Childhood abuse and lifetime psychopathology in a community sample

Childhood trauma and alcohol misuse in college students: The moderating role of minimization

BACKGROUND

History of childhood trauma as a risk factor for alcohol misuse in early adulthood is very well documented. Given the associations between childhood trauma and alcohol misuse, more work is needed to understand the factors that influence this relationship.

OBJECTIVE

The purpose of this study was to examine the relationship between childhood trauma, minimization of such events and alcohol misuse in a French college student sample.

PARTICIPANTS AND SETTING

A convenience sampling method was used to recruit students from several colleges located in Western France. The data set included 1180 records with complete responses.

METHODS

This study employed a cross-sectional online survey. Data collection instruments included the Childhood Trauma Questionnaire Short-Form (CTQ-SF) and the Alcohol Use Disorders Identification Test (AUDIT).

RESULTS

The strength of the association between CTQ score and AUDIT total score was increased by minimization score (β = 0.122, p = .07). This result suggests that under-reporting childhood trauma experiences tends to increase the impact of such events on alcohol misuse.

CONCLUSION

These findings suggest that a tendency to minimize threatening childhood events may specifically be related to increased risk of greater alcohol misuse among college students. Therefore, it may be important for clinician to assess minimization of early events in students with a history of childhood trauma.

Routine Sensitive Enquiry of Adult Interpersonal Trauma in Community Mental Health Teams: An Audit of the Initial Assessment Tool

This audit aimed to evaluate the utility of the Initial Assessment Tool (IAT) in documenting routine sensitive enquiry of adult interpersonal trauma within three Community Mental Health Teams (CMHTs) in North-East Glasgow. In addition, it sought to evaluate if disclosures informed patient risk assessments and if patients were signposted to additional support services. 57% of 90 IATs had evidence of routine sensitive enquiry. Of 51 casefiles with evidence of routine sensitive enquiry, 61% had evidence of the information informing their risk assessments and 14% had documented recommendations of support organisations. The IAT appeared able to assist clinicians with routine sensitive enquiry in adulthood. However, there may be advantage in supporting staff understanding of how to ask questions to specific populations and to use this information to inform treatment planning. Given the prevalence of adult interpersonal trauma experienced by patients presenting to CMHTs, trauma-informed approaches to care should be implemented.

Gender differences in the associations between childhood adversity and psychopathology in the general population

PURPOSE

To explore gender differences of the associations between childhood adversity (CA) subtypes and psychiatric symptoms in the general population.

METHODS

Data of 791 participants were retrieved from a general population twin cohort. The Symptom Checklist-90 Revised (SCL-90) and the Childhood Trauma Questionnaire were used to assess overall psychopathology with nine symptom domains scores and total CA with exposure to five CA subtypes, respectively. The associations between CA and psychopathology were analyzed in men and women separately and were subsequently compared.

RESULTS

Total CA was associated with total SCL-90 and all symptom domains without significant gender differences. However, the analyses of CA subtypes showed that the association between emotional abuse and total SCL-90 was stronger in women compared to men [χ2(1) = 4.10, P = 0.043]. Sexual abuse was significantly associated with total SCL-90 in women, but emotional neglect and physical neglect were associated with total SCL-90 in men. Exploratory analyses of CA subtypes and SCL-90 subdomains confirmed the pattern of gender-specific associations. In women, emotional abuse was associated with all symptom domains, and sexual abuse was associated with all except phobic anxiety and interpersonal sensitivity. In men, emotional neglect was associated with depression, and physical neglect was associated with phobic anxiety, anxiety, interpersonal sensitivity, obsessive-compulsive, paranoid ideation, and hostility subdomains.

CONCLUSION

CA is a trans-syndromal risk factor regardless of gender. However, differential associations between CA subtypes and symptom manifestation might exist. Abuse might be particularly associated with psychopathology in women, whereas neglect might be associated with psychopathology in men.

Gender differences in the association between childhood maltreatment and the onset of major depressive disorder

BACKGROUND

Childhood maltreatment is widely acknowledged as a risk factor for developing major depressive disorders (MDDs) in adulthood. However, the influence of gender on age at MDD onset and the relationships between various forms of maltreatment remain unclear.

AIMS

This study aimed to evaluate the effect of gender on the relationship between childhood maltreatment and depressive disorder onset with regard to maltreatment severity, age at onset, and the correlation between different forms of maltreatment.

METHODS

Data for this study were derived from the Objective Diagnostic Marker and Personalized Intervention in MDD Patients (ODMPIM) study, a multi-center collaborative research project. The data used here include 1001 patients diagnosed with depressive disorder and 494 healthy participants. Childhood maltreatment levels were assessed using the Childhood Trauma Questionnaire-Short Form (CTQ-SF).

RESULTS

Emotional abuse was correlated with physical abuse, and emotional neglect was correlated with physical neglect in the MDD patient population. Emotional abuse significantly contributed to early onset of MDD in both genders. Regarding gender differences, male patients with MDD experienced more severe physical abuse during childhood. The correlation between childhood sexual abuse and physical abuse was stronger among males than among females. Levels of physical abuse and neglect tended to be positively associated with the age of MDD onset. Gender is a moderator in the relationship between MDD onset age and childhood physical abuse or neglect.

CONCLUSIONS

Gender plays a role in certain aspects of the relationship between MDD and childhood maltreatment.

Can computational models help elucidate the link between complex trauma and hallucinations?

Recently, a number of predictive coding models have been proposed to account for post-traumatic stress disorder (PTSD)'s symptomatology, including intrusions, flashbacks and hallucinations. These models were usually developed to account for traditional/type-1 PTSD. We here discuss whether these models also apply or can be translated to the case of complex/type-2 PTSD and childhood trauma (cPTSD). The distinction between PTSD and cPTSD is important because the disorders differ in terms of symptomatology and potential mechanisms, how they relate to developmental stages, but also in terms of illness trajectory and treatment. Models of complex trauma could give us insights on hallucinations in physiological/pathological conditions or more generally on the development of intrusive experiences across diagnostic classes.

Childhood maltreatment and mentalizing capacity: A meta-analysis

BACKGROUND

The protective role of mentalizing capacity against the adverse effects of childhood maltreatment (CM) is acknowledged; however, empirical studies have yielded diverse conclusions regarding the relationship between childhood maltreatment and mentalizing capacity.

OBJECTIVE

This meta-analytic review aims to comprehensively summarize and quantify the association between childhood maltreatment and mentalizing capacity.

PARTICIPANTS AND SETTING

A total of 23 studies involving 3910 participants were included in the analysis.

METHODS

Systematic searches across eight bibliographic databases identified peer-reviewed publications describing empirical studies on the interplay between CM and mentalizing capacity. Effect sizes (r) were synthesized using random-effects models. A moderated effects analysis was conducted on five variables: participant gender, age group, mental health status, mentalizing capacity measurement, and childhood maltreatment measurement.

RESULTS

The findings showed a significant moderate negative correlation between childhood maltreatment and mentalizing capacity (r = -0.21, 95 % CI = [-0.26, -0.15]). This suggests that heightened severity of childhood maltreatment corresponds to lower mentalizing capacity. Moreover, the strength of this correlation was influenced by participant gender, age group, mental health status, mentalizing capacity measurement, and CM measurement.

CONCLUSIONS

The controversy surrounding the link between CM and mentalizing capacity gains clarity when considering significant moderating variables. The pooled effect provides a preliminary definition of the magnitude and direction of this correlation.

Can I Leave the Past Behind? Associations between Childhood Abuse and Adult Psychopathology

BACKGROUND

Research consistently shows that abuse during childhood is related to adult psychopathology. Information regarding childhood abuse is frequently collected from either previous documentation or from participants' self-reports.

OBJECTIVE

In the current study, we combined information on reports of childhood abuse from several informants (patients, treating clinicians, and independent interviewer), as well as diagnostic assessments of adult patients based on independent interviewer assessments based on structured diagnostic interviews (SCID) and clinician judgments, to better examine the association between exposure to abuse during childhood and adult psychopathology.

PARTICIPANTS AND SETTING

A convenience sample of patients in community mental health and hospital-based clinics (N = 170) and their clinicians (N = 80) participated in the study.

METHODS

Patients and clinicians completed the Clinical Data Form. Patients also completed the Childhood Trauma Questionnaire. Independent interviewer-assessed patients and completed the Familial Experiences Interview. Clinicians completed a diagnostic assessment of their patients based on clinical judgment. Independent interviewers completed the Structured Clinical Interview (SCID).

RESULTS

Reports of exposure to physical, emotional, and sexual abuse during childhood from all informants correlated with the treating clinician's diagnosis of borderline personality disorder (BPD; r range 0.23-0.37, p < 0.05), but not with SCID diagnosis of BPD. Clinician and SCID diagnosis of post-traumatic stress disorder (PTSD) correlated with patient and interviewer reports of childhood sexual abuse (r range 0.23-0.30, p < 0.05), but there were no correlations with treating clinician's reports of sexual abuse.

CONCLUSIONS

The association between BPD and childhood abuse is consistent across different ratings and measurements. The study raises questions of the ability of a structured interview to accurately capture BPD and highlights the connection between sexual abuse and PTSD, and the importance of treating clinicians' examination of childhood sexual abuse among their patients.

Addressing the Complex Links between Psychopathy and Childhood Maltreatment, Emotion Regulation, and Aggression-A Network Analysis in Adults

Childhood maltreatment is the strongest predictor of psychopathology and personality disorders across the lifespan and is strongly associated with a variety of psychological problems, namely, mood and anxiety disorders, behavioral and personality disorders, substance abuse, aggression, and self-harm. In this study, we aim to provide a comprehensive picture of the interplay between different traits of psychopathy and distinct dimensions of childhood maltreatment, emotion regulation, and aggression. Using a cross-sectional design, we employed correlational network analysis to explore the nomological network of psychopathy and provide a sample-based estimate of the population parameters reflecting the direction, strength, and patterns of relationships between variables. The sample consisted of 846 adults (71% females) who completed questionnaires measuring psychopathy, childhood maltreatment, emotion regulation, and aggression. The results highlight that disinhibition traits of psychopathy are the closest attributes of early experiences of abuse (but not neglect) in childhood and correlate with all dimensions of emotion regulation difficulties, being specifically associated with reactive aggression. Neglect was a unique attribute in the nomological network of meanness, with widespread correlations with emotion regulation difficulties but also an increased ability to engage in goal-directed behavior. Physical abuse was the only dimension of childhood adversity that was found to be intercorrelated with boldness and increased emotional regulation was found in this psychopathic trait. No significant associations were found between boldness, meanness, and aggression once shared variance with disinhibition was controlled. These results are discussed in terms of their implication for research and clinical practice.

Child Maltreatment History, Deployment-Related Traumatic Events, and Past 12-Month Cannabis Use Among Veterans in Canada

OBJECTIVE

Cannabis use among veterans in Canada is an understudied public health priority. The current study examined cannabis use prevalence and the relationships between child maltreatment histories and deployment-related traumatic events (DRTEs) with past 12-month cannabis use including sex differences among Canadian veterans.

METHOD

Data were drawn from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (response rate 68.7%; veterans only n = 1,992). Five child maltreatment types and 9 types of DRTEs were assessed in relation to the past 12-month cannabis use.

RESULTS

The prevalence of lifetime and past 12-month cannabis use was 49.4% and 16.7%, respectively. Females were less likely than males to report lifetime cannabis use (41.9% vs. 50.4%; odds ratio [OR] 0.71; 95% CI, - 0.59 to 0.86). No sex differences were noted for past 12-month cannabis use (14.1% vs. 17.0%; OR 0.80; 95% CI, 0.60 to 1.07). Physical abuse, sexual abuse, neglect, any child maltreatment, most individual DRTEs, and any DRTE were associated with increased odds of past 12-month cannabis use after adjusting for sociodemographic and military variables. Some models were attenuated and/or nonsignificant after further adjustments for mental disorders and chronic pain conditions. Sex did not statistically significantly moderate these relationships. Cumulative effects of having experienced both child maltreatment and DRTEs compared to DRTEs alone increased the odds of past 12-month cannabis use. Statistically significant interaction effects between child maltreatment history and DRTE on cannabis use were not found.

CONCLUSIONS

Child maltreatment histories and DRTEs increased the likelihood of past 12-month cannabis use among Canadian veterans. A history of child maltreatment, compared to DRTEs, indicated a more robust relationship. Understanding the links between child maltreatment, DRTEs, and cannabis use along with mental disorders and chronic pain conditions is important for developing interventions and improving health outcomes among veterans.

The mediating role of childhood maltreatment in the association between residence migration and adolescent depression

BACKGROUND

It is well established that residence migration can negatively affect the mental health of adolescents. However, the related factors that mediate the association between residence migration and depression are still uncertain.

METHODS

The participants were 16,037 adolescents in junior middle schools. A self-administered questionnaire was used for the survey. In addition to collecting general demographic characteristics of the participants, including age, gender, local residence status, only child status, parental marriage status and parent-child relationship, the questionnaire also contained the 9-item Patient Health Questionnaire, the short form of the Childhood Trauma Questionnaire and the Connor-Davidson Resilience Scale. Data analysis was conducted using SPSS software.

RESULTS

A total of 14,059 valid questionnaires were collected, resulting in 12,122 local adolescents, defined as being born and raised locally, and 1937 migrant adolescents, defined as being transferred from other regions. Meanwhile, 53.3 % of local adolescents and 58.2 % of migrant adolescents reported depressive symptoms. This result indicated that residence migration might contribute to depression symptoms(OR = 1.136, 95%CI: 1.013-1.273, p < 0.05). Childhood maltreatment and parental divorce are risk factors for depression in migrant adolescents. For all adolescents, resilience and a good parent-child relationship may reduce the risk of depression. Childhood maltreatment completely mediates residence migration-related depression(95 % bootstrap CI = 0.146, 0.323).

CONCLUSION

This study revealed that residence migration could contribute to adolescent depression, and childhood maltreatment may largely mediate this process, providing new insight into the relationship between adolescent depressive symptoms and residence migration. Reducing childhood maltreatment may effectively improve the depressive symptoms of migrant adolescents.

Positive parent-child interactions moderate certain maltreatment effects on psychosocial well-being in 6-year-old children

BACKGROUND

Positive parental interactions may buffer maltreated children from poor psychosocial outcomes. The study aims to evaluate the associations between various types of maltreatment and psychosocial outcomes in early childhood, and examine the moderating effect of positive parent-child interactions on them.

METHODS

Data were from a representative Chinese 6-year-old children sample (n = 17,088). Caregivers reported the history of child maltreatment perpetrated by any individuals, completed the Strengths and Difficulties Questionnaire as a proxy for psychosocial well-being, and reported the frequency of their interactions with children by the Chinese Parent-Child Interaction Scale.

RESULTS

Physical abuse, emotional abuse, neglect, and sexual abuse were all associated with higher odds of psychosocial problems (aOR = 1.90 [95% CI: 1.57-2.29], aOR = 1.92 [95% CI: 1.75-2.10], aOR = 1.64 [95% CI: 1.17-2.30], aOR = 2.03 [95% CI: 1.30-3.17]). Positive parent-child interactions were associated with lower odds of psychosocial problems after accounting for different types of maltreatment. The moderating effect of frequent parent-child interactions was found only in the association between occasional only physical abuse and psychosocial outcomes (interaction term: aOR = 0.34, 95% CI: 0.15-0.77).

CONCLUSIONS

Maltreatment and positive parent-child interactions have impacts on psychosocial well-being in early childhood. Positive parent-child interactions could only buffer the adverse effect of occasional physical abuse on psychosocial outcomes. More frequent parent-child interactions may be an important intervention opportunity among some children.

IMPACT

It provides the first data on the prevalence of different single types and combinations of maltreatment in early childhood in Shanghai, China by drawing on a city-level population-representative sample. It adds to evidence that different forms and degrees of maltreatment were all associated with a higher risk of psychosocial problems in early childhood. Among them, sexual abuse posed the highest risk, followed by emotional abuse. It innovatively found that higher frequencies of parent-child interactions may provide buffering effects only to children who are exposed to occasional physical abuse. It provides a potential intervention opportunity, especially for physically abused children.

Hippocampal volume mediates the relationship of parental rejection in childhood with social cognition in healthy adults

Childhood abuse reduces hippocampal and amygdala volumes and impairs social cognition, including the ability to recognize facial expressions. However, these associations have been studied primarily in individuals with a history of severe abuse and psychiatric symptoms; researchers have not determined whether these associations can also be observed in healthy adults. In the present study, we analyzed data from 400 healthy adults (208 men and 192 women) at Tamagawa University. Parental rejection reflecting childhood abuse was assessed using the short form of Egna Minnen Beträffande Uppfostran, while social cognition was assessed using the "Fake Smile Detection Task." Hippocampal and amygdala volumes were extracted from T1-weighted magnetic resonance imaging data using FreeSurfer. We found that greater parental rejection resulted in smaller hippocampal and amygdala volumes and poorer performance in the Fake Smile Detection Task. Structural equation modeling analysis supported the model that hippocampal volume mediates maternal rejection effect on performance on the Fake Smile Detection Task, with involvement of the amygdala. These findings are in line with the structural and functional connectivity found between the hippocampus and amygdala and their joint involvement in social cognition. Therefore, parental rejection may affect hippocampal and amygdala volumes and social cognitive function even in symptom-free adults.

Early-life stress and ovarian hormones alter transcriptional regulation in the nucleus accumbens resulting in sex-specific responses to cocaine

Early-life stress and ovarian hormones contribute to increased female vulnerability to cocaine addiction. Here, we reveal molecular substrates in the reward area, the nucleus accumbens, through which these female-specific factors affect immediate and conditioning responses to cocaine. We find shared involvement of X chromosome inactivation-related and estrogen signaling-related gene regulation in enhanced conditioning responses following early-life stress and during the low-estrogenic state in females. Low-estrogenic females respond to acute cocaine by opening neuronal chromatin enriched for the sites of ΔFosB, a transcription factor implicated in chronic cocaine response and addiction. Conversely, high-estrogenic females respond to cocaine by preferential chromatin closing, providing a mechanism for limiting cocaine-driven chromatin and synaptic plasticity. We find that physiological estrogen withdrawal, early-life stress, and absence of one X chromosome all nullify the protective effect of a high-estrogenic state on cocaine conditioning in females. Our findings offer a molecular framework to enable understanding of sex-specific neuronal mechanisms underlying cocaine use disorder.

Brain insulin signaling as a potential mediator of early life adversity effects on physical and mental health

In numerous brain structures, insulin signaling modulates the homeostatic processes, sensitivity to reward pathways, executive function, memory, and cognition. Through human studies and animal models, mounting evidence implicates central insulin signaling in the metabolic, physiological, and psychological consequences of early life adversity. In this review, we describe the consequences of early life adversity in the brain where insulin signaling is a key factor and how insulin may moderate the effects of adversity on psychiatric and cardio-metabolic health outcomes. Further understanding of how early life adversity and insulin signaling impact specific brain regions and mental and physical health outcomes will assist in prevention, diagnosis, and potential intervention following early life adversity.

The impact of family interventions on communication in the context of anxiety and depression in those aged 14-24 years: systematic review of randomised control trials

BACKGROUND

The ability to communicate is integral to all human relationships. Previous research has specifically highlighted communication within families as both a risk and protective factor for anxiety disorders and/or depression. Yet, there is limited understanding about whether communication is amenable to intervention in the context of adolescent psychopathology, and whether doing so improves outcomes.

AIMS

The aim of this systematic review was to determine in which contexts and for whom does addressing communication in families appear to work, not work and why?

METHOD

We pre-registered our systematic review with PROSPERO (identifier CRD42022298719), followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance and assessed study quality with the Risk of Bias 2 tool.

RESULTS

Seven randomised controlled trials were identified from a systematic search of the literature. There was significant heterogeneity in the features of communication that were measured across these studies. There were mixed findings regarding whether family-focused interventions led to improvements in communication. Although there was limited evidence that family-focused interventions led to improvements in communication relative to interventions without a family-focused component, we discuss these findings in the context of the significant limitations in the studies reviewed.

CONCLUSIONS

We conclude that further research is required to assess the efficacy of family-focused interventions for improving communication in the context of anxiety and depression in those aged 14-24 years.

Exposure to household dysfunction at childhood and later number of teeth among older Japanese adults: A life course study from the Japan Gerontological Evaluation Study

OBJECTIVES

The aim of this retrospective cohort study was to investigate the life course association between exposure to two household dysfunctions (father violence against mother and parental divorce) at childhood (≤18 years) with later number of remaining teeth (≥65 years) in functionally independent older Japanese population. This was the first study to investigate this research question in the Asian context.

METHODS

The Japan Gerontological Evaluation study (JAGES) self-reported retrospective data gathered in 2013 was used (n = 21,604). Each household dysfunction was binary variable (Yes/No), while the five categories of the number of remaining teeth were ≥20, 10-19, 5-9, 1-4, and no teeth. Sex-stratified ordered logistic regression models were used to calculate the odds ratios (OR) of having fewer teeth. The models were adjusted for age, economic adversity in childhood, educational attainment, comorbidities, and smoking status.

RESULTS

Overall, 46.4% were men and a total of 1149 participants (5.3%) experienced household dysfunction at childhood [men = 642 (6.4%), women = 507 (4.4%)]. The regression models showed higher OR of having fewer teeth among men who experienced a household dysfunction [OR = 1.16; 95% Confidence interval (CI) = 1.00-1.36] than men who did not. This association was not observed among women [OR = 0.94; 95% CI = 0.79-1.13]. Similar magnitude and direction of the association was observed among men but not among women when the two components of household dysfunction were used separately and aggregately as exposure variables.

CONCLUSION

An exposure to a household dysfunction at childhood was associated with having fewer teeth in later life among men but not among women.

Association between parental separation, childhood trauma, neuroticism, and depression: a case control study

Background

Parental separation has been suggested to be associated with depression development in offspring. The new family constellation subsequent to separation could be associated with elevated scores of childhood trauma, shaping more emotionally instable personalities. This could ultimately be a risk factor for mood disorders and particularly the development of depression in life.

Methods

To test this hypothesis, we investigated the associations between parental separation, childhood trauma (CTQ) and personality (NEO-FFI) in a sample of N = 119 patients diagnosed with depression and N = 119 age and sex matched healthy controls.

Results

While parental separation was associated with elevated scores of childhood trauma, there was no association between parental separation and Neuroticism. Furthermore, in a logistic regression analysis, Neuroticism and childhood trauma were found to be significant predictors for depression diagnosis (yes/no), but not parental separation (yes/no).

Conclusion

Parental separation might be associated with depression only indirectly via childhood trauma. Childhood trauma or Neuroticism seem more directly related to the development of depression. However, it is worthwhile to install prevention programs helping parents and children to cope with parental separation in order to minimize the impact of separation and associated stressors.

Gender-specific association of adverse childhood experiences with frailty index level and trajectory in China

BACKGROUND

The determinants of gender differences in frailty remain unknown but may include social factors. International attention is increasingly focusing on the adverse childhood experiences of women. This study therefore examined the gender-specific association of adverse childhood experiences with frailty index level and trajectory.

METHODS

This population-based study used data from the China Health and Retirement Longitudinal Study, with a nationally representative sample of people aged 45 years or more. The frailty index was based on 41 health measurements, and 18 types of adverse childhood experiences were examined. Weighted ordered logistic models were used with additive interaction.

RESULTS

Compared with those exposed to one or no adverse events, exposure to two or three childhood adverse experiences was associated with a 44 % (95%CI: 1.16-1.80) increase in the likelihood of frail status for women, but not significantly associated with the likelihood of frail status for men. Additionally, for men and women, experiencing four or more adversities was associated with a 69 % (95%CI: 1.36-2.09) and a 138 % (95%CI: 1.93-2.94) increase in the likelihood of frail status, respectively. A similar association was found between accumulative scores for adverse childhood experiences and trajectory of the frailty index (men vs. women: OR of exposure to two or three adversities: 1.17 (95%CI: 0.84-1.64) vs. 1.26 (95%CI: 1.02-1.56); OR of exposure to four or more adversities: 1.70 (95%CI: 1.24-2.34) vs. 2.12 (95%CI: 1.70-2.63)). The greatest increase in risk of frailty was observed among men and women experiencing a high level of adversity, followed by socioeconomic deprivation and intrafamilial aggression. There was a significant additive interaction between women and childhood socioeconomic deprivation or a high level of adversity. The risk of being frail or having a rapidly increasing frailty index trajectory for women with a high level of adversity was approximately 4.34 (95%CI: 3.36-5.59) and 4·07 (95%CI: 3·34-4.96) times higher than that for men with a low level of adversity. However, gender differences were not found in the effects of childhood intrafamilial aggression.

CONCLUSIONS

Men and women routinely experienced adult frailty as a result of adverse childhood events. The biological interaction between women and adverse childhood experiences was evident, with women's frailty being more sensitive to childhood socioeconomic deprivation and a high level of adversity. The findings have important implications for reducing the risk of frailty by mitigating early life stress, especially among women.

Differential prevalence of Adverse Childhood Experiences (ACEs) by gender and substance used in individuals with cannabis, cocaine, opioid, and tobacco use disorders

Background: Adverse childhood experiences (ACEs) show a graded association with the development of substance use disorders (SUDs) and engagement in risky substance use behaviors. Women are overrepresented among individuals with more severe childhood adversity (≥4 types of ACEs) and may be at particular risk for aberrant substance use.Objectives: To assess the prevalence of ACEs among men and women with cannabis, opioid, cocaine, and tobacco use disorders.Methods: Non-treatment-seeking individuals participating in clinical addiction research at a single site completed the ACE questionnaire and provided a detailed substance use history. Data were analyzed using proportional odds models and logistic regression.Results: Most participants (424/565; 75%) reported at least one ACE, and more than one-quarter (156/565; 27%) reported severe childhood adversity. Relative to men (n = 283), women (n = 282) reported more ACEs (OR = 1.49; p = .01) and more experiences of emotional/physical abuse (OR = 1.52; p = .02), sexual abuse (OR = 4.08; p = .04), and neglect (OR = 2.30; p < .01). Participants in the cocaine (OR = 1.87; n = .01) and opioid (OR = 2.21; p = .01) use disorder, but not cannabis use disorder (OR = 1.46; p = .08), studies reported more severe adversity relative to the tobacco group. Relative to tobacco users, emotional/physical abuse (OR = 1.92; p = .02) and neglect (OR = 2.46; p = .01) scores were higher in cocaine users and household dysfunction scores were higher in opioid users (OR = 2.67; p = .01).Conclusion: The prevalence of ACEs differs with respect to both participant gender and primary substance used. Novel SUD treatment strategies that incorporate ACEs may be uniquely beneficial in specific subpopulations of people with SUDs.

Early life adversity across different cell- types in the brain

Early life adversity (ELA)- which includes physical, psychological, emotional, and sexual abuse is one of the most common predictors to diverse psychopathologies later in adulthood. As ELA has a lasting impact on the brain at a developmental stage, recent findings from the field highlighted the specific contributions of different cell types to ELA and their association with long lasting consequences. In this review we will gather recent findings describing morphological, transcriptional and epigenetic alterations within neurons, glia and perineuronal nets and their associated cellular subpopulation. The findings reviewed and summarized here highlight important mechanisms underlying ELA and point to therapeutic approaches for ELA and related psychopathologies later in life.

A latent class analysis of the socio-demographic factors and associations with mental and behavioral disorders among Australian children and adolescents

BACKGROUND

Previous studies have shown a relationship between socio-demographic variables and the mental health of children and adolescents. However, no research has been found on a model-based cluster analysis of socio-demographic characteristics with mental health. This study aimed to identify the cluster of the items representing the socio-demographic characteristics of Australian children and adolescents aged 11-17 years by using latent class analysis (LCA) and examining the associations with their mental health.

METHODS

Children and adolescents aged 11-17 years (n = 3152) were considered from the 2013-2014 Young Minds Matter: The Second Australian Child and Adolescent Survey of Mental Health and Wellbeing. LCA was performed based on relevant socio-demographic factors from three levels. Due to the high prevalence of mental and behavioral disorders, the generalized linear model with log-link binomial family (log-binomial regression model) was used to examine the associations between identified classes, and the mental and behavioral disorders of children and adolescents.

RESULTS

This study identified five classes based on various model selection criteria. Classes 1 and 4 presented the vulnerable class carrying the characteristics of "lowest socio-economic status and non-intact family structure" and "good socio-economic status and non-intact family structure" respectively. By contrast, class 5 indicated the most privileged class carrying the characteristics of "highest socio-economic status and intact family structure". Results from the log-binomial regression model (unadjusted and adjusted models) showed that children and adolescents belonging to classes 1 and 4 were about 1.60 and 1.35 times more prevalent to be suffering from mental and behavioral disorders compared to their class 5 counterparts (95% CI of PR [prevalence ratio]: 1.41-1.82 for class 1; 95% CI of PR [prevalence ratio]: 1.16-1.57 for class 4). Although children and adolescents from class 4 belong to a socio-economically advantaged group and shared the lowest class membership (only 12.7%), the class had a greater prevalence (44.1%) of mental and behavioral disorders than did class 2 ("worst education and occupational attainment and intact family structure") (35.2%) and class 3 ("average socio-economic status and intact family structure") (32.9%).

CONCLUSIONS

Among the five latent classes, children and adolescents from classes 1 and 4 have a higher risk of developing mental and behavioral disorders. The findings suggest that health promotion and prevention as well as combating poverty are needed to improve mental health in particular among children and adolescents living in non-intact families and in families with a low socio-economic status.

Childhood Maltreatment and Dementia Risk Factors in Midlife: A Prospective Investigation

BACKGROUND

Previous studies have linked childhood adversities to dementia risk, yet most studies are cross-sectional in design and utilize retrospective self-reports to assess childhood experiences. These design characteristics make it difficult to establish temporal order and draw firm conclusions.

OBJECTIVES

Using a longitudinal design, we sought to determine whether childhood maltreatment predicts dementia risk factors in middle adulthood.

METHODS

Data have been obtained from a prospective cohort design study of children with documented cases of childhood maltreatment (ages 0-11 years at case identification) and demographically matched controls who were followed up and interviewed in middle adulthood. Outcomes were assessed through a medical examination and interview, and 807 of the cases that included blood collection at mean age 41. Dementia risk were investigated using 11 potentially modifiable risk factors.

RESULTS

Compared to controls, individuals with histories of childhood maltreatment had a higher risk of low educational attainment, low social contact, smoking, and clinical depression, and a higher total number of dementia risk factors. In general, childhood maltreatment predicted a higher risk of dementia for females, males, and Black and White participants. Black maltreated participants had a greater risk for traumatic brain injury compared to Black controls. Physical abuse, sexual abuse, and neglect, each predicted a higher number of dementia risk factors in mid-life.

CONCLUSION

These findings provide evidence that childhood maltreatment increases the risk for dementia in mid-life and has a demonstrable impact lasting over 30 years. Reducing the prevalence of mid-life dementia risk factors could reduce the risk of later-life dementia.

Differential Associations between Guilt and Shame Proneness and Religious Coping Styles in a Diverse Sample of Young Adults

Positive religious coping is linked with better mental health outcomes following physical and sexual abuse while negative religious coping is associated with poorer outcomes. Religious coping styles may be linked with dispositional tendencies to experience guilt or shame. This study compared the associations between guilt and shame proneness and religious coping styles and tested whether abuse history moderated these relationships. We conducted a cross-sectional study with 425 college students (n = 145 with physical and/or sexual abuse history, n = 280 with no abuse history). Participants completed questionnaires assessing positive and negative religious coping style, as well as two dimensions of guilt proneness and shame proneness. Structural equation models were fitted to examine associations between guilt proneness and shame proneness, and positive and negative religious coping, respectively, accounting for abuse history as a binary moderator. Across the full sample, positive religious coping was positively associated with guilt repair (i.e., the tendency to engage in reparative behaviors following one's wrongdoing), guilt negative behavior evaluation (i.e., the tendency to feel bad about how one acted in a given scenario), and shame withdrawal (i.e., the tendency to try and avoid unpleasant situations in which one has done something wrong), and negatively associated with shame negative self-evaluation (i.e., the tendency to make internal, negative self-attributions about one's wrongdoing). Negative religious coping was positively associated with shame withdrawal and, for participants with no abuse history, shame negative self-evaluation. Results suggest that positive religious coping is more closely related to guilt proneness, and negative religious coping to shame proneness. Additional research with longitudinal designs and more defined abuse history subgroups is needed.

Evaluation of a Trauma-Informed Parenting Program for Resource Parents

Child maltreatment impacts many young people involved in the child welfare system, and it is important that the resource parents supporting these youth have knowledge and skills in trauma-informed care. The current study is a preliminary evaluation of the Resource Parent Curriculum (RPC), an in-service, 8-module, group-based parenting program developed by the National Child Traumatic Stress Network. Youth and caregiver outcomes were examined by way of a quasi-experimental design that included 22 resource parents in the experimental group and 21 in the waitlist control group and involved baseline, post-program, and 2-month follow-up assessments. For learning outcomes, RPC resulted in improvements in resource parents' knowledge and beliefs about trauma-informed parenting. While not statistically significant, potential effects included improvements in resource parents' tolerance of challenging youth behaviors and parenting self-efficacy. For behavioral outcomes, several non-significant potential effects were noted, including improvements in resource parents' attachment relationships with their youth and increased social supports. This study was the first to evaluate RPC using a quasi-experimental design within a Canadian context and through a virtual delivery. Findings highlighted several benefits of the program and resource parents' ongoing training needs.

Early-life stress lastingly impacts microglial transcriptome and function under basal and immune-challenged conditions

Early-life stress (ELS) leads to increased vulnerability to psychiatric disorders including depression later in life. Neuroinflammatory processes have been implicated in ELS-induced negative health outcomes, but how ELS impacts microglia, the main tissue-resident macrophages of the central nervous system, is unknown. Here, we determined the effects of ELS-induced by limited bedding and nesting material during the first week of life (postnatal days [P]2-9) on microglial (i) morphology; (ii) hippocampal gene expression; and (iii) synaptosome phagocytic capacity in male pups (P9) and adult (P200) mice. The hippocampus of ELS-exposed adult mice displayed altered proportions of morphological subtypes of microglia, as well as microglial transcriptomic changes related to the tumor necrosis factor response and protein ubiquitination. ELS exposure leads to distinct gene expression profiles during microglial development from P9 to P200 and in response to an LPS challenge at P200. Functionally, synaptosomes from ELS-exposed mice were phagocytosed less by age-matched microglia. At P200, but not P9, ELS microglia showed reduced synaptosome phagocytic capacity when compared to control microglia. Lastly, we confirmed the ELS-induced increased expression of the phagocytosis-related gene GAS6 that we observed in mice, in the dentate gyrus of individuals with a history of child abuse using in situ hybridization. These findings reveal persistent effects of ELS on microglial function and suggest that altered microglial phagocytic capacity is a key contributor to ELS-induced phenotypes.

Impact of childhood maltreatment on psychosomatic outcomes among men and women with disabilities

PURPOSE

This project examined the impact of childhood maltreatment types on psychosomatic outcomes among adults with a range of self-reported disabilities.

MATERIALS AND METHODS

Participants (n = 643) were recruited using Amazon Mechanical Turk and Cloud Research. Single-item questions assessed sociodemographic information. The Childhood Trauma Questionnaire measured childhood maltreatment types (emotional, physical, and sexual abuse, and emotional and physical neglect) and the RAND-36 Item Health Survey evaluated physical functioning, pain, and energy/fatigue. Logistic regressions determined associations between childhood trauma and psychosomatic outcomes; stratified models compared men and women.

RESULTS

Multivariate-adjusted models indicated physical abuse was positively associated with poor physical functioning (OR: 2.03; 95%CI: 1.35-3.06) with this relationship being stronger for men (OR: 3.25; 95%CI: 1.42-7.43) than women (OR: 1.91; 95%CI: 1.17-3.13). Adjusted models showed that physical neglect was protective against fatigue (OR: 0.58; 95% CI: 0.36-0.94), while emotional neglect increased the risk of fatigue (OR: 1.74; 95%CI: 1.02-2.95). Lastly, physical abuse was positively associated with pain (OR: 1.53; 95%CI: 1.01-2.33). This relationship was stronger in men (OR: 4.99; 95%CI: 1.91-12.99).

CONCLUSIONS

Results improve our understanding of risk factors for poor physical health outcomes and can guide the development of trauma-sensitive rehabilitation services.Implications for RehabilitationIndividuals with disabilities who report childhood maltreatment may experience poor psychosomatic outcomes in adulthood.Consequences of experiencing childhood maltreatment may manifest differently between men and women over the course of the lifespan.It is essential to integrate trauma-informed principles into treatment plans for individuals with poor psychosomatic health.Rehabilitation professionals should screen for abuse and refer individuals to the appropriate mental and physical health services.

Self-Compassion Moderates the Mediating Effect of Self-Criticism in the Link Between Childhood Maltreatment and Psychopathology

Childhood maltreatment (CM) has been associated with psychological symptoms (i.e., psychopathology) among clinical and nonclinical samples. The mechanisms underlying this link have been understudied, especially among well-functioning adults. Arguably, exposure to CM may be translated into negative and critical self-appraisals and self-blame, reflected in high self-criticism. CM may also result in difficulty in extending kindness towards oneself, that is, low self-compassion. These characteristics are linked with elevated psychopathology. Nevertheless, no study has yet tested the extent to which self-criticism and self-compassion may serve as independent mechanisms linking CM and psychopathology and whether in this context self-compassion buffers the link between self-criticism and psychopathology. Here, we tested an integrative model in which the relation between CM and psychopathology was mediated by self-compassion and self-criticism, and the path between self-criticism and psychopathology was moderated by self-compassion. A convenience sample of 914 individuals completed online self-report questionnaires. Results indicated that CM was related to psychopathology through the mediation of self-compassion and self-criticism, with a significant interaction between self-criticism and self-compassion. Showing a moderated-mediational effect, the link between self-criticism and psychopathology was weaker under high than under low levels of self-compassion. Our findings highlight the importance of self-compassion, a robust resilience factor related to reduced psychopathology and moderating the link between self-criticism, a potent transdiagnostic risk factor, and psychopathology in the context of CM. These results thus provide empirical evidence for the relevance of compassion and mindfulness in counseling settings, particularly with CM survivors, who are at greater risk for psychopathology.

Plasma complement C3 and C3a are increased in major depressive disorder independent of childhood trauma

BACKGROUND

Dysregulated complement system is linked to pathophysiology of major depressive disorder (MDD). Childhood trauma has been associated with an increased incidence of adult depression via a putative mechanism of immune activation. This study aimed to measure and compare peripheral levels of complement C3, C3a, C1q and C-reactive protein (CRP) in MDD patients and healthy controls and explore the relationship between these molecule levels and childhood trauma history in the participants.

METHODS

The participants were 49 medication-free MDD patients and 45 healthy controls. All participants were asked to finish the Childhood Trauma Questionnaire, followed by blood sampling for measurement of plasma complement C3, C3a, C1q and CRP by means of enzyme-linked immunosorbent assay.

RESULTS

Peripheral plasma concentration of C3 and C3a in medication-free MDD group was significantly higher than that in the healthy controls; whereas the concentration of plasma C1q and CRP in depressed patients was comparable to that in healthy controls. All these inflammatory factors were not associated to childhood trauma experience in patients with MDD.

CONCLUSION

Our data suggest that complement C3 and C3a may be implicated in the pathophysiology of MDD, although traumatic childhood experiences were not associated with the circulating levels of complement C3, C3a, C1q and CRP.

Ke ala i ka Mauliola: Native Hawaiian Youth Experiences with Historical Trauma

Native Hawaiians (NH), like other Indigenous peoples, continue to experience the subversive impacts of colonization. The traumatic effects of colonization, especially the forced relocation from land that sustained their life and health, have led to complex, interconnected health disparities seen today. NHs have described a collective feeling of kaumaha (heavy, oppressive sadness) resulting from mass land dispossession, overthrow of the Hawaiian Kingdom, cultural loss, and early loss of loved ones. Although historical trauma is linked to high rates of substance misuse, depression, suicidality, and other mental health disparities in American Indian populations. However, the link between NH historical trauma and health disparities among NHs has been less explored. This qualitative study used Indigenous talk story interviews with 34 NH 'ōpio (youth) and ka lawelawe (service providers) to explore how NH 'ōpio understand and experience historical trauma. Eight themes and 35 sub-themes were identified covering individual, community, and systemic domains representing the first step in addressing NH historical trauma.

Childhood maltreatment and cognitive functioning in middle adulthood

BACKGROUND

Childhood maltreatment (physical abuse, sexual abuse, and/or neglect) is associated with cognitive deficits in adulthood. Little is known about how childhood maltreatment affects the trajectory of cognitive functioning during early to middle adulthood.

OBJECTIVE

To explore the relationship between childhood maltreatment and change in cognitive functioning over a 10-year period in adulthood.

METHODS

Utilizing a prospective cohort design, a large group of court-substantiated cases of childhood maltreatment (ages 0-11) and demographically matched controls were followed into adulthood (N = 1196). Verbal intelligence and reading ability were assessed at age 29, and executive functioning was assessed at age 41. Linear, mixed-effects modeling was used to evaluate childhood maltreatment as a predictor of cognitive functioning and change in cognitive functioning over time.

RESULTS

Childhood maltreatment was associated with lower cognitive functioning at age 29 compared to controls (β = -0.28, p < .001), and this association was stronger for childhood neglect (β = -0.33, p < .001). Controls declined in cognitive functioning over the 10-year period (β = -0.12, p = .039), whereas childhood maltreatment overall was associated with no change. Adults with histories of neglect demonstrated an increase in cognitive functioning (β = 0.13, p = .021).

CONCLUSIONS

Our results demonstrate that childhood maltreatment is associated with cognitive functioning deficits in adulthood and suggest that cognitive change in adulthood may be differentially impacted by type of maltreatment. The initial deficit demonstrated by adults with childhood neglect was largely erased by a subsequent increase in cognitive functioning over 10 years.

Infant Stimulation Induced a Rapid Increase in Maternal Salivary Oxytocin

Oxytocin (OT) is a neuropeptide involved in human social behaviors and reproduction. Non-invasive OT levels in saliva have recently roused interest as it does not require a specialized medical setting. Here, we observed one woman’s basal serum and saliva OT from pregnancy to 1 year postpartum to track OT concentration changes over this period. We examined the changes in salivary OT levels over time in response to maternal physiological and behavioral responses. The fluctuation of saliva OT levels is well correlated with serum OT during pregnancy and breastfeeding. However, while salivary OT increased rapidly during direct interaction (social interaction tests) with the infant and/or when the mother was watching her own infant’s video (video tests), no increase was observed in serum. We used social interaction and video tests on a group of mothers (nine mothers for social interaction and six for the video test) to clarify these single-subject results. In both tests, the mothers had increased OT in their saliva but not serum. Our study may suggest that salivary samples reflect not only the physical but also the emotional state and that saliva samples may be useful for monitoring women’s OT levels during pre- and postpartum periods. Further studies with larger sample numbers are necessary to confirm the rapid changes in salivary OT levels in response to maternal physiological and behavioral responses.

Early-life stress and dietary fatty acids impact the brain lipid/oxylipin profile into adulthood, basally and in response to LPS

Brain lipid dysregulation is a hallmark of depression and Alzheimer's disease, also marked by chronic inflammation. Early-life stress (ELS) and dietary intake of polyunsaturated fatty acids (PUFAs) are risk factors for these pathologies and are known to impact inflammatory processes. However, if these early-life factors alter brain lipid homeostasis on the long-term and thereby contribute to this risk remains to be elucidated. We have recently shown that an early diet enriched in omega(ω)-3 PUFAs protected against the long-term negative effects of ELS on cognition and neuroinflammation. Here, we aim to understand if modulation of brain lipid and oxylipin profiles contributes to the detrimental effects of ELS and the protective ones of the diet. We therefore studied if and how ELS and early dietary PUFAs modulate the brain lipid and oxylipin profile, basally as well as in response to an inflammatory challenge, to unmask possible latent effects. Male mice were exposed to ELS via the limited bedding and nesting paradigm, received an early diet with high or low ω6/ω3 ratio (HRD and LRD) and were injected with saline or lipopolysaccharide (LPS) in adulthood. Twenty-four hours later plasma cytokines (Multiplex) and hypothalamic lipids and oxylipins (liquid chromatography tandem mass spectrometry) were measured. ELS exacerbated the LPS-induced increase in IL-6, CXCL1 and CCL2. Both ELS and diet affected the lipid/oxylipin profile long-term. For example, ELS increased diacylglycerol and LRD reduced triacylglycerol, free fatty acids and ceramides. Importantly, the ELS-induced alterations were strongly influenced by the early diet. For example, the ELS-induced decrease in eicosapentaenoic acid was reversed when fed LRD. Similarly, the majority of the LPS-induced alterations were distinct for control and ELS exposed mice and unique for mice fed with LRD or HRD. LPS decreased ceramides and lysophosphotidylcholine, increased hexosylceramides and prostaglandin E₂, reduced triacylglycerol species and ω6-derived oxylipins only in mice fed LRD and ELS reduced the LPS-induced increase in phosphatidylcholine. These data give further insights into the alterations in brain lipids and oxylipins that might contribute to the detrimental effects of ELS, to the protective ones of LRD and the possible early-origin of brain lipid dyshomeostasis characterizing ELS-related psychopathologies.

Biological aging in maltreated children followed up into middle adulthood

BACKGROUND

Childhood adversity has been linked to many indicators of shorter healthy lifespan, including earlier onset of disease and disability as well as early mortality. These observations suggest the hypothesis that childhood maltreatment may accelerate aging.

OBJECTIVE

To characterize the relationship between childhood maltreatment and accelerated biological aging in a prospective cohort of 357 individuals with documented cases of childhood maltreatment and 250 controls matched on demographic and socioeconomic factors.

METHODS

Cases were drawn from juvenile and adult court records from the years 1967 through 1971 in a large Midwest metropolitan geographic area. Cases were defined as having court-substantiated cases of childhood physical or sexual abuse, or neglect occurring at age 11 or younger. Controls were selected from the same schools and hospitals of birth and matched on age, sex, race, and approximate socioeconomic status. We compared biological aging in these two groups using two blood-chemistry algorithms, the Klemera-Doubal method Biological Age (KDM BA) and the PhenoAge. Algorithms were developed and validated in data from the National Health and Nutrition Examination Surveys (NHANES) using published methods and publicly available software.

RESULTS

Participants (55% women, 49% non-White) had mean age of 41 years (SD=4). Those with court substantiated childhood maltreatment history exhibited more advanced biological aging as compared with matched controls, although this difference was statistically different for only the KDM BA measure (KDM BA Cohen's D=0.20, 95% CI=[0.03,0.36], p = 0.02; PhenoAge Cohen's D=0.09 95% CI=[-0.08,0.25], p = 0.296). In subgroup analyses, maltreatment effect sizes were larger for women as compared to men and for White participants as compared to non-White participants, although these differences were not statistically significant at the α= 0.05 level.

CONCLUSIONS AND RELEVANCE

As of midlife, effects of childhood maltreatment on biological aging are small in magnitude but discernible. Interventions to treat psychological and behavioral sequelae of exposure to childhood maltreatment, including in midlife adults, have potential to protect survivors from excess burden of disease, disability, and mortality in later life.

Emotion Regulation and Distress During the COVID-19 Pandemic: The Role of Childhood Abuse

The COVID-19 pandemic may be experienced as traumatogenic and may fuel or exacerbate psychological distress and trauma-related symptoms. Based on trauma research, one might expect that survivors of childhood abuse would be susceptible to these negative outcomes during the pandemic, and that among this population a stronger relation between emotion regulation difficulties and symptomatology would be found. Aiming to explore these suppositions, an online survey was conducted among 710 Israeli adults. Of them, 370 were childhood abuse survivors. A history of childhood abuse, COVID-19-related stressors, overall psychological distress, and peritraumatic stress symptoms during the pandemic were assessed via self-report measures. Participants with a history of childhood abuse had elevated overall psychological distress as well as peritraumatic stress symptoms during the pandemic, compared to nonabused participants, above and beyond demographic characteristics and COVID-19-related stressors. Emotion regulation difficulties were related to elevated psychological distress and peritraumatic stress symptoms among both childhood abuse survivors and nonabused participants. Nonetheless, a history of childhood abuse moderated the relations between the emotion regulation difficulty of being unable to engage in goal-directed behaviors when distressed (on one hand) and mental outcomes (on the other): Although the associations between inability to engage in goal-directed behaviors, overall psychological distress, and peritraumatic stress symptoms were nonsignificant among nonabused participants, they were significant among childhood abuse survivors. The current findings suggest that a history of childhood abuse might be a risk factor for distress in the face of COVID-19, and that childhood abuse survivors would benefit from clinical interventions that promote emotion regulation skills during this ongoing global health crisis.

Alexithymia in individuals maltreated as children and adolescents: a meta-analysis

BACKGROUND

Children who are maltreated show deficits in emotion recognition, expression, and understanding. The goal of the current meta-analysis was to determine the degree to which maltreatment is associated with deficits in the ability to recognize one's own emotions - a phenomenon known as alexithymia. Alexithymia may be a mechanism explaining the association between childhood maltreatment and various psychological disorders.

METHODS

This meta-analytic review (88 studies, n = 43,076) examined the association between the experience of childhood maltreatment and alexithymia, mainly in adulthood. Additional meta-analyses were run to examine if the strength of the association between maltreatment as a child and alexithymia varied as a function of the type of maltreatment individuals reported and other moderators.

RESULTS

We found significant small effect sizes for all models, indicating higher levels of maltreatment in childhood or adolescence were associated with higher levels of alexithymia. Alexithymia was more strongly associated with forms of neglect than with physical or sexual abuse. The effect sizes also increased as the percentages of females in the sample increased.

CONCLUSIONS

Results suggest that researchers should examine whether alexithymia is a transdiagnostic mechanism in the association between childhood maltreatment and psychopathology and whether targeting alexithymia in treatment could reduce a wide range of symptoms.

Sex-dependence and comorbidities of the early-life adversity induced mental and metabolic disease risks: Where are we at?

Early-life adversity (ELA) is a major risk factor for developing later-life mental and metabolic disorders. However, if and to what extent ELA contributes to the comorbidity and sex-dependent prevalence/presentation of these disorders remains unclear. We here comprehensively review and integrate human and rodent ELA (pre- and postnatal) studies examining mental or metabolic health in both sexes and discuss the role of the placenta and maternal milk, key in transferring maternal effects to the offspring. We conclude that ELA impacts mental and metabolic health with sex-specific presentations that depend on timing of exposure, and that human and rodent studies largely converge in their findings. ELA is more often reported to impact cognitive and externalizing domains in males, internalizing behaviors in both sexes and concerning the metabolic dimension, adiposity in females and insulin sensitivity in males. Thus, ELA seems to be involved in the origin of the comorbidity and sex-specific prevalence/presentation of some of the most common disorders in our society. Therefore, ELA-induced disease states deserve specific preventive and intervention strategies.

Association Between Interpersonal Violence With Inadequate Nutritional Status Among Brazilian Adolescents

Research focusing on the relationship between interpersonal violence and nutritional status in adolescence is scarce and has distinct results. The objective of this study is to investigate the association of family physical and sexual violence with inadequate nutritional status in Brazilian adolescents. We used data from the 2015 Brazilian National Survey of School Health. This study includes 11.850 students, older than 13 years, attending from sixth to ninth grade of elementary school and from the 1st to the 3rd year of high school. The exposures were family physical violence and rape. The outcome was nutritional status, assessed through body mass index. The association between exposures and outcome were investigated using a multinomial logistic regression model. These analyses were adjusted for demographic, socioeconomic, and family variables. The prevalence of family physical violence victimization was approximately 14% among adolescents for both sexes. The prevalence of rape was 4.6% and 5.7% among male and female adolescents, respectively. Family physical violence was not associated with being underweight, overweight, or obese, in either crude or adjusted models for both sexes. Sexual violence was inversely associated with being underweight only for male adolescents (OR: 0.21, CI 95%: 0.06-0.75). In female adolescents, sexual violence was associated with overweight/obesity (OR: 1.64, CI 95%:1.15-2.33). In this study, rape, but not family physical violence victimization, was associated with nutritional status in adolescents of both sexes. Nonetheless, this association was different between boys and girls. Rape was inversely associated with being underweight in male adolescents, whereas, in female adolescents, it was associated with excess body weight.

Parental and own substance use disorder: The intersection of gender and early adversity

BACKGROUND

Children who are exposed to parental substance use disorder (SUD) have a higher risk of SUD themselves. This study examines the extent to which the association between parental and own SUD is conditional upon childhood trauma, socioeconomic status, and gender.

METHODS

This study uses data from the Nashville Stress and Health Study with 1234 respondents ages 25-65 collected from 2011 to 2014, weighted be representative of the general population. The association between parental SUD and own SUD was estimated using Cox Proportional Hazard Models, controlling for covariates, and testing for interactions.

RESULTS

Other things being equal, the risk of own SUD is more strongly associated with parental SUD in households with childhood traumas among men, but not women. Childhood trauma is not associated with own SUD in the absence of parental SUD among men. For men with parental SUD exposure, just one traumatic event is associated with a 38% increased risk of own SUD (HR=1.382, SE=.201, p < 0.05). For men, living with grandparents is associated with added SUD risk (HR=1.476, SE=.228, p < 0.05). For women, childhood trauma is not associated with own SUD, but parental SUD (HR=1.556, SE=.238, p < 0.01), and early onset mood or anxiety disorder (HR=1.682, SE=.316, p < 0.01) are. For both genders, those who are African American have lower risk of SUD than those who are White (HR=0.774, SE=.109, p < 0.05 for women; HR=0.672, SE=.079, p < 0.01 for men).

CONCLUSIONS

Parental SUD is associated with a substantial increase in risk for own SUD, and this association differs by gender and early trauma.

Going beyond risk factor: Childhood maltreatment and associated modifiable targets to improve life-long outcomes in mood disorders

Childhood maltreatment increases risk for mood disorders and is associated with earlier onset-and more pernicious disease course following onset-of mood disorders. While the majority of studies to date have been cross-sectional, longitudinal studies are emerging and support the devastating role(s) childhood maltreatment has on development of, and illness course in, mood disorders. This manuscript extends prior reviews to emphasize more recent work, highlighting longitudinal data, and discusses treatment studies that provide clues to mechanisms that mediate disease risk, course, relapse, and treatment response. Evidence suggesting systemic inflammation, alterations in hypothalamic-pituitary-adrenal (HPA) axis function and corticotropin-releasing factor (CRF) neural systems, genetic and other familial factors as mechanisms that mediate risk and onset of, and illness course in, mood disorders following childhood maltreatment is discussed. Risky behaviors following maltreatment, e.g., substance use and unhealthy lifestyles, may further exacerbate alterations in the HPA axis, CRF neural systems, and systematic inflammation to contribute to a more pernicious disease course. More research on sex differences and the impact of maltreatment in vulnerable populations is needed. Future research needs to be aimed at leveraging knowledge on modifiable targets, going beyond childhood maltreatment as a risk factor, to inform prevention and treatment strategies and foster trauma-informed care.

Mindful Awareness Promotes Resilience: Buffered Links Among Childhood Sexual Abuse Severity, Goal-Directed Emotion Dysregulation, and Psychopathology

Objectives

Childhood sexual abuse is linked to long-term consequences, including depression and anxiety in adulthood. Although considerable progress has been made to understand mechanisms that may account for this relation, such as emotion dysregulation, less attention has been given to protective factors that may mitigate it. One such protective factor might be mindful awareness. Those who act with awareness in daily living tend to engage in healthy emotion regulation skills when faced with stressors and experience less depression and anxiety. In the current study, we aimed to replicate the positive associations among childhood sexual abuse severity, emotion dysregulation, and psychopathology across time, and also identify a personal strength-in this case, mindful awareness-that might mitigate these effects.

Methods

Participants were 491 women recruited from the community who completed self-report assessments at three time points over a 32-month period.

Results

A series of moderated mediation models revealed childhood sexual abuse severity predicted later reports of depression and anxiety symptoms through greater emotion dysregulation in the form of difficulties engaging in goal-directed behaviors. As expected, mindful awareness weakened the relation between goal-directed emotion dysregulation and symptoms of depression and anxiety, such that greater levels of mindful awareness fully buffered these effects.

Conclusions

Through a better understanding of natural resiliency processes among survivors, we can ultimately encourage continued examination of what might be effective additions to existing treatments for the mental health consequences of trauma and adversity.

Impact of Fkbp5 × early life adversity × sex in humanised mice on multidimensional stress responses and circadian rhythmicity

The cumulative load of genetic predisposition, early life adversity (ELA) and lifestyle shapes the prevalence of psychiatric disorders. Single nucleotide polymorphisms (SNPs) in the human FKBP5 gene were shown to modulate disease risk. To enable investigation of disease-related SNPs in behaviourally relevant context, we generated humanised mouse lines carrying either the risk (AT) or the resiliency (CG) allele of the rs1360780 locus and exposed litters of these mice to maternal separation. Behavioural and physiological aspects of their adult stress responsiveness displayed interactions of genotype, early life condition, and sex. In humanised females carrying the CG- but not the AT-allele, ELA led to altered HPA axis functioning, exploratory behaviour, and sociability. These changes correlated with differential expression of genes in the hypothalamus, where synaptic transmission, metabolism, and circadian entrainment pathways were deregulated. Our data suggest an integrative role of FKBP5 in shaping the sex-specific outcome of ELA in adulthood.

Childhood Abuse, Social Support, and Long-Term Pharmacological Treatment Outcomes in Patients With Depressive Disorders

OBJECTIVES

This study was performed to investigate the roles of childhood abuse and social support in predicting short- and long-term pharmacological treatment outcomes in outpatients with depressive disorders in a naturalistic 1-year prospective design.

METHODS

Patients were recruited at a university hospital in South Korea between March 2012 and April 2017. Subjects with stepwise pharmacotherapy (switching, augmentation, combination, and mixture of these approaches) included 1246 patients at 12-week points in the acute treatment response and 1,015 patients at 12-months in the long-term treatment response. Remission was defined as Hamilton Depression Rating Scale score ≤ 7. Exposure to three types of childhood abuse (physical, emotional, and sexual) before the age of 16 and perceived social support were assessed at baseline.

RESULTS

Individual associations of childhood abuse were associated with poorer treatment outcomes in the 12-month long-term phase, and no significant individual associations were found for social support level with any period outcome. In combination, any child abuse, emotional abuse, and physical abuse were significantly associated with long-term 12-month remission rate in the presence of higher level of social support after adjustment with significant interaction terms. However, no significant interactions were found with sexual abuse.

CONCLUSION

Synergistic interactive effects of child abuse and social support levels on treatment outcomes in depressive patients were found during long-term pharmacotherapy. Thus, depressed patients with a history of childhood abuse may require specialized clinical approaches, including social support, to enhance the long-term treatment outcomes.

Violent experiences and neighbourhoods during adolescence: understanding and mitigating the association with mental health at the transition to adulthood in a longitudinal cohort study

PURPOSE

Violence occurs at multiple ecological levels and can harm mental health. However, studies of adolescents' experience of violence have often ignored the community context of violence, and vice versa. We examined how personal experience of severe physical violence and living in areas with high levels of neighbourhood disorder during adolescence combine to associate with mental health at the transition to adulthood and which factors mitigate this.

METHOD

Data were from the Environmental Risk Longitudinal Twin Study, a nationally representative birth cohort of 2232 British twins. Participants' experience of severe physical violence during adolescence and past-year symptoms of psychiatric disorder were assessed via interviews at age 18. Neighbourhood disorder was reported by residents when participants were aged 13-14. Potential protective factors of maternal warmth, sibling warmth, IQ, and family socio-economic status were assessed during childhood, and perceived social support at age 18.

RESULTS

Personal experience of severe physical violence during adolescence was associated with elevated odds of age-18 psychiatric disorder regardless of neighbourhood disorder exposure. Cumulative effects of exposure to both were evident for internalising and thought disorder, but not externalising disorder. For adolescents exposed to severe physical violence only, higher levels of perceived social support (including from family and friends) were associated with lower odds of psychiatric disorder. For those who also lived in areas with high neighbourhood disorder, only family support mitigated their risk.

CONCLUSION

Increasing support or boosting adolescents' perceptions of their existing support network may be effective in promoting their mental health following violence exposure.

Dental anxiety and potentially traumatic events: a cross-sectional study based on the Tromsø Study-Tromsø 7

OBJECTIVE

The objectives of the study were to describe the prevalence of dental anxiety and the possible associations between dental anxiety and potentially traumatic events in an adult population.

METHOD

The study is based on cross-sectional questionnaire data from the 7th wave of the Tromsø Study, a study of the adult general population in the municipality of Tromsø carried out in 2015-2016. The Modified Dental Anxiety Scale was used to measure dental anxiety across potentially traumatic events, oral health, dental attendance (avoidance) and current mental health symptoms (Hopkins Symptom Checklist). Individuals with high and low dental anxiety scores were compared to investigate differences in the distribution of potentially traumatic events, current mental health symptoms, avoidance, sex and oral health, and hierarchical multivariable regression was used to study the influence of traumatic events on dental anxiety.

RESULTS

High dental anxiety was reported by 2.9% of the sample and was most prevalent among females and in the youngest age groups. Individuals with high dental anxiety reported more current mental health symptoms, and they were more likely to report poorer oral health and more irregular dental visits compared to individuals with no or lower dental anxiety scores. Concerning traumatic events, the reporting of painful or frightening dental treatment showed the biggest difference between those with high dental anxiety and low dental anxiety scores (a moderate effect). The hierarchical regression model indicated that reporting sexual abuse, traumatic medical treatment in hospital and childhood neglect significantly predicted dental anxiety in the step they were entered in, but only sexual abuse remained a significant individual contributor after controlling for current mental health symptoms.

CONCLUSIONS

The prevalence of high dental anxiety was lower than expected (2.9%), but dentally anxious individuals expressed a high burden of mental health symptoms, poor oral health and the avoidance of dental care. The regression analysis indicated that experiences with sexual abuse could affect dental anxiety levels in the absence of generalised symptoms of anxiety and depression.

Atypical interoception as a common risk factor for psychopathology: A review

The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.

Childhood Maltreatment, Sleep Disturbances, and Anxiety and Depression: A Prospective Longitudinal Investigation

This research sought to determine whether inadequate sleep conditions in childhood and sleep problems in young adulthood in part explain the relationship between childhood abuse and neglect and anxiety and depression later in life. Children with documented histories of abuse and neglect and matched controls were followed up and assessed in young and middle adulthood. Abused and neglected children were more likely to report experiencing inadequate sleep conditions in childhood, sleep problems in young adulthood, and higher levels of depression and anxiety later in middle adulthood. Results revealed significant indirect paths from childhood maltreatment to anxiety and depression in middle adulthood through inadequate sleep conditions in childhood and sleep problems in young adulthood. This longitudinal follow-up of children with documented cases of maltreatment reveals the important role of sleep disturbances in the lives of maltreated children and adults and sleep disturbances in the development of subsequent anxiety and depression.

Alterations of the HPA Axis Observed in Patients with Major Depressive Disorder and Their Relation to Early Life Stress: A Systematic Review

BACKGROUND

Alterations of the hypothalamic-pituitary-adrenal (HPA) axis are common in patients diagnosed with major depressive disorder (MDD). Nevertheless, these alterations are not found in every patient. There is evidence to indicate a possible mediating role of early life stress (ELS) in the relation between dysfunction of the HPA axis and MDD. We conducted a systematic review to understand if the alterations of the HPA axis commonly found in patients with MDD are due to early life stress or are caused by the disorder itself.

METHODS

The review was conducted by following the PRISMA guidelines. Original articles were found in PubMed and via a manual search. Only studies whose design allowed comparison of the HPA functioning in the 4 groups no-MDD/no-ELS, MDD/no-ELS, no-MDD/ELS, and MDD/ELS were included.

RESULTS

Hyperactivity or hypoactivity of the HPA axis was found in 8 articles. A greater number of abnormalities and a higher rate of posttraumatic stress disorder comorbidity were found in the MDD/ELS group. Dysfunction of the HPA axis was also found in the no-MDD/ELS groups.

CONCLUSION

HPA dysfunction found in MDD seems to be more related to the presence of ELS rather than to the MDD itself. Future studies are needed to clarify the exact mechanisms involved.

An Examination of Downward Drift as an Explanation of the Relationship Between Childhood Maltreatment and Residence in Unhealthy Neighborhoods in Adulthood: The Role of Psychiatric Symptoms

This study sought to determine whether downward drift explains relationships among childhood maltreatment, psychiatric disorders, and residence in unhealthy neighborhoods. Using data from a prospective cohort design study, individuals with court substantiated cases of child abuse and/neglect (ages 0-11 during the years 1967-1971) and matched controls were followed up in adulthood. Mental health symptoms and neighborhood disadvantage were measured in young (M_age  = 29) and middle adulthood (M_age  = 40). Physical disorder and social cohesion were also measured in middle adulthood. Childhood maltreatment increased risk for more symptoms of depression, anxiety, and illicit drug use in young adulthood and depression and anxiety in middle adulthood. Childhood maltreatment negatively impacted neighborhood residence in young and middle adulthood, increasing a person's risk of living in neighborhoods with higher levels of physical disorder and economic disadvantage, and lower levels of social cohesion. Neighborhood disadvantage in young adulthood did not increase risk for psychiatric symptoms in middle adulthood. With one exception, neighborhood disadvantage earlier in life, not psychiatric symptoms, helped explain the relationship between childhood maltreatment and living in unhealthy neighborhoods. The negative impact of childhood maltreatment was evident earlier in life and continued into middle adulthood.

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.