportional white blood cell type estimates. This association was driven by experiences of physical neglect, β = -.25, p = .001. Lifetime trauma exposure (LEC-R) was not a significant predictor of epigenetic age residuals.Conclusion: Childhood trauma, and physical neglect in particular, was associated with decelerated epigenetic aging in our sample. More studies focusing on formerly institutionalized at-risk populations are needed to better understand which factors affect stress-related adaptations following traumatic experiences.

Maternal insecure attachment representation as a long-term risk factor for disrupted mother-child-interaction and child mental health

Maternal childhood maltreatment (CM) represents an important factor in the transmission of trauma that may lead to impaired child mental health. Apart from childhood maltreatment insecure attachment has been identified as a risk factor for insensitive caregiving behavior, which may affect child's mental health. The aim of this study is to identify the working mechanisms in the relationship between maternal CM and child mental health, considering maternal attachment representation, mother-child-interaction und maternal helplessness and fear. N = 103 mother-child-dyads from a longitudinal cohort study were examined at four different measuring points. Data was assessed using self and external report questionnaires as well as the AMBIANCE scales during the Strange Situation Procedure and the Adult Attachment Projective Picture System (AAP). Maternal CM experience did not predict an insecure attachment representation (OR = 2.46 [0.98, 6.53], p = .060). Maternal insecure attachment was associated with higher AMBIANCE scores (F(8, 94) = 11.46, p < .001), which indicates more disrupted communication between mother and child. AMBIANCE scores in turn predicted higher self-perceived helplessness (F(9, 93) = 8.62, p < .001) and fear (F(9, 93) = 7.40, p < .001) in mothers. Helplessness and fear both were associated with higher SDQ-scores, indicating more mental health problems in children (F(10, 92) = 3.98, p < .001; F(10, 92) = 3.87, p < .001). The results of this study highlight how even insecure attachment in a low-risk sample has a long-term impact on parenting behavior and child mental health, therefore underlining the need of early intervention programs in affected and at-risk families.

Long-term consequences of childhood emotional abuse in mothers on parental load and child mental health

BACKGROUND

Childhood emotional maltreatment can be associated with long-term consequences on mental health. In addition, transgenerational transmission of adverse childhood experiences to the next generation can occur and thus have an impact on the mental health of one's own children.

OBJECTIVE

The purpose of this study was to examine the role of stress on the association between childhood emotional maltreatment and parental load what is referred to in this study as limitations in parental functioning that affect the resources available to parents to cope with the demands of raising, caring for, and providing for their child. Furthermore the effect of parental load on the mental health of one's own children will be examined.

PARTICIPANTS AND SETTING

N = 237 mother-child dyads (age mother M = 33.76, SD = 4.07 years; age child M = 11.91 months, SD = 0.89 months) from a longitudinal cohort study were examined at two different measuring points.

METHODS

Emotional abuse, perceived stress, parental load and child mental health were assessed using self and external report questionnaires.

RESULTS

The calculation of a mediation showed that the association of emotional abuse and parental load was completely mediated by perceived stress (indirect effect ab = 0.44, 95 %-CI[0.17, 0.78]). In addition, effects of parental load on the child's mental health (β = 0.13, 95%CI [0.07;0.20]), mainly hyperactivity (β = 0.06, 95%CI [0.03;0.11]) and prosocial behavior (β = -0.04, 95%CI [-0.07; -0.01]), were evident.

CONCLUSIONS

The results of this study provide evidence that the mental health of children can be influenced in the long term by increased parental load.

Personality Disorders and Attachment Trauma in Adolescent Patients with Psychiatric Disorders

This study examined how personality disorders (PD) differ with respect to gender, attachment status and traumatic childhood experiences in adolescent psychiatric inpatients. In particular, we investigated attachment-related traumatic material underlying adolescent PD. Our sample consisted of 175 inpatient adolescents aged 14 to 18 years (77% female, Mage = 15.13, SD = 1.35; 23% male, Mage =14.85, SD = 1.41). Thirty-nine patients (22%) fulfilled the diagnostic criteria for a PD according to the SCID-II PD: 51% avoidant, 13% obsessive-compulsive, 13% antisocial, 19% borderline, 2% paranoid and 2% histrionic. In the total sample, eighty-three (47%) of our inpatients were classified with an unresolved attachment status using the Adult Attachment Projective Picture System (AAP). We did not find any significant gender differences for patients with and without a PD. Our results revealed a higher percentage of unresolved attachment status in patients with a PD. The in-depth analysis of the total sample showed that patients with a PD demonstrated more traumatic material in their attachment interviews indicating a greater severity of attachment trauma. Furthermore, patients with a PD reported higher scores on emotional and physical neglect. Intervention strategies targeting traumatic attachment-related themes might be useful to treat adolescents with PD.

Multifactorial stress reactivity to virtual TSST-C in healthy children and adolescents-It works, but not as well as a real TSST-C

A virtual version of the Trier Social Stress Test (TSST) has been increasingly used in stress research. Benefits of the virtual TSST include that it is more economical, and offers improved control of context and enhanced flexibility of use. Many studies have confirmed the applicability of virtual TSSTs in stress research, but only in adulthood. In the present study, we aimed to experimentally verify the transferability of a virtual TSST to adolescence. A total of 73 healthy adolescents (aged 11-17 years) of both sexes completed either a real (IV-TSST-C) or virtual (VR-TSST-C) TSST for children. The surveyed stress parameters included salivary cortisol and alpha amylase concentrations, heart rate, heart rate variability, and subjective stress ratings across test sessions, as well as a pre- to post-TSST-C comparison. All parameters revealed significant stress responses over time. We observed significant effects of group on cortisol and subjective stress ratings, with the VR-TSST-C inducing less stress than the IV-TSST-C. In alpha amylase, heart rate, and heart rate variability, we found no significant difference between TSST versions, but only significant equivalence for alpha amylase. Some parameters may have been influenced by an expectancy effect and the participant's sex. In conclusion, among adolescents, a virtual TSST-C effectively elicits stress at multiple levels (endocrinological, autonomic, and subjective); however, the magnitude is not always comparable to with the real TSST-C, which should be considered when applied.

Longitudinal course of endocannabinoids and N-acylethanolamines in hair of mothers and their children in the first year postpartum: investigating the relevance of maternal childhood maltreatment experiences

BACKGROUND

Childhood maltreatment (CM) exerts long-lasting psychological and biological alterations in affected individuals and might also affect the endocannabinoid (eCB) system which modulates inflammation and the endocrine stress response. Here, we investigated the eCB system of women with and without CM and their infants using hair samples representing eCB levels accumulated during the last trimester of pregnancy and 10-12 months postpartum.

METHODS

CM exposure was assessed with the Childhood Trauma Questionnaire. At both timepoints, 3 cm hair strands were collected from mothers and children (N = 170 resp. 150) to measure anandamide (AEA), 2/1-arachidonoylglycerol (2-AG/1-AG), stearoylethanolamide (SEA), oleoylethanolamide (OEA), and palmitoylethanolamide (PEA).

RESULTS

Maternal hair levels of 2-AG/1-AG increased and SEA levels decreased from late pregnancy to one year postpartum. Maternal CM was associated with lower SEA levels in late pregnancy, but not one year later. In the children's hair, levels of 2-AG/1-AG increased while levels of SEA, OEA, and PEA decreased from late pregnancy to one year later. Maternal CM was not consistently associated with the eCB levels measured in children's hair.

CONCLUSIONS

We provide first evidence for longitudinal change in the eCB system of mothers and infants from pregnancy to one year later. While maternal CM influenced the maternal eCB system, we found no consistent intergenerational effects on early regulation of the eCB system in children. Longitudinal research on the importance of the eCB system for the course and immunoregulation of pregnancy as well as for the children's development.

The negative association of the SARS-CoV-2 pandemic with the health of mother and child considering maternal childhood maltreatment

BACKGROUND

Social distancing strategies during the SARS-CoV-2 pandemic have left families facing a variety of different constraints. Especially in this stressful time, children need a stable parental home to prevent developmental consequences. Additional risk factors such as maternal childhood maltreatment (CM) may affect mother's psychosomatic health and children's physical well-being in this period.

OBJECTIVE

It was aimed to analyze the associations between maternal CM, mother's mental health, and children's physical complaints during the SARS-CoV-2-pandemic.

METHOD

Mothers of a well-documented birth cohort from a longitudinal study were included in this study. Psychosomatic health was assessed with the PHQ-D and children's physical health with the GBB-KJ during the pandemic. N = 159 mothers completed the online survey. To describe the maternal CM, data from a longitudinal survey were used.

RESULTS

The calculation of three mediation analyses demonstrate that maternal depression symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.07, p = .13), somatic symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.07, p = .13) and psychosomatic symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.06, p = .19) fully mediate the relationship between CM and children's physical health complaints.

CONCLUSIONS

Maternal CM experiences seem to be one relevant risk factor during the pandemic and seem to influence the way in which parents deal with stressful situations and increase the risk for depressive symptoms. The present results highlight the importance to provide individually adjusted assistance to help the families to get through the pandemic.

Supplementary data analyses for the associations of child maltreatment and diabetes in adulthood and the mediating effect of personality functioning

In this article, supplementary data analyses regarding the association between different types of child maltreatment (CM) and diabetes as well as mediation analyses examining the role of personality functioning are provided (original research article: 'Associations of different types of child maltreatment and diabetes in adulthood - the mediating effect of personality functioning: findings from a population-based representative German sample') (Zara et al., 2023). Analyses are based on a representative sample of the German population (N = 5,041). Data was acquired through a representative survey conducted by the independent research institute USUMA Berlin. CM, personality functioning, a diabetes diagnosis as well as symptoms of depression and anxiety were assessed using self-report questionnaires (CTQ, OPD-SQS, PHQ-4). Correlation analyses for all used variables were conducted. Independent t-tests were performed to examine whether symptoms of depression and anxiety are elevated in patients with diabetes and CM (compared to no CM). Regarding the odd ratios (ORs) calculated to examine the association between types of CM and diabetes as well as mediation analyses investigating the role of personality functioning in these associations, sensitivity analyses with persons ≥ 30 years are provided. The additional analyses are intended to add to the body of research showing that patients with diabetes experience symptoms of depression and anxiety more frequently compared to the general population (Kampling and Kruse, 2020; Chireh et al., 2019; Smith et al., 2018), examine the association between different types of CM and diabetes, and explore the role of personality functioning in the association between CM and diabetes.

The association between adverse childhood experiences and peripartal pain experience

ABSTRACT

Adverse childhood experiences (ACEs) are associated with altered ongoing and evoked pain experiences, which have scarcely been studied for the peripartum period. We aimed to investigate how ACEs affect pain experience in pregnancy and labor. For this noninterventional trial with a short-term follow-up, pregnant women were divided into a trauma group (TG) with ACEs (n = 84) and a control group (CG) without ACEs (n = 107) according to the Childhood Trauma Questionnaire. Pain experience in pregnancy and labor was recorded by self-report and the German Pain Perception Scale. Pain sensitivity prepartum and postpartum was assessed by Quantitative Sensory Testing and a paradigm of conditioned pain modulation (CPM), using pressure pain thresholds (PPTs) and a cold pressor test. The TG showed higher affective and sensory scores for back pain and a more than doubled prevalence of preexisting back pain. Pelvic pain differences were nonsignificant. The TG also exhibited increased affective scores (1.71 ± 0.15 vs 1.33 ± 0.11), but not sensory scores for labor pain during spontaneous delivery. There were no group differences in prepartum pain sensitivity. While PPTs increased through delivery in the CG (clinical CPM), and this PPT change was positively correlated with the experimental CPM ( r = 0.55), this was not the case in the TG. The association of ACEs with increased peripartal pain affect and heightened risk for preexisting back pain suggest that such women deserve special care. The dissociation of impaired clinical CPM in women with ACEs and normal prepartum experimental CPM implies at least partly different mechanisms of these 2 manifestations of endogenous pain controls.

The DNA methylation landscape of the human oxytocin receptor gene (OXTR): data-driven clusters and their relation to gene expression and childhood adversity

The oxytocin receptor gene (OXTR) is of interest when investigating the effects of early adversity on DNA methylation. However, there is heterogeneity regarding the selection of the most promising CpG sites to target for analyses. The goal of this study was to determine functionally relevant clusters of CpG sites within the OXTR CpG island in 113 mother-infant dyads, with 58 of the mothers reporting childhood maltreatment (CM). OXTR DNA methylation was analyzed in peripheral/umbilical blood mononuclear cells. Different complexity reduction approaches were used to reduce the 188 CpG sites into clusters of co-methylated sites. Furthermore, associations between OXTR DNA methylation (cluster- and site-specific level) and OXTR gene expression and CM were investigated in mothers. Results showed that, first, CpG sections differed strongly regarding their statistical utility for research of individual differences in DNA methylation. Second, cluster analyses and Partial Least Squares (PLS) suggested two clusters consisting of intron1/exon2 and the protein-coding region of exon3, respectively, as most strongly associated with outcome measures. Third, cross-validated PLS regression explained 7% of variance in CM, with low cross-validated variance explained for the prediction of gene expression. Fourth, substantial mother-child correspondence was observed in correlation patterns within the identified clusters, but only modest correspondence outside these clusters. This study makes an important contribution to the mapping of the DNA methylation landscape of the OXTR CpG island by highlighting clusters of CpG sites that show desirable statistical properties and predictive value. We provide a Companion Web Application to facilitate the choice of CpG sites.

Emotional problems in young children during the SARS-CoV-2-pandemic and child attachment

Background

Restrictions imposed by national governments during SARS-CoV-2-pandemic have impacted the mental health of children around the world. Studies have already proven the importance of secure attachment acting as a protective factor in child development. Therefore, children with secure attachment have a higher chance of developing and using appropriate coping mechanisms.

Objective

The goal of this study was to explore the possible connection between the pandemic, as well as child attachment, and young children's emotional health. The general hypothesis assumes a lower rate of emotional problems among children with secure attachment and a higher rate of emotional problems among children with insecure-disorganized attachment, as well as an increase of these problems during the pandemic.

Method

The analysis included N = 129 mothers (M = 39.98 years) and their children (M = 5.19 years). Via an online survey, which was held at different time points during the pandemic, information on the children's emotional problems was retrieved. The survey used the Strengths and Difficulties Questionnaire (SDQ). Data regarding the quality of attachment was collected via the Strange Situations Test (SST). At this point the participating children were approximately 12 months old.

Results

The calculation of a mixed ANCOVA showed, that attachment quality had a significant influence on children's emotional problems [F(2, 121) = 4.01, p = .021]. The interaction effect between time and child attachment reached significance [F(3.45, 208.42) = 3.58, p = .011]. The calculation of an additional mixed ANCOVA showed, that the reported emotional problems of girls were higher than those of boys F(1, 118) = 4.56, p = .035).

Conclusions

Our study shows that there is an association between attachment security and emotional problems and the impact of the SARS-CoV-2 pandemic on the mental health of preschool children in Germany. The emotional problems of all children increased, especially the disorganized attached children had been reported as emotionally stressed in the first lockdown. The results indicate the need for preventive services (for children and parents) to promote and maintain stress coping skills in order to maintain children's mental health in times of crisis.

Investigating mitochondrial bioenergetics in peripheral blood mononuclear cells of women with childhood maltreatment from post-parturition period to one-year follow-up

BACKGROUND

Childhood maltreatment (CM) exerts various long-lasting psychological and biological changes in affected individuals, with inflammation being an interconnecting element. Besides chronic low-grade inflammation, CM might also affect the energy production of cells by altering the function and density of mitochondria, i.e. the body's main energy suppliers. Here, we compared mitochondrial respiration and density in intact peripheral blood mononuclear cells (PBMC), from women with and without CM between two time points, i.e. at the highly inflammatory phase within 1 week after parturition (t0) and again after 1 year (t2).

METHODS

CM exposure was assessed with the Childhood Trauma Questionnaire. Whole blood was collected from n = 52 healthy women within the study 'My Childhood - Your Childhood' at both time points to isolate and cryopreserve PBMC. Thawed PBMC were used to measure mitochondrial respiration and density by high-resolution respirometry followed by spectrophotometric analyses of citrate-synthase activity.

RESULTS

Over time, quantitative respiratory parameters increased, while qualitative flux control ratios decreased, independently of CM. Women with CM showed higher mitochondrial respiration and density at t0, but not at t2. We found significant CM group × time interaction effects for ATP-turnover-related respiration and mitochondrial density.

CONCLUSIONS

This is the first study to longitudinally investigate mitochondrial bioenergetics in postpartum women with and without CM. Our results indicate that CM-related mitochondrial alterations reflect allostatic load, probably due to higher inflammatory states during parturition, which normalize later. However, later inflammatory states might moderate the vulnerability for a second-hit on the level of mitochondrial bioenergetics, at least in immune cells.

Study protocol for a randomized controlled trial investigating the effect of online interpretation bias intervention on stress reactivity in the children of parents with depression: the CoCo study

BACKGROUND

Current preventive interventions for the children of parents with depression demonstrate modest effects on depression incidence. This may be because existing interventions tend to comprise general psychotherapeutic tools, rather than targeting the specific mechanisms underlying familial transmission. Improved theoretical models of familial transmission could enhance the development of targeted interventions. Although existing models assume that cognitive and biological vulnerability factors influence one another, the precise mechanisms are unknown. This project is the first to experimentally test whether negative interpretation bias has an impact on cortisol response in children of parents with depression. This study protocol reports a randomised controlled trial of an interpretation bias intervention which aims to shift participants' interpretation bias in a more positive direction and thereby alter their stress response.

METHODS

Children aged 10-14 years who have i) one parent with a current or previous depression diagnosis, with at least one episode occurring during the child's lifetime and ii) do not have a current or previous psychiatric diagnosis themselves, will be assigned to one of two conditions: an interpretation bias intervention (n = 50) or a structurally similar placebo intervention (n = 50). The interpretation bias intervention consists of a short lab-based cognitive reappraisal of interpretations training, a four-week app-based Cognitive Bias Modification of Interpretations intervention and interpretation bias specific if-then plans. Interpretation bias will be assessed before and after the intervention using the Scrambled Sentences Task. The effect of the intervention on participants' stress response will be assessed by salivary cortisol collected at five different time points: from immediately before until 45 min after administering the Trier Social Stressor Test for Children. Stress reactivity will be measured via baseline to peak cortisol and stress recovery will be measured via the 45 min cortisol marker. We hypothesise that children who participate in the interpretation bias intervention will display a positive shift in interpretation bias and this, in turn, will alter their stress response. Children who receive the placebo intervention are expected to show a smaller positive shift in interpretation bias and stress reactivity.

DISCUSSION

The findings of the present study will contribute to models of familial depression transmission as well as informing preventive interventions. If training a more positive interpretation bias subsequently alters participants' stress response, then incorporating such tools may increase the efficacy of existing preventive interventions.

TRIAL REGISTRATION

Deutsches Register Klinischer Studien DRKS00028842. Registered August 19, 2022.

Individuals with and without child maltreatment experiences are evaluated similarly and do not differ in facial affect display at zero- and first-acquaintance

BACKGROUND

Individuals with a history of child maltreatment (CM) are more often disliked, rejected and victimized compared to individuals without such experiences. However, contributing factors for these negative evaluations are so far unknown.

OBJECTIVE

Based on previous research on adults with borderline personality disorder (BPD), this preregistered study assessed whether negative evaluations of adults with CM experiences, in comparison to unexposed controls, are mediated by more negative and less positive facial affect display. Additionally, it was explored whether level of depression, severity of CM, social anxiety, social support, and rejection sensitivity have an influence on ratings.

METHODS

Forty adults with CM experiences (CM +) and 40 non-maltreated (CM-) adults were filmed for measurement of affect display and rated in likeability, trustworthiness, and cooperativeness by 100 independent raters after zero-acquaintance (no interaction) and 17 raters after first-acquaintance (short conversation).

RESULTS

The CM + and the CM- group were neither evaluated significantly different, nor showed significant differences in affect display. Contrasting previous research, higher levels of BPD symptoms predicted higher likeability ratings (p = .046), while complex post-traumatic stress disorder symptoms had no influence on ratings.

CONCLUSIONS

The non-significant effects could be attributed to an insufficient number of participants, as our sample size allowed us to detect effects with medium effect sizes (f2 = .16 for evaluation; f2 = .17 for affect display) with a power of .95. Moreover, aspects such as the presence of mental disorders (e.g., BPD or post-traumatic stress disorder), might have a stronger impact than CM per se. Future research should thus further explore conditions (e.g., presence of specific mental disorders) under which individuals with CM are affected by negative evaluations as well as factors that contribute to negative evaluations and problems in social relationships.

SARS-CoV-2 pandemic as a catalyst? Development of emotional problems of preschool children of mothers with childhood maltreatment experiences in the course of the pandemic-a longitudinal analysis

Background

SARS-CoV-2 pandemic have posed great challenges for all families and children. Health risks and fears associated with SARS-CoV-2 negatively affect the parental mental health and perceived stress, which in turn influence parental coping and thereby impairs the mental health and well-being of their children. Additional risk factors within the parents, such as maternal childhood maltreatment (CM) experiences, may increase the risk of children to develop emotional problems during the pandemic.

Objective

The purpose of this longitudinal study is to determine whether preschool children of mothers with CM are at higher risk of developing emotional problems during the pandemic than preschool children of mothers without CM.

Method

74 mothers from a birth cohort examining pathways to resilience or vulnerability in the transgenerational transmission of CM, provided information on emotional problems of their children (aged 3-7 years) at two measurement time points (t1: May 2020, t2: March 2021) as part of an online "SARS-CoV-2 pandemic" survey. In addition, parents were asked for a retrospective assessment of their children's emotional problems before the pandemic at time t1. Children's emotional problems were assessed using the "emotional problems" scale of the German version of the Strengths and Difficulties Questionnaire (SDQ) and linked to previously collected data on mothers' childhood maltreatment experiences, which were collected using the German short version of the Trauma in Childhood Questionnaire (CTQ).

Results

Our analyses showed that children's emotional problems increased significantly over the SARS-CoV-2 pandemic [F(1.86, 116.88) = 3.72, p = 0.030 η ² = 0.06] and were rated significantly higher in the group of children of mothers with CM, than in the group of mothers without CM [F(1, 63) = 126.06, p < 0.001 η ²= 0.67]. Furthermore children's emotional problems of mothers with CM increased significantly more and reached a clinically significant value during the pandemic than for children of mothers without CM [F(1.86, 116.88) = 8.89, p < 0.001, η ²= 0.12].

Conclusions

Children of mothers with CM appear to be at increased risk of developing emotional problems during the pandemic. CM therefore needs to be considered as an additional risk factor in the impact of the pandemic on children.

Sources of social support for postpartum women with a history of childhood maltreatment: Consequences for perceived stress and general mental health in the first year after birth

BACKGROUND

Women with a history of childhood maltreatment (CM) experience the postpartum period as particularly stressful and may benefit less from social support, implicating a higher risk for mental health problems and higher stress levels in mothers with CM.

OBJECTIVE

Thus, we investigated the complex relationship of CM and social support provided by different sources (intimate partner, parents, parents-in-law, friends) in predicting stress perception and mental health over the course of the first year postpartum.

PARTICIPANTS

In N = 295 postpartum women we assessed CM experiences, stress perception, perceived social support and general mental health 3 and 12 months postpartum.

METHOD

Linear mixed effect models were used to examine the course of social support over the first year postpartum and path analyses were used to investigate mediation and moderation effects.

RESULTS

We found that CM was linked to lower levels of perceived social support, accounted for more mental health problems, and amplified the negative association between perceived stress and maternal mental health. Most importantly, we showed that only partner support was beneficial for maternal mental health, and this association was mediated by reductions in perceived stress.

CONCLUSION

CM as a major risk factor for mental health impairs the stress resilience of affected postpartum women. Extending previous research, our results reveal that the source of postpartum social support determines its benefits for maternal health. Our findings emphasize the need of at-risk mothers to be provided with additional sources of support to cope with daily practical, organizational and emotional challenges.

Negative effects of the SARS-CoV-2 pandemic: The interlinking of maternal attachment representation, coping strategies, parental behavior, and the child's mental health

For more than two years, young families have been confronted with a large number of restrictions and following burdens as a result of the SARS-CoV-2 pandemic. In fact, it became evident, that the current circumstances are particularly stressful for child's mental health. With regard to the child's mental health in times of a pandemic, additional factors within the family, such as maternal attachment representations as well as coping strategies and parental behavior, may play an important role. This study aims to investigate the interplay of maternal attachment representation, coping strategies, parental behavior and child's mental health during the SARS-CoV-2 pandemic. In this longitudinal study, previously collected data regarding maternal attachment representation and newly attained data from the SARS-CoV-2-pandemic-assesment (lack of coping strategies, children's mental health and parental behavior) were combined and analyzed. The data were collected in an online survey since beginning of the pandemic, including N = 73 mothers. A path model was calculated in form of multiple linear regression. A path model could be confirmed, which indicates that insecure maternal attachment representation predicts lack of coping strategies during the pandemic [b = 5.55, 95%-CI = (4.51; 6.55), p = 0.001]. Furthermore, lack of coping strategies predicts harmful parental behavior during the pandemic [b = -0.77, 95%-CI = (-1.27; -0.21), p = 0.007], which in turn predicts children's mental health problems, namely behavioral problems [b = -0.08, 95%-CI = (-0.14; -0.01), p = 0.027]. Presence of short-time work and decrease in income since beginning of the pandemic were used as control variables. This means that since the pandemic mothers with insecure attachment representation have an increased risk of having only a few coping mechanisms available, leading to harmful parental behaviors and ultimately affecting the mental health of their children. In conclusion, the pandemic could potentially have a particularly negative influence on mothers with an insecure attachment type and therefore on their children. Therefore, tailored interventions for families should be offered that both focus on the different types of mental health problems in children and support parents in their coping skills.

The Maltreatment–Aggression Link among Prosecuted Males: What about Psychopathy?

Criminal offenders constitute a high-risk sample regarding experiences of childhood maltreatment and engagement in severe aggression. Moreover, psychopathic traits are more common in samples of offenders than non-offenders. Although research has underlined the relationship between childhood maltreatment and adult aggression, the influence of psychopathy on this link is still unclear. We examined the dynamics of maltreatment, aggression, and psychopathy in a mixed sample of 239 male violent, sexual, and other offenders using latent factor structural equation modeling. We found a consistent positive association of maltreatment with aggression. Psychopathy did not mediate this relation. Maltreatment was not associated with psychopathy, although psychopathy had a positive effect on aggressive behavior. These dynamics appeared similar for violent, sexual, and other offenders. However, latent variables were constructed somewhat differently depending on the offender status. For instance, sexual abuse appeared to be of specific importance in sexual offenders. Violent offenders showed high rates of psychopathy compared to sexual and other offenders. The current findings may inspire future research to focus more closely on the different subtypes of psychopathy when examining its role in the prediction of aggression based on childhood maltreatment. Moreover, childhood maltreatment must not be neglected in treatment and prevention approaches aimed at reducing the risk of aggressive behavior.

Identifying Risk and Resilience Factors in the Intergenerational Cycle of Maltreatment: Results From the TRANS-GEN Study Investigating the Effects of Maternal Attachment and Social Support on Child Attachment and Cardiovascular Stress Physiology

Introduction

Childhood maltreatment (CM) is a developmental risk factor and can negatively influence later psychological functioning, health, and development in the next generation. A comprehensive understanding of the biopsychosocial underpinnings of CM transmission would allow to identify protective factors that could disrupt the intergenerational CM risk cycle. This study examined the consequences of maternal CM and the effects of psychosocial and biological resilience factors on child attachment and stress-regulatory development using a prospective trans-disciplinary approach.

Methods

Mother-child dyads (N = 158) participated shortly after parturition (t 0), after 3 months (t 1), and 12 months later (t 2). Mothers' CM experiences were assessed at t 0, attachment representation at t 1 and psychosocial risk and social support were assessed at t 1 and t 2. At t 2, dyads participated in the Strange Situation Procedure (SSP). Children's attachmen status were classified as organized vs. disorganized, including their level of disorganized behavior, and heart rate (HR) and respiratory sinus arrhythmia (RSA) were recorded as stress response measures of the autonomic nervous system. Maternal caregiving during SSP was assessed using the AMBIANCE scale. Child's single nucleotide polymorphisms rs2254298 within the oxytocin receptor (OXTR) and rs2740210 of the oxytocin gene (OXT) were genotyped using DNA isolated from cord blood.

Results

Maternal CM experiences (CM+) were significantly associated with an unresolved attachment status, higher perceived stress and more psychological symptoms. These negative effects of CM were attenuated by social support. As expected, maternal unresolved attachment and child disorganized attachment were significantly associated. Maternal caregiving did not mediate the relationship between maternal and child attachment but influenced children's HR and RSA response and disorganized behavior. Moreover, the rs2254298 genotype of the OXTR gene moderated the stress response of children from mothers with CM. Children carrying the rs2740210 risk allele of the OXT gene showed more disorganized behavior independent from maternal CM experiences.

Conclusion

We replicated and extended existing CM and attachment models by co-examining maternal attachment, social support, and child genetic susceptibility on child attachment and cardiovascular stress regulation. The findings contribute to an extended understanding of risk and resilience factors and enable professionals to target adequate services to parents and children at risk.

Experimental Induction of Emotional and Sexual Intimacy: Exploring the Validity of the German Fast Friends Procedure in Individuals with and without Childhood Maltreatment

The Fast Friends Procedure (FFP) is a widely used experimental paradigm to induce emotional intimacy. Besides exploring the validity of a German translation of the paradigm (n = 46), we developed an extension of the FFP that induces sexual intimacy and assessed heart rate, high-frequency heart rate variability, and electrodermal activity responses to the FFP and its extension. Furthermore, we examined its applicability to individuals with childhood maltreatment (n = 56), who frequently suffer from intimacy-related difficulties. Intimacy, positive affect, liking, and attraction increased during the FFP and partly during the sexual intimacy extension in both study groups. Moreover, both groups showed physiological responses consistent with positive social interactions. The use of the German FFP and its sexual intimacy extension can thus be recommended for research in the general population and in individuals with childhood maltreatment, although more studies are needed to further validate the paradigms.

Long-Term Consequences of Childhood Maltreatment Among Postpartum Women-Prevalence of Psychosocial Risk Factors for Child Welfare: An Independent Replication Study

Introduction

As an especially burdensome experience, childhood maltreatment (CM) can have lifelong consequences on the mental health and wellbeing of an individual well into adulthood. We have previously reported that CM constitutes a central risk factor not only for the development of mental problems, but also for facing additional psychosocial risks, endangering healthy development of mother and offspring throughout life (e.g., financial problems, intimate partner violence, substance use). This study was designed to replicate these findings in a larger, independent study cohort.

Method

In this cross-sectional replication study an independent cohort of 533 healthy postpartum women was interviewed within seven days after parturition. CM experiences were assessed retrospectively using the German version of the Childhood Trauma Questionnaire (CTQ) and current psychosocial risk factors for child welfare were assessed using the Konstanzer Index (KINDEX).

Results

Of all women, 16.1% experienced emotional and 10.1% physical abuse, 28.5% emotional neglect, 9.4% physical neglect and 10.3% experienced sexual abuse. Most importantly, the higher the CM load the more psychosocial stressors existed in women's life. In Particular, women with higher CM load had a higher risk for mental health problems, intimate partner violence, financial problems, and a higher postnatal stress load.

Conclusions

In an independent sample, this study replicated the previous findings that CM and psychosocial risk factors for child welfare were strongly associated in a dose-response manner. Our results emphasize the higher vulnerability of women with a CM history in the postpartum period. To avoid negative consequences for mother and child, a regular and evidence-based screening for CM and psychosocial risk factors during pregnancy and puerperium is needed to identify at-risk mothers early during pregnancy and to provide appropriate support. Hence, our findings highlight the mandatory requirement for an interdisciplinary collaboration of gynecological practices, hospitals and midwifes, along with psychologists and psychotherapists and child and youth welfare services.

Experiences of maltreatment in childhood and attention to facial emotions in healthy young women

Using reaction-time measures, research on the relationship between childhood maltreatment and biased attention to emotional stimuli in adults has obtained inconsistent results. To help clarify this issue, we conducted an eye-tracking study on the link between childhood maltreatment and allocation of attention to facial emotions analyzing gaze behavior in addition to manual reactions. In contrast to prior investigations, we excluded individuals with tendencies to minimize maltreatment experiences from analyses. Gaze behavior and manual response time of 58 healthy women were examined in a dot-probe task in which pairs of emotional (happy, sad, or disgusted) and neutral faces were presented. In our analyses, participants’ affectivity, level of alexithymia, and intelligence were controlled. Entry time and dwell time on facial expressions were used as indicators of attention allocation. Childhood maltreatment showed no effect on response latencies but was associated with shorter entry times on emotional faces and shorter dwell time on disgusted faces. Experiences of childhood maltreatment seem to be linked to an increased early vigilance to emotional social signals and to an attentional avoidance of hostile facial expressions at a later stage of perception. The present results suggest a vigilance-avoidance pattern of attention allocation associated with childhood maltreatment.

Don't get too close to me: depressed and non-depressed survivors of child maltreatment prefer larger comfortable interpersonal distances towards strangers

BACKGROUND

Childhood maltreatment (CM) is frequently linked to interpersonal problems such as difficulties in social relationships, loneliness, and isolation. These difficulties might partly stem from troubles regulating comfortable interpersonal distance (CIPD).

OBJECTIVE

We experimentally investigated whether CM manifests in larger CIPD and whether all subtypes of CM (i.e., physical, emotional, or sexual abuse and physical or emotional neglect) affect CIPD.

METHODS

Using the stop-distance method (i.e. a team member approached participants until the latter indicated discomfort), we assessed CIPD in 84 adults with a self-reported history of CM (24 with depressive symptoms) and 57 adult controls without a history of CM (without depressive symptoms).

RESULTS

Adults with CM showed a larger CIPD (Mdn = 86 cm) than controls (Mdn = 68 cm), and CIPD was largest for those with CM combined with current depressive symptoms (Mdn = 145 cm) (p's < .047). In the latter group, all subtypes of CM were associated with a larger CIPD compared to controls (p's < .045). In the CM group without depressive symptoms, only those with emotional abuse (p = .040) showed a larger CIPD than controls.

CONCLUSIONS

These results add to findings of differential socio-emotional long-term consequences of CM, depending upon the subtype of CM. Future research should explore whether a larger CIPD has a negative impact on social functioning in individuals exposed to CM, particularly in those with depressive symptoms.

HIGHLIGHTS

Adults with child maltreatment (CM) prefer larger physical distances.• This effect is more pronounced in those with CM and depressive symptoms.• Troubled regulation of physical distance might contribute to interpersonal problems.

A history of childhood maltreatment is associated with altered DNA methylation levels of DNA methyltransferase 1 in maternal but not neonatal mononuclear immune cells

Childhood maltreatment (CM) is associated with alterations in DNA methylation (DNAm) especially in stress response genes. Due to the higher risk of overall health complications of individuals with a parental history of CM, intergenerational transmission of CM-associated DNAm changes has been investigated but remains unclear. In this study, we investigated if different severities of CM have any influence on the DNAm of DNA methyltransferase 1 (DNMT1), an important enzyme of the DNAm machinery, in immune and buccal cells of mother-newborn dyads. DNAm was assessed by mass spectrometry using immune cell DNA from mothers (N = 117) and their newborns (N = 113), and buccal cell DNA of mother-newborn dyads (N = 68 each). Mothers with a history of CM had lower mean methylation of DNMT1 in immune cells compared to the mothers without a CM history. CM status only influenced maternal DNMT1 gene expression when at least moderate CM was reported. Buccal cell DNAm was not associated with CM status. Maternal history of CM was not linked to any alterations in DNMT1 mean DNAm in any of the cell types studied in newborns. We conclude that the CM-associated alterations in DNMT1 DNAm might point to allostatic load and can be physiologically relevant, especially in individuals with more severe CM experiences, resulting in an activated DNA methylation machinery that might influence stress response genes. Our lack of significant findings in buccal cells shows the tissue-specific effects of CM on DNAm. In our sample with low to moderate maternal CM history, there was no intergenerational transmission of DNMT1 DNAm in newborns.

Atypical maternal interaction is associated with elevated levels of hair cortisol in children

The quality of maternal caregiving is an important factor in the healthy development of a child. One consequence of prolonged insensitive and atypical maternal interaction behavior (e.g., withdrawing from interactions with the child and role-reversal, i.e., the takeover of the parental role or parts of it by the child) in mother-child-dyads can cause alteration of the child's stress response system. Higher salivary cortisol concentrations were reported in infants and toddlers directly after negative interactions with their parents. However, no study to date has examined the association between atypical maternal interaction behavior and hair cortisol concentrations (HCC) in infants. Here, we studied the association of maternal interaction behavior with HCC of the child. Mother-child dyads (N = 112) participated in the longitudinal study My Childhood-Your Childhood. The AMBIANCE scale and its subscales were used to assess atypical maternal interaction behavior during the Strange Situation Procedure. Chronic stress levels in the child were assessed by HCC of 3 cm hair strands at the age of 12 months. Maternal educational level (operationalized in highest education level) served as a control variable. Robust multiple linear regression analyses revealed that role/boundary confusion was associated with HCC, i.e., the higher atypical interaction behavior of the mother the higher the HCC in the children. By measuring hair cortisol in this study, it is possible to determine the average long-term activity of the child's stress response system.Thus, atypical maternal interaction behavior could be a risk factor for persistent stress in children, contributing to a higher risk for negative health outcomes in later life. The results of this study highlight the importance of early intervention programs that focus on the relationship between mother and child.

Misshandlungs- und Vernachlässigungserfahrungen in der Kindheit: Ein Risikofaktor für die soziale Teilhabe ehemals außerfamiliär platzierter junger Erwachsener

Zusammenfassung. Theoretischer Hintergrund: Eine Reihe von Studien zeigen soziale Folgen von Misshandlung und Vernachlässigung in der Kindheit im weiteren Lebenslauf. Fragestellung: Diese Studie zielt darauf ab, die langfristigen Auswirkungen von Misshandlungs- und Vernachlässigungserfahrungen auf die soziale Teilhabe in einer Stichprobe von ehemals fremdplatzierten jungen Erwachsenen in der Schweiz zu untersuchen. Methode: Im Rahmen der Studie wurden 218 ehemals fremdplatzierte junge Erwachsene ( MAlter=26.1, 32.6 % weiblich) mit einer psychometrischen Testbatterie befragt. Dabei wurden Misshandlungserfahrungen in der Kindheit erfasst sowie die soziale Teilhabe bezüglich psychischer Gesundheit, Legalbewährung, sozio-ökonomische Lage und Beziehungen untersucht. Ergebnisse: Die Ergebnisse zeigen die hohe Prävalenz und negativen Folgen von kumulierten Misshandlungserfahrungen bei ehemals fremdplatzierten jungen Menschen. Eine höhere Anzahl von Misshandlungserfahrungen ging mit signifikant mehr Problemen in gesundheitlichen, finanziellen und sozialen Lebensbereichen einher. Diskussion und Schlussfolgerung: Die gravierenden Folgen von Misshandlungserfahrungen in der Kindheit unterstreichen die Bedeutung der Prävention und frühzeitigen Intervention. Sie zeigen aber auch, dass viele schwer betroffene junge Menschen neben therapeutischen auch konkrete und lebensweltorientierte Hilfen benötigen, um ihre Entwicklungsaufgaben adäquat zu bewältigen und erfolgreich an der Gesellschaft teilzuhaben.

Maternal attachment representation, the risk of increased depressive symptoms and the influence on children's mental health during the SARS-CoV-2-pandemic

The social distancing measures and the related closure of education institutions have confronted young families, in particular, with various challenges. Additional risk factors such as an insecure or even unresolved maternal attachment representation may affect mental health of mothers and their children in times of increased stress such as during the ongoing pandemic. We aimed to analyze the interplay between maternal attachment representation and mother's and children's mental health before and during the SARS-CoV-2-pandemic. 91 mothers completed a "SARS-CoV-2 pandemic survey" examining the pandemic-related stress of their families including their own depressive symptomology and their children's mental health. Our mediation analysis demonstrates that the mothers' depressive symptomology significantly and fully mediated the relationship between maternal attachment representations and children's mental health during the pandemic. In contrast, the indirect effect of the maternal attachment representation on children's mental health before the pandemic through the depressive symptoms experienced by the mothers before the pandemic did not reach significance alongside the total and direct effect. The quality of the maternal attachment representation, promoted by childhood maltreatment, seems to be one relevant risk factor for the mothers' and children's mental health during a stressful time like a pandemic. The risk for mothers to develop depressive symptoms in times of a pandemic is significantly influenced by their current representation of previous attachment experiences. In addition, the mental well-being of mothers showed a considerable influence on the children's mental health during a pandemic. The results underline the necessity to consider unique needs of family members and to offer specific support in the current crisis focusing on attachment issues.

Two of a Kind? Mapping the Psychopathological Space between Obesity with and without Binge Eating Disorder

(1) Background: Obesity (OB) is a frequent co-morbidity in Binge Eating Disorder (BED), suggesting that both conditions share phenotypical features along a spectrum of eating-related behaviors. However, the evidence is inconsistent. This study aimed to comprehensively compare OB-BED patients against OB individuals without BED and healthy, normal-weight controls in general psychopathological features, eating-related phenotypes, and early life experiences. (2) Methods: OB-BED patients (n = 37), OB individuals (n = 50), and controls (n = 44) completed a battery of standardized questionnaires. Responses were analyzed using univariate comparisons and dimensionality reduction techniques (linear discriminant analysis, LDA). (3) Results: OB-BED patients showed the highest scores across assessments (e.g., depression, emotional and stress eating, food cravings, food addiction). OB-BED patients did not differ from OB individuals in terms of childhood traumatization or attachment styles. The LDA revealed a two-dimensional solution that distinguished controls from OB and OB-BED in terms of increasing problematic eating behaviors and attitudes, depression, and childhood adversities, as well as OB-BED from OB groups in terms of emotional eating tendencies and self-regulation impairments. (4) Conclusions: Findings support the idea of a shared spectrum of eating-related disorders but also highlight important distinctions relevant to identifying and treating BED in obese patients.

The association of childhood maltreatment, somatization and health-related quality of life in adult age: Results from a population-based cohort study

BACKGROUND

Population-based data regarding the relationship between childhood maltreatment (CM), somatization and health-related quality of life (HRQoL) in adults are limited.

OBJECTIVE

To investigate the association of CM history (emotional and physical abuse and neglect, sexual abuse) with somatization and with physical and mental HRQoL in adults.

PARTICIPANTS AND SETTING

Data from 2305 participants from the population-based Study of Health in Pomerania were analyzed (aged 20 to 80 years).

METHODS

We applied the Childhood Trauma Questionnaire. Somatoform disorders were diagnosed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) in a clinical interview. Using a self-administered questionnaire, we assessed the number of somatic symptoms and physical and mental HRQoL.

RESULTS

Sexual abuse was related to the diagnosis of a somatoform disorder (odds ratio [OR] 1.87; 95% confidence interval [CI] 1.29, 2.69). Emotional abuse and physical neglect were associated with the number of somatic symptoms (B = 0.93; 95% CI 0.42, 1.45 and B = 0.50; 95% CI 0.17, 1.83, respectively). Sexual abuse and physical neglect were related to lower physical HRQoL (B = -1.87; 95% CI -3.17, -0.57 and B = -1.26; 95% CI -2.02, -0.49, respectively), and emotional abuse was associated with lower mental HRQoL (B = -2.83; 95% CI -4.03, -1.62).

CONCLUSIONS

A history of CM, in particular sexual abuse, emotional abuse and physical neglect, is a risk factor for somatization and impaired HRQoL in adults. Individuals with somatic symptoms are an important target group for CM screening. Addressing HRQoL might be significant in psychotherapy for individuals with CM experience.

Associations between childhood maltreatment and DNA methylation of the oxytocin receptor gene in immune cells of mother-newborn dyads

The neuropeptide oxytocin (OXT) and its receptor (OXTR) modulate interpersonal relationships, particularly mother-child interactions. DNA methylation (DNAm) changes of the OXTR gene were observed in individuals who experienced Childhood Maltreatment (CM). A modulatory role of single nucleotide polymorphisms (SNP) within OXTR in association with CM on the regulation of OXTR was also postulated. Whether these CM-induced epigenetic alterations are biologically inherited by the offspring remains unknown. We thus investigated possible intergenerational effects of maternal CM exposure on DNAm and OXTR gene expression, additionally accounting for the possible influence of three SNP: rs53576 and rs2254298 (OXTR gene), and rs2740210 (OXT gene). We used the Childhood Trauma Questionnaire to classify mothers into individuals with (CM+) or without CM (CM-). Maternal peripheral immune cells were isolated from venous blood (N = 117) and fetal immune cells from the umbilical cord (N = 113) after parturition. DNA methylation was assessed using MassARRAY. Taqman assays were performed for genotyping and gene expression analyses. Among mothers, CM was not associated with OXTR mean methylation or gene expression. However, four CpG sites showed different methylation levels in CM- compared to CM+. In mothers, the OXTR rs53576 and OXT rs2740210 allelic variations interacted with CM load on the OXTR mean methylation. Maternal and newborns' mean methylation of OXTR were positively associated within CM- dyads, but not in CM+ dyads. We show gene×environment interactions on the epigenetic regulation of the oxytocinergic signaling and show the intergenerational comparability of the OXTR DNAm might be altered in infants of CM+ mothers.

Hair-based biomarkers in women with major depressive disorder: Glucocorticoids, endocannabinoids, N-acylethanolamines, and testosterone

Background

Stress-related alterations in the regulation of several endocrine systems, including the hypothalamus-pituitary-adrenal (HPA) and -gonadal (HPG) axes and the endocannabinoid system are proposed to be involved in the etiology of major depressive disorder (MDD). Therefore, this study examines whether altered concentrations of glucocorticoids, testosterone, endocannabinoids, and related N-acylethanolamines accumulated in hair are present in MDD.

Methods

Female participants (range: 19–59, Mdn = 30.5 years) were recruited, including n = 21 with a current MDD episode and n = 27 nondepressed controls without any current mental disorder. Weight-standardized samples of 3 cm hair segments were analyzed which equals to three months of retrospectively assessed biomarkers in hair. Concentrations of cortisol, cortisone, testosterone, endocannabinoids (i.e., anandamide [AEA], 2-arachidonylglycerol [2-AG]), and selected N-acylethanolamines (i.e., stearoylethanolamide [SEA], oleoylethanolamide [OEA], palmitoylethanolamide [PEA]) were measured using mass spectrometry.

Results

Female MDD patients exhibited lower cortisol and cortisone levels in hair than nondepressed controls, whereas the hair concentrations of endocannabinoids, N-acylethanolamines, and testosterone did not differ between the groups.

Conclusions

Our results add to the heterogeneous body of findings on alterations in hair-stored glucocorticoids and endocannabinoids in MDD. As in previous studies, there was no evidence of altered testosterone concentrations in the hair of MDD patients. Larger and longitudinal studies are needed to comprehensively explore the overall picture of endocrine alterations in MDD.

•

Analysis of hair-based markers of endocrine alterations in female MDD outpatients.

•

Lower hair cortisol and cortisone concentrations in mild to moderately severe MDD.

•

No differences in endocannabinoid, N-acylethanolamine, and testosterone hair levels.

•

Testosterone and cortisone levels were linked to higher stress/trauma exposure.

Mothers' daily perceived stress influences their children's mental health during SARS-CoV-2-pandemic-an online survey

BACKGROUND

The current situation caused by the SARS-CoV-2-pandemic is associated with serious losses for everyone and has been affecting social life, politics, the economy and the media worldwide. Preventive isolation and social distancing strategies have confronted families with a large number of different challenges. The current epidemic and quarantine restrictions have a verifiable influence on the emotional and social development of children and adolescents. During this ongoing situation children of parents, who already were mentally stressed, seem particularly at risk.

OBJECTIVE

We aimed to assess the role of maternal daily perceived stress on children's mental health during the SARS-CoV-2-pandemic.

METHODS

An online "SARS-CoV-2-pandemic survey" was developed to assess children's mental health since the beginning of the SARS-CoV-2 pandemic. To describe maternal perceived everyday stress, data from a longitudinal survey was utilized. Our survey includes elements and versions of the Childhood Trauma Questionnaire, the Strengths and Difficulties Questionnaire and the Perceived Stress Scale. We furthermore collected socio-demographic data. Due to our limited dependent variables we applied Tobit models for estimation.

RESULTS

We found a positive and significant effect of the maternal perceived everyday stress on children's emotional problems during the pandemic. Furthermore, results provide empirical evidence for an increase of the children's hyperactivity level dependent on the mother's perceived stress before the SARS-COV-2 crisis. We could not find significant effects for the relationship between mother's perceived everyday stress and the children's behavioral problems.

CONCLUSIONS

Analyses illustrate the effects on children's mental distress during everyday life in the SARS-CoV-2 pandemic. Future research needs to identify influencing factors with regard to political, economic and social restrictions, in order to prevent children's mental health problems.

Structural Equation Modeling of a Global Stress Index in Healthy Soldiers

Accumulation of stress is a prognostic trigger for cardiovascular disease. Classical scores for cardiovascular risk estimation typically do not consider psychosocial stress. The aim of this study was to develop a global stress index (GSI) from healthy participants by combining individual measures of acute and chronic stress from childhood to adult life. One-hundred and ninety-two female and male soldiers completed the Perceived Stress Scale (PSS4), Trier Inventory for Chronic Stress (TICS), Hospital Anxiety and Depression Scale (HADS), Childhood Trauma Questionnaire (CTQ), Posttraumatic Diagnostic Scale Checklist (PDS), and the Deployment Risk and Resilience Inventory (DRRI-2). The underlying structure for the GSI was examined through structural equation modeling. The final hierarchical multilevel model revealed fair fit by taking modification indices into account. The highest order had a g-factor called the GSI. On a second level the latent variables stress, HADS and CTQ were directly loading on the GSI. A third level with the six CTQ subscales was implemented. On the lowest hierarchical level all manifest variables and the DRRI-2/PDS sum scores were located. The presented GSI serves as a valuable and individual stress profile for soldiers and could potentially complement classical cardiovascular risk factors.

Childhood maltreatment is associated with distrust and negatively biased emotion processing

BACKGROUND

Cognitive models of post-traumatic stress disorder (PTSD) propose that trauma entails cognitive alterations of increased distrust and perceived threat from others. We tested whether these predictions also hold in individuals with varying levels of childhood maltreatment (CM), which is much more prevalent than traumatic events as required for a PTSD diagnosis. We hypothesized that higher levels of CM would entail greater distrust and perceived threat, and that distrust would be more change-resistant in participants with more CM.

METHODS

The study was pre-registered; the pre-registration protocol, data, and code are available at https://osf.io/pufy2/ . We recruited 549 participants (M age = 29.2, 74.5% women) for an online study via websites related to CM, Borderline Personality Disorder, and via snowball method on social media. Participants self-reported their level of CM on the childhood trauma questionnaire (CTQ). Next, they played two rounds of a hypothetical distrust game, indicating the perceived trustworthiness of avatars by way of estimating expected monetary deductions from them (i.e. higher amounts indicating greater distrust). After the first round, we provided participants with the feedback that very little money was taken from them. We expected those with more CM to be less responsive to the positive feedback and to adapt their estimates less in the subsequent round. Following the distrust game, participants completed an emotion rating task in which they rated the emotional expressions of 60 faces on a scale from 'very negative' to 'very positive'. We included angry, fearful, and happy facial expressions, and expected individuals with higher CM levels to provide more negative ratings. We conducted linear mixed effects models with random intercepts for raters and stimuli (crossed), and modelled random slopes for all within-person predictors.

RESULTS

As hypothesized, higher levels of CM were associated with higher levels of distrust and a weaker decrease in distrust following positive feedback. Further supporting our hypotheses, individuals with higher levels of CM showed more negatively shifted emotion ratings.

CONCLUSIONS

Increased distrust and perceived interpersonal threat following trauma, as proposed in cognitive models of PTSD, likely also apply to individuals with CM, following a dose-response relationship. We discuss clinical implications of considering any level of CM as a potentially relevant treatment-factor, even when a trauma-related disorder is not the main diagnosis, and propose future research avenues.

Characterization of the effects of age and childhood maltreatment on ELOVL2 DNA methylation

DNA methylation of the elongation of very long chain fatty acids protein 2 (ELOVL2) was suggested as a biomarker of biological aging, while childhood maltreatment (CM) has been associated with accelerated biological aging. We investigated the association of age and CM experiences with ELOVL2 methylation in peripheral blood mononuclear cells (PBMC). Furthermore, we investigated ELOVL2 methylation in the umbilical cord blood mononuclear cells (UBMC) of newborns of mothers with and without CM. PBMC and UBMC were isolated from 113 mother-newborn dyads and genomic DNA was extracted. Mothers with and without CM experiences were recruited directly postpartum. Mass array spectrometry and pyrosequencing were used for methylation analyses of ELOVL2 intron 1, and exon 1 and 5' end, respectively. ELOVL2 5' end and intron 1 methylation increased with higher age but were not associated with CM experiences. On the contrary, overall ELOVL2 exon 1 methylation increased with higher CM, but these changes were minimal and did not increase with age. Maternal CM experiences and neonatal methylation of ELOVL2 intron 1 or exon 1 were not significantly correlated. Our study suggests region-specific effects of chronological age and experienced CM on ELOVL2 methylation and shows that the epigenetic biomarker for age within the ELOVL2 gene does not show accelerated biological aging years after CM exposure.

Childhood Maltreatment in Individuals With Schizophrenia Spectrum Disorders: The Impact of Cut-Off Scores on Prevalence Rates

Childhood maltreatment is a common phenomenon in various psychiatric disorders. Accordingly, patients with disorders from the schizophrenia spectrum (SSD) appear to have high prevalence rates of childhood maltreatment. However, the interpretation and comparability of prevalence rates is impeded by methodological weaknesses and differences such as measures and thresholds used in previous studies. Therefore, we aimed to provide and compare systematically captured data on prevalence rates of all common types of childhood maltreatment in patients with SSD using a standardized and well-established questionnaire and the most frequently used thresholds. The sample consisted of 48 patients with a primary diagnosis of SSD. 58.3-77.1% of the sample experienced at least one type of childhood maltreatment. Prevalence rates for physical abuse, physical neglect, and emotional abuse were dependent on the thresholds used, while equal rates were found for emotional neglect and sexual abuse. Physical neglect (46-67%), and emotional abuse (44-48%) were most commonly reported, followed by emotional neglect (38%), physical abuse (25-38%), and sexual abuse (25%). Additionally, high levels of peer victimization were reported by SSD patients. It appears that childhood maltreatment is a common phenomenon in SSD, even though methodological details, especially cut-off scores, have a substantial impact on the prevalence rates that are determined. Therefore, the methodology of studies should be closely examined when drawing conclusions from presented prevalence rates.

Mitochondrial bioenergetics in leukocytes and oxidative stress in blood serum of mild to moderately depressed women

Major depressive disorder (MDD) has been associated with lower mitochondrial energy production and higher oxidative stress. We investigated whether these alterations manifest in patients with current mild to moderate MDD severity. We observed no differences in mitochondrial respiration and density (i.e., citrate-synthase activity) in peripheral blood mononuclear cells and oxidative stress markers (i.e., 8-hydroxy-2'-deoxyguanosine, 8-isoprostane) in blood serum of 20 female MDD patients compared to 24 non-depressed women. Alterations in mitochondrial energy production and oxidative stress did not linearly depend on the current severity of MDD. However, biological alterations might rather manifest with higher MDD severity/chronicity and at higher age.

Unresolved Attachment Mediates the Relationship Between Childhood Trauma and Impaired Personality Functioning in Adolescence

The present study investigates the mediating effect of attachment trauma on the relationship between childhood maltreatment and personality functioning in 199 adolescents (12-18 years) using a novel approach of an in-depth analysis of attachment-related traumatic contents during an attachment interview (AAP). Our findings demonstrate that adolescents with a high amount of traumatic attachment-related material show a lower resilience when facing traumatic childhood experiences, resulting in a greater severity of personality dysfunction. In particular, the associations between emotional abuse and neglect and the domains of identity, empathy, self-direction, and intimacy were mediated by the severity of attachment trauma. These results advance our understanding of the different nuances of attachment-related traumatic material and how they might shape personality structure in an adolescent age group.

Attentional bias and childhood maltreatment in clinical depression - An eye-tracking study

Major depressive disorder (MDD) has been found to be associated with biased attention to emotional stimuli: increased attention for dysphoric information and/or decreased attention for positive information compared to healthy individuals. A history of childhood maltreatment (CM) has been discussed as a factor that might have an impact on the occurrence and extent of biased attention in depression. The present study examined the association between CM and attention for facial emotions in currently depressed patients using eye-tracking methodology. In a free viewing paradigm, 31 individuals with MDD and 31 healthy subjects viewed images of four facial expressions (happy, sad, angry, and neutral). Dwell time on each facial expression was used as an indicator of attention allocation. Childhood maltreatment was assessed using the German version of the Childhood Trauma Questionnaire. Depressed patients showed shorter gaze durations for happy faces compared to healthy controls. This result is in line with the assumption that depression goes along with a loss of elaborative processing of positive stimuli. No group differences were observed concerning dwell times on negative faces. However, CM was associated with reduced attention for angry and sad facial expressions in the depressed sample. Depressed individuals with a history of CM seem to avoid processing of threatening or burdensome stimuli. Early life adversity appears to impact attention allocation in depressed individuals and might help to explain discordant results in the literature regarding biased attention to negative facial expressions in depression.

The effects of childhood maltreatment on epigenetic regulation of stress-response associated genes: an intergenerational approach

While biological alterations associated with childhood maltreatment (CM) have been found in affected individuals, it remains unknown to what degree these alterations are biologically transmitted to the next generation. We investigated intergenerational effects of maternal CM on DNA methylation and gene expression in N = 113 mother-infant dyads shortly after parturition, additionally accounting for the role of the FKBP5 rs1360780 genotype. Using mass array spectrometry, we assessed the DNA methylation of selected stress-response-associated genes (FK506 binding protein 51 [FKBP5], glucocorticoid receptor [NR3C1], corticotropin-releasing hormone receptor 1 [CRHR1]) in isolated immune cells from maternal blood and neonatal umbilical cord blood. In mothers, CM was associated with decreased levels of DNA methylation of FKBP5 and CRHR1 and increased NR3C1 methylation, but not with changes in gene expression profiles. Rs1360780 moderated the FKBP5 epigenetic CM-associated regulation profiles in a gene × environment interaction. In newborns, we found no evidence for any intergenerational transmission of CM-related methylation profiles for any of the investigated epigenetic sites. These findings support the hypothesis of a long-lasting impact of CM on the biological epigenetic regulation of stress-response mediators and suggest for the first time that these specific epigenetic patterns might not be directly transmitted to the next generation.

Kindheitsbelastungen und gestörtes Essverhalten – Die Rolle von Selbstregulation

Zusammenfassung. Die verschiedenen Formen der Kindesmisshandlung (körperlicher, sexueller oder emotionaler Missbrauch sowie emotionale und körperliche Vernachlässigung) gelten sowohl für die Entwicklung von Essstörungen als auch für einzelne Symptome pathologischen Essverhaltens (Essanfälle, Adipositas) als Risikofaktoren. Darüber hinaus ist bekannt, dass sich selbstregulatorische Fähigkeiten durch die Erfahrung von Kindesmisshandlung defizitär entwickeln können. Aus diesem Grund soll die Rolle von Selbstregulation für den Zusammenhang von erinnerter Kindheitsbelastung und Essverhalten eruiert werden, um Ansatzpunkte für Prävention und Behandlung von gestörtem Essverhalten zu erhalten. Eine hinsichtlich Geschlecht, Alter und Bildung bevölkerungsrepräsentative Stichprobe von 2508 Personen (1174 Männer und 1334 Frauen) im Alter von 14–92 Jahren ( M = 49.67, SD = 18.32) wurde im Rahmen eines umfassenden Gesundheits-Surveys zu Essverhalten, erinnerter Kindheitsbelastung und selbstregulatorischen Fähigkeiten befragt. Neben umfangreichen deskriptiven Analysen zu Essverhalten und Kindheitsbelastung wurde die Interaktion von Selbstregulation und Kindheitsbelastung unter Berücksichtigung von Geschlechtsunterschieden auf die Ausprägungen des Essverhaltens mittels einer moderierten Regressionsanalyse überprüft. Die Prävalenzraten für auffälliges Essverhalten liegen für Frauen höher als für Männer (14.7% vs. 6.5%). Frauen berichteten ebenfalls häufiger, dass sie eine Form der Kindesmisshandlung erlebt haben. Bei Betrachtung der einzelnen Formen von Kindesmisshandlung unterscheiden sich Männer und Frauen nur in der Häufigkeit von sexuellem Missbrauch, den Frauen häufiger berichteten. Die Interaktion aus höherer Kindheitsbelastung und Selbstregulationsdefiziten stellte sich lediglich für Männer als Risikofaktor für gestörtes Essverhalten heraus, nicht bei Frauen. Männer und Frauen zeigen unterschiedliche Risikoprofile, die weiter untersucht werden sollten. Bessere Kenntnisse geschlechtsspezifischer Unterschiede dienen der Prävention und Behandlung von Essstörungen sowie Adipositas.

The Association of Childhood Maltreatment With Lipid Peroxidation and DNA Damage in Postpartum Women

Childhood maltreatment (CM) is associated with an increased risk for the development of psychiatric and somatic disorders in later life. A potential link could be oxidative stress, which is defined as the imbalance between the amount of reactive oxygen species (ROS) and the neutralizing capacity of anti-oxidative defense systems. However, the findings linking CM with oxidative stress have been inconsistent so far. In this study, we aimed to further explore this association by investigating biological markers of DNA and lipid damage due to oxidation in a comprehensive approach over two study cohorts of postpartum women (study cohort I and study cohort II). The severity of CM experiences (maltreatment load) was assessed in both studies using the Childhood Trauma Questionnaire. In study cohort I (N = 30), we investigated whether CM was associated with higher levels of structural DNA damage in peripheral blood mononuclear cells (PBMC) by two methods that are highly sensitive for detecting nuclear DNA strand breaks (comet assay and γH2AX staining). In study cohort II (N = 117), we then assessed in a larger cohort, that was specifically controlled for potential confounders for oxidative stress measurements, two established serum and plasma biomarkers of oxidative stress, one representing oxidative DNA and RNA damage (8-hydroxy-2'-deoxyguanosine and 8-hydroxyguanosine; 8-OH(d)G) and the other representing lipid peroxidation (8-isoprostane). In study cohort I, the analyses revealed no significant main effects of maltreatment load on cellular measures of nuclear DNA damage. The analyses of peripheral oxidative stress biomarkers in study cohort II revealed a significant main effect of maltreatment load on free 8-isoprostane plasma levels, but not on total 8-isprostane plasma levels and 8-OH(d)G serum levels. Taken together, by combining different methods and two study cohorts, we found no indications for higher oxidative DNA damages with higher maltreatment load in postpartum women. Further research is needed to investigate whether this increase in free 8-isoprostane is a marker for oxidative stress or whether it is instead functionally involved in ROS-related signaling pathways that potentially regulate inflammatory processes following a history of CM.

The association between cortisol, oxytocin, and immune cell mitochondrial oxygen consumption in postpartum women with childhood maltreatment

Childhood maltreatment (CM) is associated with an increased risk for the development of psychiatric and somatic diseases in later life. Individual risk and resilience factors may, however, influence how deep psychological stress gets under the skin. We hypothesized that the stress-related hormone cortisol and the attachment-related hormone oxytocin constitute biological factors that might moderate the biological sequelae and long-term health outcomes associated with CM. As biological outcome, we thereby focused on immunocellular oxygen consumption, which we previously found to be increased with a higher severity of CM experiences. In a study cohort of N = 49 postpartum women, we investigated the interaction between CM experiences, serum cortisol and plasma oxytocin levels, and the cellular oxygen consumption of intact peripheral blood mononuclear cells (PBMC) by high-resolution respirometry. Regression analyses revealed a significant interaction between the severity of CM experiences and cortisol as well as oxytocin on cellular oxygen consumption of PBMC three months postpartum: higher cortisol levels were thereby associated with an increase in oxygen consumption related to basal mitochondrial respiration and ATP turnover, while oxygen consumption related to basal mitochondrial respiration and ATP turnover were reduced with higher oxytocin levels in individuals with higher CM severity. These associations were not seen among women with no or low CM experiences. Together, the results suggest that cortisol and oxytocin might be associated with opposite effects on CM-related alterations in the bioenergetic profile of peripheral immune cells.

[Childhood Experiences of Adolescents in Boarding Schools. A Comparison with Adolescents in Residential Care and with the General Population]

Childhood Experiences of Adolescents in Boarding Schools. A Comparison with Adolescents in Residential Care and with the General Population Various studies indicate that students in boarding schools experience a lot of violence during their accommodation. However, it is not proved whether adolescents in boarding schools are also a burdensome group regarding early childhood experiences such as neglect and abuse. The aim of the study was to find out more about the experiences of adolescents in boarding schools and to determine whether there are differences between adolescents in residential care and between the general population. Furthermore, it should be examined whether boys and girls differ in their experiences. In the study, adolescents of boarding schools and of residential care all over Germany, starting at the age of 15 (n = 322), were asked regarding physical and emotional neglect/abuse, light/severe parent violence, negative/positive educational behavior of the parents. The results show that students in boarding schools were less likely to be affected by childhood maltreatment and more likely to have experienced positive parental behavior compared to children in residential care. Compared to the general population, students in boarding schools were more often and more severely affected by parental violence. Moreover, girls had experienced parental violence more often than boys. The results indicate that in boarding schools there is a need for support offers for adolescents with a history of violent experiences and that the risk group should be identified directly at the admission to the school.