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Broekhof R, Nordahl HM, Eikenæs IUM, Selvik SG. Adverse Childhood Experiences Are Associated With Personality Disorder: A Prospective, Longitudinal Study. J Pers Disord 2024; 38:19-33. [PMID: 38324247 DOI: 10.1521/pedi.2024.38.1.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
There is a lack of studies that have prospectively examined adverse childhood experiences (ACEs) in association with a personality disorder (PD). Data from a sample of 8,199 adolescents first assessed for ACEs were linked with subsequent data from the Norwegian Patient Register in order to obtain diagnoses of a PD in adulthood (after a 14-year follow-up). We used logistic regression analysis. Any type of ACE gave a 3.8-fold higher risk of developing a PD. Abuse, more specifically emotional abuse, came out as one of the strongest predictors. Of the adolescents who developed a PD, approximately 90% had a history of ACE. The results of this study support the importance of assessing ACEs, such as abuse, neglect, and household dysfunction, in the diagnostic procedure and treatment for PD.
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Affiliation(s)
| | - Hans M Nordahl
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- St. Olavs University Hospital, Østmarka, Trondheim, Norway
| | - Ingeborg Ulltveit-Moe Eikenæs
- National Advisory Unit for Personality Psychiatry (NAPP), Section for Personality Psychiatry and Specialized Treatment, Oslo University Hospital, Oslo, Norway
| | - Sara G Selvik
- Namsos Hospital, Nord-Trøndelag Hospital Trust, Namsos, Norway
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
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Kerr-Davis A, Hillman S, Anderson K, Cross R. Introducing Routine Assessment of Adverse Childhood Experiences For Looked-After Children: The Use and Properties of the Trauma and Adverse Life Events (TALE) Screening Tool. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:981-994. [PMID: 38045847 PMCID: PMC10689631 DOI: 10.1007/s40653-023-00559-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 12/05/2023]
Abstract
The present study aims to illustrate the process of developing, implementing, and clinically validating a new assessment measure, the Trauma and Adverse Life Events (TALE) screening tool, to assess Adverse Childhood Experiences (ACEs) among looked-after children. The TALE was developed by adapting existing ACEs measures to reflect the experiences of looked-after children. The TALE was completed by the local authority social worker for 218 children placed with Five Rivers Child Care (a UK fostering agency, residential, and educational care provider). Reliability was examined and exploratory factor analysis was conducted. Correlations between TALE scores, background variables, and psychosocial wellbeing using the carer-report Strengths and Difficulties Questionnaire (SDQ) and Child Dissociative Checklist (CDC) were also explored. The TALE was found to have acceptable reliability (α = .71). A three-factor solution was found which explained 46.24% of the variance, with factors labelled 'Direct Experience of Abuse', 'Witnessing Harm', and 'Household Dysfunction'. Exposure score was significantly associated with total difficulties score on the SDQ (rs = .24, p < .001) and Impact score was associated with the SDQ's impact score (rs = .33, p < .001). Exposure and Impact scores were both positively correlated with CDC scores (rs = .16, p = .021 and rs = .22, p = .002). This paper presents evidence of the importance of screening looked-after children for ACEs and demonstrates that the TALE is a valid and reliable tool for this purpose. Adverse and traumatic experiences were highly prevalent in this population and appeared to be closely related with children's psychosocial wellbeing. Results emphasise the importance of routine assessment of past experiences within trauma-informed psychological care and intervention planning for looked-after children.
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Affiliation(s)
- Asa Kerr-Davis
- Assessment and Therapy, Five Rivers Child Care Limited, Salisbury, Wiltshire UK
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Child Attachment and Psychological Therapies Research (ChAPTRe), Anna Freud Centre, London, UK
| | - Saul Hillman
- Child Attachment and Psychological Therapies Research (ChAPTRe), Anna Freud Centre, London, UK
| | - Katharine Anderson
- Assessment and Therapy, Five Rivers Child Care Limited, Salisbury, Wiltshire UK
| | - Richard Cross
- Assessment and Therapy, Five Rivers Child Care Limited, Salisbury, Wiltshire UK
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Ye Z, Wei X, Zhang J, Li H, Cao J. The impact of adverse childhood experiences on depression: the role of insecure attachment styles and emotion dysregulation strategies. CURRENT PSYCHOLOGY 2023:1-11. [PMID: 37359705 PMCID: PMC10099002 DOI: 10.1007/s12144-023-04613-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 06/28/2023]
Abstract
Objectives: The previous studies have reported that adverse childhood experiences (ACEs) can have detrimental effects on victims' attachment styles, emotion regulation strategies and depression. How the insecure attachment styles and emotion dysregulation strategies play a role in the relationship between ACEs and depression among Chinese university students remains unclear. Methods: The research was made known to students studying at universities in China. Five hundred and eighty-nine college students completed questionnaires measuring ACEs, insecure attachment styles, emotion dysregulation strategies and depression. Sequential chain mediation model was built by Mplus. Results: The model showed that insecure attachment styles and emotion dysregulation strategies mediated the relationship between ACEs and depression respectively. Moreover, the sequential chain mediation showed an indirect path (ACEs - insecure attachment styles - emotion dysregulation strategies - depression). Conclusion: Following childhood adversities, students can experience elevated depression which is influenced by attachment styles and emotion regulation strategies. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-023-04613-1.
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Affiliation(s)
- Zilan Ye
- School of Humanities and Management, Guangdong Medical University, Dongguan, China
- Department of Psychology, School of Humanities and Management, Guangdong Medical University, Dongguan, 523808 China
| | - Xiaoqi Wei
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Jieting Zhang
- School of Psychology, Shenzhen University, Shenzhen, China
- The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen university, Shenzhen, China
| | - Huilin Li
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Jiageng Cao
- School of Psychology, Shenzhen University, Shenzhen, China
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Amari N, Mahoney A. Compassion and complex interpersonal trauma in adolescence: An early systematic review. Clin Psychol Psychother 2022; 29:799-814. [PMID: 34779081 DOI: 10.1002/cpp.2689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/24/2021] [Accepted: 11/08/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Whilst childhood trauma has been identified as a transdiagnostic risk factor for poly-psychopathology, compassion-focused interventions have emerged as transdiagnostic treatment modality. However, no previous systematic review has specifically explored the relationship between complex interpersonal trauma and compassion in adolescence. The aim of this early systematic review was to evaluate the existing evidence on the role of compassion in adolescents with complex interpersonal trauma. METHODS A systematic search of electronic databases was undertaken to identify cross-sectional and intervention studies that examined the role of compassion in the amelioration of psychopathology in adolescence. RESULTS Nine studies, including three intervention studies and six cross-sectional studies, met the inclusion criteria. The findings suggested a mediating role of compassion in trauma-specific and overall psychopathology. CONCLUSION Despite the dearth of research, this review suggests that integrating compassion might mediate the relationship between complex trauma and psychopathology in adolescents.
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Affiliation(s)
- Nicola Amari
- Department of Psychology, Glasgow Caledonian University, Glasgow, UK
| | - Adam Mahoney
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
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Chinvararak C, Kirdchok P, Lueboonthavatchai P. The association between attachment pattern and depression severity in Thai depressed patients. PLoS One 2021; 16:e0255995. [PMID: 34407094 PMCID: PMC8372919 DOI: 10.1371/journal.pone.0255995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/27/2021] [Indexed: 12/24/2022] Open
Abstract
Objective We aimed to study attachment patterns and their association with depression severity in Thai depressed patients. Method We conducted a descriptive study of depressed participants at King Chulalongkorn Memorial Hospital from November 2013 to April 2014. The Thai Short Version of Revised Experience of Close Relationships Questionnaire and the Beck Depression Inventory-II (BDI-II) were administered to all participants. We assessed BDI-II scores, classified by attachment patterns, using one-way analyses of variance. The associated factors and predictors of depression severity were analysed by chi-square and logistic regression analyses, respectively. Results A total of 180 participants (75% female; mean age = 45.2 ± 14.3 years) were recruited. Dismissing attachment was the most common pattern in Thai depressed patients (36.1%). Depressed patients with preoccupied attachment demonstrated the highest BDI-II scores. The best predictor of moderate to severe depression severity was preoccupied/fearful attachment (odds ratio = 3.68; 95% confidence interval = 2.05–7.30). Conclusions Anxious attachment was found to be associated with higher depression severity. Preoccupied/fearful attachment was the predictor of moderate to severe depression severity.
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Affiliation(s)
- Chotiman Chinvararak
- Department of Psychiatry, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
- * E-mail:
| | - Pantri Kirdchok
- Department of Psychiatry, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
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Abstract
This article examines the relationship between poverty and mental health problems. We draw on the experience of Glasgow, our home city, which contains some of Western Europe's areas of greatest concentrated poverty and poorest health outcomes. We highlight how mental health problems are related directly to poverty, which in turn underlies wider health inequalities. We then outline implications for psychiatry.
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Affiliation(s)
- Lee Knifton
- Centre for Health Policy, University of Strathclyde, Scotland, and Mental Health Foundation, Scotland and Northern Ireland
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Hanlon P, McCallum M, Jani BD, McQueenie R, Lee D, Mair FS. Association between childhood maltreatment and the prevalence and complexity of multimorbidity: A cross-sectional analysis of 157,357 UK Biobank participants. JOURNAL OF COMORBIDITY 2020; 10:2235042X10944344. [PMID: 32844098 PMCID: PMC7416137 DOI: 10.1177/2235042x10944344] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 06/08/2020] [Accepted: 06/22/2020] [Indexed: 11/16/2022]
Abstract
Background: Child maltreatment is associated with long-term conditions (LTCs) in
adulthood. Its relationship to multimorbidity (≥2 LTCs) is less clear. We
explore the relationship between child maltreatment, multimorbidity and
factors complicating management. Methods: Cross-sectional analysis of 157,357 UK Biobank participants. Experience of
four maltreatment types (physical/sexual/emotional/neglect) was identified.
We explored the relationship between type, number and frequency of
maltreatment and LTC count (0, 1, 2, 3, ≥4) using multinomial logistic
regression. Binary logistic regression assessed the relationship between
maltreatment and self-rated health, loneliness, social isolation, frailty
and widespread pain in those with multimorbidity, adjusting for
sociodemographics and lifestyle factors. Results: 52,675 participants (33%) experienced ≥1 type of maltreatment; 983 (0.6%)
experienced all four. Type, frequency and number of types of maltreatment
were associated with higher LTC count. People experiencing four types of
maltreatment were 5 times as likely to have a LTC count of ≥4 as those
experiencing none (odds ratio (OR): 5.16; 99% confidence interval (CI):
3.77-7.07). Greater number of types of maltreatment was associated with
higher prevalence of combined physical/mental health LTCs (OR: 2.99; 99% CI:
2.54–3.51 for four types of maltreatment). Compared to people who reported
no maltreatment, people experiencing all four types of maltreatment were
more likely to have poor self-rated health (OR: 3.56; 99% CI: 2.58–4.90),
loneliness (OR: 3.16; 99% CI: 2.17–4.60), social isolation (OR: 1.45; 99%
CI: 1.03–2.05), widespread pain (OR: 3.19; 99% CI: 1.87–5.44) and frailty
(OR: 3.21; 99% CI: 2.04–5.05). Conclusion: Peoplewith a history of maltreatment have higher LTC counts and potentially
more complicated management needs reinforcing calls for early
intervention.
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Affiliation(s)
- Peter Hanlon
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, UK
| | - Marianne McCallum
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, UK
| | - Bhautesh Dinesh Jani
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, UK
| | - Ross McQueenie
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, UK
| | - Duncan Lee
- School of Mathematics and Statistics, The mathematics and Statistics Building, University of Glasgow, University Place, Glasgow, UK
| | - Frances S Mair
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, UK
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General practice recording of adverse childhood experiences: a retrospective cohort study of GP records. BJGP Open 2020; 4:bjgpopen20X101011. [PMID: 32071039 PMCID: PMC7330192 DOI: 10.3399/bjgpopen20x101011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 11/25/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are linked to negative health outcomes in adulthood. Poor engagement with services may, in part, mediate the association between adverse outcomes and ACEs. While appointment recording is comprehensive, it is not yet known if or how ACEs are recorded in the GP clinical record (GPR). AIM To investigate recording of ACEs in the GPR and assess associations between available ACE-related Read codes and missed appointments. DESIGN & SETTING Retrospective cohort study of 824 374 anonymised GPRs. Nationally representative sample of 136 Scottish general practices; data collected 2013-2016. METHOD Read codes were mapped onto ACE questionnaire and wider ACE-related domains. Natural language processing (NLP) was used to augment capture of non-Read-coded ACEs. Frequency counts and proportions of mapped codes, and associations of these with defined levels of missing GP appointments, are reported. RESULTS In total, 0.4% of patients had a record of any code that mapped onto the ACE questionnaire, contrasting with survey-reported rates of 47% in population samples. This increased only modestly by including inferred ACEs that related to safeguarding children concerns, wider aspects of ACEs, and adult consequences of ACEs. Augmentation via NLP did not substantially increase capture. Despite poor recording, there was an association between ever having an ACE code recorded and higher rates of missing GP appointments. CONCLUSION General practices would require substantial support to implement the recording of ACEs in the GPR. This study adds to the evidence that patients who often miss appointments are more likely to be socially vulnerable.
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Morita A, Fujiwara T. Association between Childhood Suicidal Ideation and Geriatric Depression in Japan: A Population-Based Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2257. [PMID: 32230812 PMCID: PMC7178046 DOI: 10.3390/ijerph17072257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/19/2020] [Accepted: 03/23/2020] [Indexed: 02/07/2023]
Abstract
Adverse childhood experiences (ACEs) are assumed to increase the risk of depression in late life via development of poor mental health conditions; however, the association between mental distress in childhood and geriatric depression has not been directly examined. This study examined the association between childhood suicidal ideation and geriatric depression, using population-based, cross-sectional survey data from 1140 community-dwelling, functionally independent older adults in Wakuya City, Japan. We assessed childhood suicidal ideation by asking the participants whether they had seriously considered attempting suicide before the age of 18, together with geriatric depression, using the Japanese version of the 15-item Geriatric Depression Scale. Poisson regression was applied to adjust for potential confounders and mediators. In total, 6.1% of the participants reported childhood suicidal ideation. After adjustment for sex, age, personality attributes and ACEs, childhood suicidal ideation was positively associated with geriatric depression prevalence ratio [PR]: 1.40, 95% Confidence Interval (95%CI): 1.04-1.88). The increased PR of geriatric depression remained significant, even after further adjustment for adulthood socio-economic status, recent life stressors and current health status (PR: 1.38, 95%CI: 1.02-1.88). Further prospective studies are warranted, but efforts to deliver mental health services to children with suicidal ideation potentially diminish the highly prevalent geriatric depression.
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Affiliation(s)
- Ayako Morita
- Department of Global Health Promotion, Tokyo Medical and Dental University, Yushima-ku, Tokyo 113-8510, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Yushima-ku, Tokyo 113-8510, Japan
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Ennis E, Trearty K. Attachment Orientations and Adult Alcohol Use Among Those With Childhood Adversities. JOURNAL OF INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1027/1614-0001/a000291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Abstract. Adverse psychological consequences have been associated with both alcohol abstinence and alcohol disorders. The current study considers those who have experienced childhood adversities and examines whether secure attachment orientation represents a protective factor against an increased likelihood of either abstinence/rare alcohol consumption or alcohol disorder diagnosis. Data were used from the National Comorbidity Survey-Revised (NCS-R) ( N = 5,692), a random sample representative of the American population. Adult personal alcohol use was considered in terms of abstinence/rare alcohol use, regular alcohol use, and alcohol disorder diagnosis. Analyses focused on those who had experienced childhood adversities ( N = 2,182) and assessed attachment orientation as a predictor of alcohol use. Within those who had experienced childhood adversities, in comparison with securely attached individuals, both anxiously attached individuals and avoidant attached individuals had a significantly increased likelihood of being in the alcohol disorder diagnosis group as opposed to the regular alcohol consumption group. Avoidant individuals also had a significantly increased likelihood of being in the abstinence/rare alcohol use group. Results are discussed in terms of subgroups (vulnerable individuals and families) that may benefit from supportive interventions, and what format these interventions might take.
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Affiliation(s)
- Edel Ennis
- School of Psychology, Ulster University, Coleraine, UK
| | - Kelly Trearty
- School of Psychology, Ulster University, Londonderry, UK
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Abstract
Objective Work on longevity has found protective social, cognitive, and emotional factors, but to date we have little understanding of the impact of motivational dynamics. Autonomy orientation, or stable patterns of self‐regulation, is theorized to be a protective factor for long‐term mental and physical health (Ryan & Deci, 2017), and it is therefore a prime candidate for examining how stable psychosocial factors are linked to longevity, or life expectancy. Method Essays written in the 1930s by participants in the Nun Study were coded for indicators of an autonomy orientation. These were selected in line with an extensive theoretical literature based in self‐determination theory (Deci & Ryan, 1985). Essays were coded for the propensity for choice in action, susceptibility to pressure, self‐reflection, integration of experiences, and parental support for autonomy. These coded variables were used to predict age of death. Results Using 176 codable essays provided by now‐deceased participants, linear regression analyses revealed that choiceful behavior, self‐reflection, and parent autonomy support predicted age of death. Participants who demonstrated these stable and beneficial motivational characteristics lived longer. Conclusions Personality constructs reflecting a healthy form of self‐regulation are associated with long‐term health. Implications for health interventions are discussed.
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Lund JI, Schmidt LA, Saigal S, Van Lieshout RJ. Personality characteristics of adult survivors of preterm birth and childhood sexual abuse. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2017.05.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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