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van den Heuvel LL, Assim A, Koning M, Nöthling J, Seedat S. Childhood maltreatment and internalizing/externalizing disorders in trauma-exposed adolescents: Does posttraumatic stress disorder (PTSD) severity have a mediating role? Dev Psychopathol 2023:1-13. [PMID: 38017689 DOI: 10.1017/s0954579423001414] [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: 11/30/2023]
Abstract
Childhood maltreatment is associated with wide-ranging psychopathology at all stages of life. In the current study, we investigated whether posttraumatic stress disorder (PTSD) severity mediated the association between childhood maltreatment and internalizing and externalizing disorders among 262 South African trauma-exposed adolescents (aged 12-18 years). Childhood maltreatment and PTSD symptom severity were assessed using the Childhood Trauma Questionnaire and the Child PTSD Checklist, respectively. Psychiatric disorders were assessed utilizing the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version and were grouped into internalizing or externalizing disorders. Hierarchal logistic regression was used to assess the association of childhood maltreatment subtype with internalizing and externalizing disorders, controlling for age and gender, with PTSD symptom severity added to the final model. We found that sexual abuse was significantly associated with internalizing disorders, although this effect was no longer significant when PTSD was added to the model demonstrating that PTSD mediated the association between sexual abuse and internalizing disorders. Physical abuse, but not PTSD, was associated with externalizing disorders. Physical abuse, emotional neglect, and PTSD were associated with comorbid internalizing and externalizing disorders. These findings have implications for intervention and prevention strategies targeted at trauma-exposed adolescents with a history of childhood maltreatment.
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Affiliation(s)
- Leigh Luella van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Ayesha Assim
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Milo Koning
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jani Nöthling
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Wang A, Duan L, Huang H, Ma J, Zhang Y, Ma Q, Guo Y, Li Z, Cheng X, Zhu J, Zhou G, Ba Y. Association between fluoride exposure and behavioural outcomes of school-age children: a pilot study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:232-241. [PMID: 32281876 DOI: 10.1080/09603123.2020.1747601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 03/20/2020] [Indexed: 06/11/2023]
Abstract
To assess the association between fluoride exposure and children's behavioural outcomes, we recruited 325 resident school-age children (7-13 years old) lived in Tongxu County of Henan Province in China. We measured urinary fluoride (UF) concentrations using the ion-selective electrode method. Children's behavioural outcomes were assessed by Conners' Parent Rating Scale-Revised, including conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive, anxiety, and ADHD index. It turned out that each 1.0 mg/L increment in UF concentration corresponded with an elevation in the psychosomatic problem score of 4.01 (95% CI: 2.74, 5.28) and a 97% (OR = 1.97, 95% CI: 1.19, 3.27) increase in the prevalence of psychosomatic problems after adjusting for potential influencing factors. The sensitivity analysis results were consistent with those observed in our preliminary analysis. Our study suggests that fluoride exposure is positively related to the behavioural problem in school-age children, psychosomatic problem in particular.
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Affiliation(s)
- Anqi Wang
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Leizhen Duan
- Department of Medical Services, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Hui Huang
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Jun Ma
- Department of Endemic Disease, Kaifeng Center for Disease Control and Prevention, Kaifeng, Henan, P. R. China
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Qiang Ma
- Teaching and Research Office, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Yao Guo
- Nursing College of Henan University of Chinese Medicine, Zhengzhou, Henan, P. R. China
| | - Zhiyuan Li
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Xuemin Cheng
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Jingyuan Zhu
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Guoyu Zhou
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Yue Ba
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
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Ponnamperuma T, Sumathipala A, Siribaddana S. Posttraumatic stress and co-occurrence of mental health problems in Sri Lankan adolescents. Asian J Psychiatr 2020; 54:102444. [PMID: 33271723 DOI: 10.1016/j.ajp.2020.102444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/26/2020] [Accepted: 10/08/2020] [Indexed: 11/27/2022]
Abstract
A significant minority (5 %) of adolescents develop posttraumatic stress disorder (PTSD) after trauma exposure. These adolescents are likely to experience many other mental health problems and have related impaired functioning. This study examined the co-occurrence of Emotional and Behavioral Problems (EBP) with PTSD symptoms and investigated the effect of PTSD symptoms on EBP-related impaired functioning. The initial sample (T1) comprised 729 Sri Lankan adolescents, age 12-16 years, living in an area impacted by the 2004 tsunami. In 2008, participants (T1) completed measures of trauma exposure, PTSD symptoms, EBP and related functional impairment. Sixteen months later a subsample of 90 adolescents (T2) underwent diagnostic interview for PTSD and co-occurrence of mental health morbidity. In the 58.2 % of the T1 sample reporting any trauma exposure, 23.7 % met criteria for full or partial PTSD. Among all participants, 13.4 % had borderline to abnormal levels of EBP. EBP was significantly higher among PTSD-positive participants compared to PTSD-negative and non-traumatized subgroups (p < 0.001). In the T2 sample, all four cases with diagnosed PTSD had coexisting psychological problems. Further, PTSD symptoms exacerbated the impact of EBP on functional impairment. Findings support the conclusion that researchers and practitioners should be alert to EBP among trauma-exposed adolescents, because such general psychological problems are common and, in combination with PTSD symptoms, are associated with even greater impairment. Moreover, identifying the presence of these trauma associated problems is of crucial clinical importance.
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Affiliation(s)
- Thyagi Ponnamperuma
- Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Sri Lanka.
| | - Athula Sumathipala
- School of Primary, Community and Social Care, Faculty of Medicine & Health Sciences, Keele University, United Kingdom.
| | - Sisira Siribaddana
- Department of Medicine, Faculty of Medicine & Allied Science, Rajarata University of Sri Lanka, Sri Lanka.
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Lin ZL, Lin DR, Chen JJ, Li J, Li XY, Wang LS, Liu ZZ, Cao QZ, Chen C, Zhu Y, Chen WR, Liu YZ, Lin HT. Increased prevalence of parent ratings of ADHD symptoms among children with bilateral congenital cataracts. Int J Ophthalmol 2019; 12:1323-1329. [PMID: 31456924 DOI: 10.18240/ijo.2019.08.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 02/14/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the behavioral and psychological disorders and the prevalence of parent ratings of attention deficit hyperactivity disorder (ADHD) symptoms among children with bilateral congenital cataracts (CCs). METHODS This cross-sectional study investigated children with bilateral CC aged 3-8y (CC group) using Conners' Parent Rating Scale-48 (CPRS-48) from July to December 2016. The abnormal rates of psychological symptoms in CC children and normal vision (NV) children were compared using the Chi-square test. The scores of CC children were compared with those of NV children and the Chinese urban norm using the independent samples t-test and one-sample t-test, respectively. RESULTS A total of 262 valid questionnaires were collected. The ratio of CC children to NV children was 119:143. The overall rate of psychological symptoms in CC children was 2.28 times higher than that in NV children (46.22% vs 20.28%, Pearson's χ 2=20.062; P<0.001). CC children showed higher scores for conduct problems, learning problems, impulsiveness/hyperactivity, anxiety, and hyperactivity index than NV children and the Chinese urban norm, particularly between the ages of 3 and 5y. Furthermore, male children aged between 6 and 8y showed a higher impulsive/hyperactive score than females of the same age (t=6.083, P<0.001). CONCLUSION Children with bilateral CCs have a higher rate of ADHD symptoms than children with NV. This study provides clinical evidence that screening for psychological symptoms and particularly for ADHD symptoms in children with bilateral CC are recommended for an early diagnosis and timely treatment.
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Affiliation(s)
- Zhuo-Ling Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Duo-Ru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Jing-Jing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Jing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Xiao-Yan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Li-Sha Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Zhen-Zhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Qian-Zhong Cao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Chuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, Florida 33136, USA
| | - Yi Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, Florida 33136, USA
| | - Wei-Rong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Yi-Zhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Hao-Tian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
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Saigh PA, Hackler D, Yasik AE, McGuire LA, Bellantuono A, Dekis C, Durham K, Halamandaris PV, Oberfield RA. The Junior Eysenck Personality Inventory ratings of traumatized youth with and without PTSD. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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