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Nivison MD, Labella MH, Raby KL, Doom JR, Martin J, Johnson WF, Zamir O, Englund MM, Simpson JA, Carlson EA, Roisman GI. Insights into child abuse and neglect: Findings from the Minnesota Longitudinal Study of Risk and Adaptation. Dev Psychopathol 2024:1-13. [PMID: 38646885 DOI: 10.1017/s0954579424000865] [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: 04/23/2024]
Abstract
The Minnesota Longitudinal Study of Risk and Adaptation (MLSRA) is a landmark prospective, longitudinal study of human development focused on a sample of mothers experiencing poverty and their firstborn children. Although the MLSRA pioneered a number of important topics in the area of social and emotional development, it began with the more specific goal of examining the antecedents of child maltreatment. From that foundation and for more than 40 years, the study has produced a significant body of research on the origins, sequelae, and measurement of childhood abuse and neglect. The principal objectives of this report are to document the early history of the MLSRA and its contributions to the study of child maltreatment and to review and summarize results from the recently updated childhood abuse and neglect coding of the cohort, with particular emphasis on findings related to adult adjustment. While doing so, we highlight key themes and contributions from Dr Dante Cicchetti's body of research and developmental psychopathology perspective to the MLSRA, a project launched during his tenure as a graduate student at the University of Minnesota.
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Affiliation(s)
- Marissa D Nivison
- Institute of Child Development, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | | | - K Lee Raby
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Jenalee R Doom
- Department of Psychology, University of Denver, Denver, CO, USA
| | | | | | - Osnat Zamir
- Social Work, Hebrew University, Jerusalem, SR, USA
| | - Michelle M Englund
- Institute of Child Development, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Jeffry A Simpson
- Old Dominion University, NorfolkNFK, VA, USA
- Department of Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Elizabeth A Carlson
- Institute of Child Development, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Glenn I Roisman
- Institute of Child Development, University of Minnesota Twin Cities, Minneapolis, MN, USA
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2
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Child maltreatment exposure and adolescent nonsuicidal self-injury: the mediating roles of difficulty in emotion regulation and depressive symptoms. Child Adolesc Psychiatry Ment Health 2023; 17:16. [PMID: 36709294 PMCID: PMC9883603 DOI: 10.1186/s13034-023-00557-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/09/2023] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Although child maltreatment (CM) experiences are recognized risk factors for nonsuicidal self-injury (NSSI), the mechanisms underlying this relationship remain unclear. The purpose of this study was to examine whether difficulty in emotion regulation (DER) and depressive symptoms mediate the relationship between child maltreatment experiences and NSSI severity, adjusting for demographic variables. METHODS The participants were 224 adolescent inpatients recruited from a hospital in China (mean age 15.30 years, SD = 1.83; 78.6% females). Study measures included the Clinician-Rated Severity of Nonsuicidal Self-Injury (CRSNSSI), Childhood Trauma Questionnaire (CTQ-SF), Difficulties in Emotion Regulation Scale (DERS), and Patient Health Questionnaire-9 (PHQ-9). The hypothesized chain mediation model was tested using the structural equation model. RESULTS A total of 146 (65.18%) adolescents reported engaging in NSSI during the past 12 months, and 103 (45.98%) participants met the DSM-5 diagnostic criteria for NSSI. Emotional neglect (48.1%) and emotional abuse (46.1%) had the highest prevalence, followed by physical neglect (43.1%) and physical abuse (24.1%), whereas sexual abuse (12.5%) was the least prevalent form of CM. Separately, both DER and depressive symptoms significantly mediated the association between CM and NSSI, with DER being the strongest mediator, with an indirect effect of 49.40% (p = 0.014). At the same time, we also proved a potential chain-mediated pathway of DER and depression in the relationship between CM and NSSI. CONCLUSION Child maltreatment seems to play a role in the aetiology of NSSI. DER and depressive symptoms both have a mediating role in the relationship between CM and NSSI. Importantly, DER seems to be a mediator with a stronger indirect effect compared to depressive symptoms.
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Robin M, Schupak T, Bonnardel L, Polge C, Couture MB, Bellone L, Shadili G, Essadek A, Corcos M. Clinical Stakes of Sexual Abuse in Adolescent Psychiatry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1071. [PMID: 36673831 PMCID: PMC9858972 DOI: 10.3390/ijerph20021071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/30/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND The extent and nature of sexual abuse (SA) and its consequences in psychiatry are still poorly described in adolescence. OBJECTIVE This article describes the frequency of SA reported in an adolescent population hospitalized in psychiatry, and assesses its links with the severity of mental disorders and the medical issues of these adolescents. METHODS The study includes 100 patients for whom SA has been mentioned, among all patients aged 13 to 17 years old hospitalized for about 4 years. The characteristics of sexual abuse were correlated with the medical severity of the patients, as well as the number, the duration of their hospitalization(s), and the time until disclosure. RESULTS The results show the central place of SA in adolescent psychiatry, with a prevalence of 28.5% and a cumulative hospital stay which is five times longer than average. Correlations have been observed between the number of suicide attempts and the number of abuses reported. The medical severity of patients is significantly increased when the named aggressor is an adult. The number of hospitalizations is positively correlated with the number of reported abuses, as well as with the intrafamilial and adult status of the perpetrator. Finally, an early age of onset, repeated abuse, and the intrafamilial nature of the abuse are associated with a longer time to disclosure. CONCLUSIONS The severity of adolescent psychiatric situation is statistically in favor of a history of SA, which should therefore be actively explored during care.
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Affiliation(s)
- Marion Robin
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
- Centre de Recherche en Epidémiologie et Santé des Populations, INSERM U1178, Team PsyDev, 94807 Villejuif, France
| | - Thomas Schupak
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
| | - Lucile Bonnardel
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
| | - Corinne Polge
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
| | - Marie-Bernard Couture
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
| | - Laura Bellone
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
| | - Gérard Shadili
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
- Centre de Soins, d’Accompagnement et de Prévention en Addictologie, Émergence Espace Tolbiac, 75013 Paris, France
| | - Aziz Essadek
- Laboratoire Interpsy, Université de Lorraine, 54015 Nancy, France
| | - Maurice Corcos
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
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Song X, Huang L, Hou D, Ran M, Huang X, Xiao Q. Influencing factors of non-suicidal self-injury according to DSM-5 in adolescents admitted to the psychiatric department: a cross-sectional study. Transl Pediatr 2022; 11:1972-1984. [PMID: 36643674 PMCID: PMC9834952 DOI: 10.21037/tp-22-588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is being increasingly recognized as a prominent mental health concern, especially among adolescents. In psychiatric clinical samples, its incidence is high and difficult to identify. However, few studies have explored the NSSI behavior of psychiatric hospitalized adolescents. This study aimed to explore the influencing factors of NSSI according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) in adolescents admitted to the psychiatric department. METHODS In this cross-sectional study, by convenient sampling, a total of 505 psychiatric adolescent inpatients aged 10-19 years completed questionnaires to record details of sociodemographic characteristics, the NSSI questionnaire, the Child Psychological Abuse and Neglect Scale (CPANS), the self-report version of the Strengths and Difficulties Questionnaire (self-report SDQ), the Coping Style Scale for Middle School Students (CSSMSS), which were compared between NSSI inpatients and non-NSSI inpatients. This study used the diagnostic criteria for NSSI disorder in DSM-5: adolescent patients who have NSSI behaviors for more than 5 times in the past 1 year are called NSSI. A multiple logistic regression model was built to explore the relationships among general information, CPANS, SDQ, CSSMSS, and NSSI. Risk for NSSI is quantified by odds ratio (OR) with 95% confidence interval (CI). RESULTS The results showed that 77.82% (n=393) of adolescent inpatients had NSSI, and 80.0% were female (n=404). NSSI adolescent inpatients experienced more family scolding, psychological abuse, and neglect and showed more positive attitudes toward NSSI than non-NSSI adolescent inpatients. However, after controlling for covariables, the difference disappeared. NSSI behavior was significantly associated with female (OR =2.391, 95% CI: 1.396-4.097, P=0.002), younger age (10-14 years old) (OR =1.876, 95% CI: 1.154-3.049, P=0.011), have close friends (OR =0.355, 95% CI: 0.164-0.768, P=0.008), peer discussion about self-injury (OR =1.977, 95% CI: 1.047-3.734, P=0.036), emotional and behavioral difficulties (OR =1.853, 95% CI: 1.054-3.258, P=0.032), problem-oriented coping styles (OR =0.968, 95% CI: 0.945-0.991, P=0.007), emotion-oriented coping styles (OR =1.035, 95% CI: 1.006-41.064, P=0.016). CONCLUSIONS Measures should be taken to prevent and reduce the occurrence of NSSI behaviors among hospitalized adolescents in psychiatric department, which include improving adolescents' attitude towards NSSI, reducing adolescents' gathering behavior in the ward, preventing adolescents from discussing NSSI through social media, improving their coping style when facing difficulties, and reasonably regulating their abnormal emotions and behaviors.
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Affiliation(s)
- Xiaozhen Song
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
| | - Lijuan Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
| | - Dandan Hou
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
| | - Maosheng Ran
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xuehua Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
| | - Qingqing Xiao
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
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5
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Miljkovitch R, Danner-Touati C, Gery I, Bernier A, Sirparanta A, Deborde AS. The role of multiple attachments in intergenerational transmission of child sexual abuse among male victims. CHILD ABUSE & NEGLECT 2022; 128:104864. [PMID: 33358280 DOI: 10.1016/j.chiabu.2020.104864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/20/2020] [Accepted: 11/26/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND According to Finkelhor (1984), difficulties child sexual abusers have in establishing adaptive adult relationships are a consequence of attachment problems with parents. Research shows that insecure attachment is associated with both the experience of child sexual abuse (CSA) as a victim and perpetration of CSA as an adult. Attachment may thus be a key factor in intergenerational transmission (IT) of CSA. OBJECTIVE The study aims to examine the direct, interactive, and mediated effects linking attachment in different relationships (mother, father, romantic partner) to IT of CSA among male victims. PARTICIPANTS AND SETTING Thirty-two abusing and 27 non-abusing male CSA survivors were recruited, respectively, in a prison and via networks of former foster children or CSA victims. METHOD All participants completed the Attachment Multiple Model Interview to assess attachment along four dimensions (security, deactivation, hyperactivation, and disorganization) in the relationship with mother, father, and partner. RESULTS Partial least square modeling suggests that the partner carries forward (mediates) the increased risk of committing sexual abuse associated with insecure/disorganized attachment with the father. A significant partner-mother interaction also suggests that the deleterious effects of attachment to the mother in terms of committing CSA are countered by more secure/organized attachment to the partner. CONCLUSIONS Findings highlight the pivotal role of the romantic partner in IT of CSA. Beyond early intervention, therapy in adulthood aimed at fostering adaptive ways of finding emotional security in the relationship with an adult could thus be encouraged.
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Affiliation(s)
- Raphaële Miljkovitch
- Laboratoire Paragraphe EA 349, Paris 8 University, 2 Rue de la Liberté, 93200, Saint-Denis, France.
| | - Camille Danner-Touati
- Laboratoire Paragraphe EA 349, Paris 8 University, 2 Rue de la Liberté, 93200, Saint-Denis, France.
| | - Isabelle Gery
- Penitentiary Center Poitiers-Divonne, Champ des Grolles - RD742, CS 80029, 86370, Vivonne, France.
| | - Annie Bernier
- Department of Psychology, University of Montreal, C.P. 6128, Succ. Centre-Ville, Montréal, Qc H3C 3J7, Canada.
| | - Aino Sirparanta
- Laboratoire Paragraphe EA 349, Paris 8 University, 2 Rue de la Liberté, 93200, Saint-Denis, France.
| | - Anne-Sophie Deborde
- Laboratoire Paragraphe EA 349, Paris 8 University, 2 Rue de la Liberté, 93200, Saint-Denis, France.
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Stagaki M, Nolte T, Feigenbaum J, King-Casas B, Lohrenz T, Fonagy P, Montague PR. The mediating role of attachment and mentalising in the relationship between childhood maltreatment, self-harm and suicidality. CHILD ABUSE & NEGLECT 2022; 128:105576. [PMID: 35313127 PMCID: PMC10466023 DOI: 10.1016/j.chiabu.2022.105576] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 01/01/2022] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Although the relationship between childhood maltreatment, self-harm and suicidality is well-established, less is known about the mediating mechanisms explaining it. Based on a developmental mentalisation-based theoretical framework, childhood adversity compromises mentalising ability and attachment security, which in turn increase vulnerability to later stressors in adulthood. OBJECTIVE This study aimed to investigate the role of attachment and mentalising as potential mechanisms in the relationship between childhood maltreatment, self-harm and suicidality. PARTICIPANTS AND SETTING We recruited 907 adults from clinical and community settings in Greater London. METHODS The study design was cross-sectional. Participants completed self-report questionnaires on retrospectively rated childhood trauma, and current attachment to the romantic partner, mentalising, self-harm, suicidal ideation and attempt. We used structural equation modelling to examine the data and conceptualized childhood maltreatment as a general factor in a confirmatory bifactor model. RESULTS The results showed that childhood maltreatment was both directly associated with self-harm and suicidality and indirectly via the pathways of attachment and mentalising. CONCLUSIONS These findings indicate that insecure attachment and impaired mentalising partially explain the association between childhood maltreatment, self-harm and suicidality. Clinically, they provide support for the potential of mentalisation-based therapy or other psychosocial interventions that aim to mitigate the risk of self-harm and suicidality among individuals who have experienced childhood maltreatment via increasing understanding of self and other mental states.
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Affiliation(s)
- Maria Stagaki
- Division of Psychiatry, University College London, London, United Kingdom.
| | - Tobias Nolte
- Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom; Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Janet Feigenbaum
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Brooks King-Casas
- Fralin Biomedical Research Institute, Department of Psychology, Virginia Tech, Roanoke, VA, United States of America
| | - Terry Lohrenz
- Fralin Biomedical Research Institute, Department of Psychology, Virginia Tech, Roanoke, VA, United States of America
| | - Peter Fonagy
- Anna Freud National Centre for Children and Families, London, United Kingdom; Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - P Read Montague
- Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom; Fralin Biomedical Research Institute, Department of Psychology, Virginia Tech, Roanoke, VA, United States of America; Department of Physics, Virginia Tech, Blacksburg, VA, United States of America; Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Virginia Tech, Roanoke, VA, United States of America
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7
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Abstract
Previous studies confirm that attachment representations are very stable and are rooted in semantic and episodic autobiographic memory systems. The Adult Attachment Interview (AAI) provides a means to assess secure, insecure, and disorganized (U) states of mind; it incorporates a fine-grained analysis of attachment-related memories. The AAI is not a measure to determine false versus true memories or to claim it can identify veridical truth; however, longitudinal research studies demonstrate that the AAI is highly stable in how (degree of coherence) the speaker discusses past events. This IRB approved study (n = 130) examined a non-clinical sample of active individuals. The results indicated that passive states of mind was a predictor variable for unresolved loss and unresolved childhood abuse and both passive states of mind and more Adverse Childhood Experiences (ACEs) predicted overall lack of resolution (U). Lack of memory and dissociative amnesia were not significant predictors. This study and previous studies demonstrate that retrospective reporting of ACEs remain stable over time. These findings suggest that clinical focus should follow the attachment protocol of examining the state of mind of the speaker. Autobiographical memory systems reveal enduring Internal Working Models (IWMs) that influence how memories are stored and recounted.
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Affiliation(s)
- Paula Thomson
- Department of Kinesiology, California State University, Northridge, California, USA
| | - S Victoria Jaque
- Department of Kinesiology, California State University, Northridge, California, USA
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8
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Peng B, Li J, Liu H, Fang H, Zhao W, Chen G, Xiu M, Zhang Y. Childhood Maltreatment, Low Serum Cortisol Levels, and Non-Suicidal Self-Injury in Young Adults With Major Depressive Disorders. Front Pediatr 2022; 10:822046. [PMID: 35722483 PMCID: PMC9203967 DOI: 10.3389/fped.2022.822046] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a serious public health problem widely present among young adults and adolescents. While finding risk factors associated with NSSI among young patients with major depressive disorder (MDD) is challenging, the current study aims to measure childhood adversity and serum cortisol levels and elucidate their relationship in MDD patients with NSSI. METHODS In this cross-sectional study, 126 young patients with MDD (aged 16 to 35 years) were recruited. The depressive symptoms were assessed by the Beck Depression Inventory (BDI-II), and the childhood adversity was evaluated by the Chinese version of the Childhood Trauma Questionnaire (CTQ) scale. Serum cortisol levels were determined by the kits in patients. RESULTS Relative to MDD patients without NSSI, MDD patients with NSSI had a higher CTQ total score and its four subscores. Moreover, the cortisol levels in patients with MDD/NSSI were significantly decreased than in MDD patients without NSSI. For patients with MDD/NSSI, there is a negative association between cortisol levels and emotional neglect, but not for MDD patients without NSSI. Further regression analysis showed that low cortisol levels, BDI-II, and emotional neglect were risk factors for NSSI in young patients with MDD. CONCLUSION Our findings suggest that young MDD patients with NSSI experience more childhood adversity and have lower cortisol levels. Also, lower cortisol levels were associated with childhood adversity but not with depressive symptoms. Further, lower cortisol levels, depressive symptoms, and emotional neglect were risk factors for NSSI in young patients with MDD.
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Affiliation(s)
- Bo Peng
- Department of Depressive Disorders, Shenzhen Kangning Hospital, Shenzhen, China.,Shenzhen Mental Health Center, Shenzhen, China
| | - Jinmeng Li
- Department of Hematology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Haitao Liu
- Shenzhen Longgang District Maternity & Child Healthcare Hospital, Shenzhen, China
| | - Han Fang
- Department of Depressive Disorders, Shenzhen Kangning Hospital, Shenzhen, China.,Shenzhen Mental Health Center, Shenzhen, China
| | - Weitan Zhao
- Department of Depressive Disorders, Shenzhen Kangning Hospital, Shenzhen, China.,Shenzhen Mental Health Center, Shenzhen, China
| | - Guanjie Chen
- Department of Depressive Disorders, Shenzhen Kangning Hospital, Shenzhen, China.,Shenzhen Mental Health Center, Shenzhen, China
| | - Meihong Xiu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Yingli Zhang
- Department of Depressive Disorders, Shenzhen Kangning Hospital, Shenzhen, China.,Shenzhen Mental Health Center, Shenzhen, China
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Uncovering the Mystery of Non-Suicidal Self-Injury Among Selected Filipino Adolescents: A Grounded Theory Approach. PSYCHOLOGICAL STUDIES 2021. [DOI: 10.1007/s12646-021-00619-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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10
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VanMeter F, Nivison MD, Englund MM, Carlson EA, Roisman GI. Childhood abuse and neglect and self-reported symptoms of psychopathology through midlife. Dev Psychol 2021; 57:824-836. [PMID: 34166025 PMCID: PMC8284929 DOI: 10.1037/dev0001169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although abuse and neglect in the early years of life have been reliably linked to poor mental health outcomes in childhood, only a few studies have examined whether the predictive significance of childhood abuse and neglect endures for symptoms of psychopathology into adulthood. Here we examined to what extent prospectively assessed child abuse and neglect is associated with self-reported symptoms of psychopathology measured from ages 23 through 39 years, controlling for early demographic covariates and self-reported symptoms of psychopathology measured at age 16 years. The sample included 140 participants from the Minnesota Longitudinal Study of Risk and Adaptation. Participants were 49% female and 69% White/non-Hispanic. At the time of their child's birth, 48% of the mothers were teenagers (M = 20.5 years, SD = 3.74), 65% were single, and 42% had completed less than a high school education. Results indicated that childhood abuse and neglect was robustly associated with symptoms of psychopathology in adulthood. Exploratory analyses focusing on specific parametrizations of abuse/neglect suggested that abuse perpetrated by maternal figures (rather than paternal or nonparental figures) was uniquely associated with high levels of self-reported symptoms of psychopathology in adulthood. We found no evidence that any subtype of abuse and/or neglect or abuse/neglect during any particular phase of development uniquely predicted symptoms of psychopathology after controlling for relevant covariates. These results highlight the long-lasting significance of childhood abuse and neglect for reports of mental health in adulthood. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Profiles of Emotion Dysregulation Among University Students Who Self-Injure: Associations with Parent-Child Relationships and Non-Suicidal Self-Injury Characteristics. J Youth Adolesc 2021; 50:767-787. [PMID: 33449284 DOI: 10.1007/s10964-020-01378-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
More research is needed to understand the different vulnerability profiles of university students who engage in non-suicidal self-injury (NSSI). This study sought to classify university students (n = 479; 83.8% female) aged 17-25 years (M = 18.77; SD = 1.42) who had engaged in NSSI within the past year into latent profiles based on their self-perceived difficulties in regulating both positive and negative emotions. Independent samples of students who had a past history of NSSI but had not self-injured within the previous year (n = 439; 82.9% females; Mage = 19.03, SD = 1.62) and who had no history of NSSI (n = 1551; 69.9% females; Mage = 19.02, SD = 1.55) were recruited for comparison purposes. Latent cluster analyses revealed three emotion regulation profiles within the NSSI sample-the Average Difficulties (47.4%), Dysregulated (33.0%), and Low Difficulties (19.6%) profiles-each of which differed meaningfully from both comparison samples on mean emotion regulation difficulties. Students across profiles also differed in their self-reported experiences with parents, particularly with fathers (pressure, antipathy, unresolved attachment, psychological control), and in the extent to which they felt alienated from parents. Lastly, students across profiles differed in the frequency, methods, functions, and addictive properties of their NSSI. Findings highlight that university students who self-injure experience distinct patterns of difficulties with emotion regulation, which are associated with variation in parent-child relational risk factors and NSSI outcomes.
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Wang L, Cui Q, Liu J, Zou H. Emotion Reactivity and Suicide Risk in Patients With Depression: The Mediating Role of Non-Suicidal Self-Injury and Moderating Role of Childhood Neglect. Front Psychiatry 2021; 12:707181. [PMID: 34721098 PMCID: PMC8553945 DOI: 10.3389/fpsyt.2021.707181] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 09/14/2021] [Indexed: 11/21/2022] Open
Abstract
Background: The association between emotion reactivity (ER) and suicide risk has been confirmed in recent studies, especially in patients with depression. However, there is a lack of understanding of the underlying mechanism of the relation from ER to suicide risk among patients with depression. This study planned to examine a model of how ER, non-suicidal self-injury (NSSI), and childhood neglect (CN) interact to affect suicide risk in depressed patients. Methods: Four hundred and ninety-six patients (64.5% female, mean age = 30.40 years, SD = 12.56) who have accomplished self-rating instruments of ER, NSSI, CN, and suicide risk were included. Results: Findings showed that ER was positively connected with suicide risk, and NSSI partially mediated the above connection. Besides, CN moderated the mediation model, that is, the mediation effect was more pronounced in depressed patients with CN compared to depressed patients without CN. Conclusions: It was concluded that there is a relationship among ER, NSSI, CN, and suicide risk in patients with depression, and it strengthens our knowledge of the mechanism behind suicide risk. Our findings emphasize that the identification of NSSI and CN should be considered when assessing the suicide risk of patients with depression, as well as the intervention focus on emotion regulation and support for patients.
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Affiliation(s)
- Lu Wang
- School of Nursing, Anhui Medical University, Hefei, China
| | - Qian Cui
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Jun Liu
- Department of Nursing, Anding Hospital, Capital Medical University, Beijing, China
| | - Haiou Zou
- School of Nursing, Peking Union Medical College, Beijing, China
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The latent structure of the adult attachment interview: Large sample evidence from the collaboration on attachment transmission synthesis. Dev Psychopathol 2020; 34:307-319. [DOI: 10.1017/s0954579420000978] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The Adult Attachment Interview (AAI) is a widely used measure in developmental science that assesses adults’ current states of mind regarding early attachment-related experiences with their primary caregivers. The standard system for coding the AAI recommends classifying individuals categorically as having an autonomous, dismissing, preoccupied, or unresolved attachment state of mind. However, previous factor and taxometric analyses suggest that: (a) adults’ attachment states of mind are captured by two weakly correlated factors reflecting adults’ dismissing and preoccupied states of mind and (b) individual differences on these factors are continuously rather than categorically distributed. The current study revisited these suggestions about the latent structure of AAI scales by leveraging individual participant data from 40 studies (N = 3,218), with a particular focus on the controversial observation from prior factor analytic work that indicators of preoccupied states of mind and indicators of unresolved states of mind about loss and trauma loaded on a common factor. Confirmatory factor analyses indicated that: (a) a 2-factor model with weakly correlated dismissing and preoccupied factors and (b) a 3-factor model that further distinguished unresolved from preoccupied states of mind were both compatible with the data. The preoccupied and unresolved factors in the 3-factor model were highly correlated. Taxometric analyses suggested that individual differences in dismissing, preoccupied, and unresolved states of mind were more consistent with a continuous than a categorical model. The importance of additional tests of predictive validity of the various models is emphasized.
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Pallini S, Terrinoni A, Iannello S, Cerutti R, Ferrara M, Fantini F, Laghi F. Attachment-Related Representations and Suicidal Ideations in Nonsuicidal Self-Injury Adolescents with and without Suicide Attempts: A Pilot Study. Suicide Life Threat Behav 2020; 50:909-920. [PMID: 32175618 DOI: 10.1111/sltb.12633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 01/15/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Consistent with the debate surrounding the association between nonsuicidal self-injury (NSSI), suicidal intent, and suicidal behavior, and between NSSI and dysregulation processes, we attempted to analyze suicide intent and emotion dysregulation in NSSI adolescents, in the framework of the attachment representations and exploring these clues of emotion dysregulation characteristics of insecure attachment. Furthermore, we intended to focus on these attachment-related segregated systems regarding death and suicidal ideations, to explore how differently they would characterize self-injuring adolescents with and without suicide attempts. METHODS Thirty-four NSSI inpatient adolescents, 17 with suicide attempts, 17 without suicide attempts, and 17 healthy controls (age 11-17) were assessed using Adult Attachment Projective, which allows for the classification of attachment status and related emotion dysregulation and segregated systems. RESULTS The majority of the NSSI group with and without suicide attempts showed unresolved (disorganized) attachment-related representations and clues of damaged reflective functions, whereas only the NSSI with suicide attempts showed clues of impaired interpersonal relationships. The two clinical groups used words expressing suicidal intent, whereas the healthy group did not. CONCLUSIONS Therapists are encouraged not to underestimate suicidal ideation in NSSI regardless of whether or not they have already attempted suicide.
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Affiliation(s)
- Susanna Pallini
- Department of Education, University of Rome Tre, Roma, Italy
| | - Arianna Terrinoni
- Department of Pediatrics and Child and Adolescent Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Sara Iannello
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Rita Cerutti
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Mauro Ferrara
- Department of Pediatrics and Child and Adolescent Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Fiorella Fantini
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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Xu H, Song X, Wang S, Zhang S, Xu S, Wan Y. Mediating Effect of Social Support in the Relationship Between Childhood Abuse and Non-Suicidal Self-Injury Among Chinese Undergraduates: The Role of Only-Child Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16204023. [PMID: 31640165 PMCID: PMC6843968 DOI: 10.3390/ijerph16204023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 01/08/2023]
Abstract
Previous research has found a relationship between child abuse and non-suicidal self-injury (NSSI). However, few studies have examined the role of social support underlying this association. Moreover, the influence of the only child status on the mediating effect of social support has not been studied yet. The aim of this study was to investigate the mediating role of social support on the association between specific forms of child abuse and NSSI as well as the role of the only child status on the mediated pathways, among undergraduates. A total of 4799 participants were selected from two medical colleges in the Anhui province using stratified cluster sampling. Pearson's correlation analysis was used in analyzing the relationship. Bootstrapping procedures were applied to examine the mediating effects. After adjusting for confounders, the results showed that the mediating effect of social support on the association between childhood abuse and NSSI was not significant in the total sample. However, among only children, the mediating effects of social support between overall childhood abuse, physical abuse, emotional abuse, and NSSI were 9.65%, 14.82%, and 8.12%, respectively. Moreover, the mediating effect of social support from family and relatives was relatively higher than that from other sources. Social support had a mediating effect on the relationship between childhood abuse and NSSI among only-children. The enhancing of social support may contribute to the prevention and control of NSSI for those who were only-children in undergraduates, especially those who have experienced childhood abuse.
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Affiliation(s)
- Huiqiong Xu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Xianbing Song
- Department of Basic Course, Anhui medical College, 632 Furong Road, Hefei 230601, Anhui, China.
| | - Shanshan Wang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Shichen Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health &Aristogenics, 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Shaojun Xu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health &Aristogenics, 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Yuhui Wan
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health &Aristogenics, 81 Meishan Road, Hefei 230032, Anhui, China.
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Talia A, Miller-Bottome M, Wyner R, Lilliengren P, Bate J. Patients' Adult Attachment Interview classification and their experience of the therapeutic relationship: are they associated? RESEARCH IN PSYCHOTHERAPY (MILANO) 2019; 22:361. [PMID: 32913798 PMCID: PMC7451326 DOI: 10.4081/ripppo.2019.361] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 04/02/2019] [Indexed: 11/23/2022]
Abstract
In the last decade of his career, Jeremy Safran became increasingly interested in investigating the ways in which attachment representations influence the therapeutic relationship. In this paper, we test such influence in a sample of thirty outpatients who received Brief Relational Therapy by comparing their independently coded pre-treatment Adult Attachment Interview (AAI) with their narratives in a post-treatment interview about the relationship with the therapist (the Patient Relationship Interview at Termination, PRI-T). The PRI-T was coded with the following three measures: i) The Patient Attachment to Therapist Rating Scale (PAT-RS), which assesses the quality of the patient's attachment relationship to the therapist; ii) the Coherence scale from the AAI, adapted for use on the PRI-T; and iii) the Patient Attachment Classification System (PACS), which measures generalized differences in how individuals convey their experiences and feelings. Results suggest that patients' AAI predicts how they experience, represent, and communicate about the therapeutic relationship at the end of treatment, as shown by the PAT-RS, the Coherence scale adapted for use on the PRI-T, and the PACS applied to the PRI-T. These findings lend support to Safran and others' hypothesis that patients' AAI-status plays a role in patients' representations of the relationship with the therapist.
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Affiliation(s)
- Alessandro Talia
- Institute for Psychosocial Prevention, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | | | | | | | - Jordan Bate
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA
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Cullen KR, Schreiner MW, Klimes-Dougan B. The Neural Basis of Social Evaluation in Adolescents with Non-Suicidal Self-Injury. EClinicalMedicine 2019; 13:6-7. [PMID: 31517255 PMCID: PMC6734095 DOI: 10.1016/j.eclinm.2019.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/02/2019] [Indexed: 11/14/2022] Open
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Abdelraheem M, McAloon J, Shand F. Mediating and moderating variables in the prediction of self-harm in young people: A systematic review of prospective longitudinal studies. J Affect Disord 2019; 246:14-28. [PMID: 30572208 DOI: 10.1016/j.jad.2018.12.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 12/03/2018] [Accepted: 12/08/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Self-harm is widespread amongst young people. A growing body of research has explored factors that predict self-harm in young people, however, a systematic review of mediators and moderators of those factors has not yet been offered. This review aims to fill this gap by synthesising research about mediators and moderators of factors that prospectively predict self-harm in young people. METHOD A systematic review of research trials published up until 2018 was undertaken. Electronic databases Scopus (Elsevier), CINAHL, PsychINFO (EBSCO) and Medline were searched. Included studies utilised prospective longitudinal designs with participants aged 25 years or younger and self-harm outcome measures with published or reported psychometric properties. The aim of the review was to identify mediators and moderators of factors that predict self-harm in young people. RESULTS Of the 25 studies that met inclusion criteria, 22 reported at least one positive finding of a mediator or moderator. Specifically, 15 significant mediators and 20 significant moderators were identified in relation to a broad range of predictors of self-harm. Predictors were classified as adverse childhood experiences and parenting factors, psychological and psychiatric factors, social factors and intrapersonal factors. A number of potentially modifiable mediators and moderators were identified including interpersonal difficulties, impulsivity, self-esteem and self-compassion. Gender was the most commonly reported moderator. LIMITATIONS Included studies were assessed as limited by the heterogeneity of the mediators and moderators assessed, and by methodological factors including study durations, population characteristics, and the definition and assessment of self-harm. In addition, replication research was limited. Therefore it was difficult to integrate results and draw firm conclusions. CONCLUSIONS This review allowed us to explore diverse relationships between factors predictive of self-harm in young people and to identify a number of potentially modifiable mediators and moderators. Our findings have important implications for future research and treatment efforts as the identification of mediators and moderators is demonstrated to assist in identifying high risk individuals as well informing potential targets for treatment.
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Affiliation(s)
- Mona Abdelraheem
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology, Ultimo, NSW, Australia
| | - John McAloon
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology, Ultimo, NSW, Australia.
| | - Fiona Shand
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
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Attachment and psychopathology: a dynamic model of the insecure cycle. Curr Opin Psychol 2018; 25:76-80. [PMID: 29614483 DOI: 10.1016/j.copsyc.2018.02.018] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 02/28/2018] [Indexed: 01/09/2023]
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Childhood maltreatment and non-suicidal self-injury: a systematic review and meta-analysis. Lancet Psychiatry 2018; 5:51-64. [PMID: 29196062 PMCID: PMC5743605 DOI: 10.1016/s2215-0366(17)30469-8] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/16/2017] [Accepted: 10/16/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Non-suicidal self-injury is being increasingly recognised as a prominent public health concern. Identification of early and modifiable risk factors is necessary to advance the screening and intervention efforts, particularly early detection of at-risk individuals. We aimed to examine childhood maltreatment, including its specific subtypes, in relation to non-suicidal self-injury. METHODS We did a comprehensive meta-analysis of childhood maltreatment (overall, sexual abuse, physical abuse and neglect, and emotional abuse and neglect) in association with non-suicidal self-injury. We also provided a qualitative review of mediators and moderators of this association. We identified relevant articles published from inception to Sept 25, 2017, through a systematic search of Embase, MEDLINE, and PsycINFO. We extracted continuous and categorical data and assessed for potential moderators using ten study characteristics. We generated random-effects models for analysis and evaluated for publication bias. FINDINGS We identified 71 publications that met eligibility criteria. Overall childhood maltreatment was associated with non-suicidal self-injury (odds ratio 3·42, 95% CI 2·74-4·26), and effect sizes for maltreatment subtypes ranged from 1·84 (1·45-2·34) for childhood emotional neglect to 3·03 (2·56-3·54) for childhood emotional abuse. Publication bias was not evident, except in the case of childhood emotional neglect. Across multiple maltreatment subtypes, we found stronger associations with non-suicidal self-injury in non-clinical samples. INTERPRETATION With the exception of childhood emotional neglect, childhood maltreatment and its subtypes are associated with non-suicidal self-injury. Screening of childhood maltreatment history in non-suicidal self-injury risk assessments might hold particular value in community settings, and increased attention to childhood emotional abuse is warranted. FUNDING National Institute of Mental Health.
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Childhood abuse and neglect and insecure attachment states of mind in adulthood: Prospective, longitudinal evidence from a high-risk sample. Dev Psychopathol 2017; 29:347-363. [PMID: 28401830 DOI: 10.1017/s0954579417000037] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The present report used data from the Minnesota Longitudinal Study of Risk and Adaptation to investigate the factor structure and childhood abuse and/or neglect related antecedents of adults' attachment states of mind in a high-risk sample. Adult Attachment Interviews (AAIs) were collected when participants were age 26 years (N = 164) and Current Relationship Interviews (CRIs) were collected from participants (N = 116) and their romantic partners when target participants were between ages 20 and 28 years (M = 25.3 years). For both the AAI and the CRI, exploratory factor analyses revealed that (a) attachment state of mind scales loaded on two weakly correlated dimensions reflecting dismissing and preoccupied states of mind and (b) ratings of unresolved discourse loaded on the same factor as indicators of preoccupied states of mind. Experiencing any subtype of abuse and/or neglect, especially during multiple developmental periods, and experiencing multiple subtypes of abuse and/or neglect during childhood were associated with risk for preoccupied (but not dismissing) AAI states of mind regarding childhood relationships with caregivers. Analyses focused on the particular subtypes, and perpetrators indicated that the predictive significance of childhood abuse/neglect for adult's AAI preoccupied states of mind was specific to experiences of abuse (but not neglect) perpetrated by primary caregivers. In addition, experiencing chronic or multiple subtypes of childhood abuse and/or neglect increased risk for dismissing (but not preoccupied) CRI states of mind regarding adult romantic partners.
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