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Tovo-Rodrigues L, Camerini L, Martins-Silva T, Carpena MX, Bonilla C, Oliveira IO, de Paula CS, Murray J, Barros AJD, Santos IS, Rohde LA, Hutz MH, Genro JP, Matijasevich A. Gene - maltreatment interplay in adult ADHD symptoms: main role of a gene-environment correlation effect in a Brazilian population longitudinal study. Mol Psychiatry 2024:10.1038/s41380-024-02589-3. [PMID: 38744991 DOI: 10.1038/s41380-024-02589-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 05/16/2024]
Abstract
Childhood maltreatment correlates with attention-deficit/hyperactivity disorder (ADHD) in previous research. The interaction between ADHD genetic predisposition and maltreatment's impact on ADHD symptom risk remains unclear. We aimed to elucidate this relationship by examining the interplay between a polygenic score for ADHD (ADHD-PGS) and childhood maltreatment in predicting ADHD symptoms during young adulthood. Using data from the 2004 Pelotas (Brazil) birth cohort comprising 4231 participants, we analyzed gene-environment interaction (GxE) and correlation (rGE). We further explored rGE mechanisms through mediation models. ADHD symptoms were assessed at age 18 via self-report (Adult Self Report Scale - ASRS) and mother-reports (Strength and Difficulties Questionnaire - SDQ). The ADHD-PGS was derived from published ADHD GWAS meta-analysis. Physical and psychological child maltreatment was gauged using the Parent-Child Conflict Tactics Scale (CTSPC) at ages 6 and 11, with a mean score utilized as a variable. The ADHD-PGS exhibited associations with ADHD symptoms on both ASRS (β = 0.53; 95% CI: 0.03; 1.03, p = 0.036), and SDQ (β = 0.20; 95% CI: 0.08; 0.32, p = 0.001) scales. The total mean maltreatment score was associated with ADHD symptoms using both scales [(βASRS = 0.51; 95% CI: 0.26;0.77) and (βSDQ = 0.24; 95% CI: 0.18;0.29)]. The ADHD-PGS was associated with total mean maltreatment scores (β = 0.09; 95% CI: 0.01; 0.17; p = 0.030). Approximately 47% of the total effect of ADHD-PGS on maltreatment was mediated by ADHD symptoms at age 6. No evidence supported gene-environment interaction in predicting ADHD symptoms. Our findings underscore the significant roles of genetics and childhood maltreatment as predictors for ADHD symptoms in adulthood, while also indicating a potential evocative mechanism through gene-environment correlation.
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Affiliation(s)
- Luciana Tovo-Rodrigues
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil.
| | - Laísa Camerini
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Thais Martins-Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Marina Xavier Carpena
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Carolina Bonilla
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
| | - Isabel Oliveira Oliveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Institute of Biology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Aluísio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Luis Augusto Rohde
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents & National Center for Research and Innovation in Child Mental Health, Sao Paulo, Brazil
- Medical School Council, UniEduK, São Paulo, Brazil
| | - Mara Helena Hutz
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Postgraduate Program in Genetics and Molecular Biology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Julia Pasqualini Genro
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Postgraduate Program in Bioscience, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
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Marta GR, Doretto VF, Scivoletto S. Maltreatment and Emotion Recognition Among Brazilian Adolescents. Front Psychiatry 2018; 9:625. [PMID: 30534089 PMCID: PMC6275306 DOI: 10.3389/fpsyt.2018.00625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 11/05/2018] [Indexed: 11/25/2022] Open
Abstract
The experience of maltreatment can impair child development, including changes in the process of emotions recognition, which may result in impairment of social interactions and behavioral disabilities. In order to measure the association between maltreatment and changes on emotion recognition among Brazilian adolescents, the Emotional Recognition Test on Human Faces (ERTHF) was applied to a sample of 50 adolescents who had suffered different intensities and types of abuse. The social and clinical characteristics of the participants were analyzed and, from ERTHF data, the accuracy and response time for the emotion recognition. Males were 60%, with mean age of 13 years and 3 months; 60% were living in shelters. Emotion recognition changes were associated with intensity and types of maltreatment. Physical neglect (48%) was associated with changes in neutral and negative emotions recognition. Emotional neglect (48%) and emotional abuse (46%) were associated with changes in both positive and negative emotions recognition. Physical abuse (38%) was associated with changes in positive emotion recognition only. False recognition of anger was the most common outcome of maltreatment, being associated with physical neglect (p = 0.015) and emotional neglect (p = 0.047). Our results point out to the need to add emotional and facial recognition's rehabilitation interventions to better attend the specific demands of maltreated children and to increase the chances of social and family reintegration.
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Affiliation(s)
- Guilherme Rodrigues Marta
- Faculdade de Medicina FMUSP, São Paulo Research Foundation (FAPESP), Universidade de São Paulo, São Paulo, Brazil
| | - Victoria Fogaça Doretto
- Departamento de Psiquiatria, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Sandra Scivoletto
- Psiquiatria da Infância e Adolescencia, Departamento de Psiquiatria, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
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Rosenheck RA, Scivoletto S. Childhood Mental Illness and Adult Homelessness: Social Policy and Long-Term Community-Based Psychiatric Care. J Am Acad Child Adolesc Psychiatry 2016; 55:923-924. [PMID: 27806856 DOI: 10.1016/j.jaac.2016.07.773] [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] [Received: 07/25/2016] [Accepted: 08/26/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Robert A Rosenheck
- Veterans Affairs New England Mental Illness, Research, Education and Clinical Center 151D, Yale Medical School, West Haven, CT, and Yale Child Study Center, New Haven, CT.
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Current Psychopathological Symptoms in Children and Adolescents Who Suffered Different Forms of Maltreatment. ScientificWorldJournal 2016; 2016:8654169. [PMID: 27579345 PMCID: PMC4989087 DOI: 10.1155/2016/8654169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 04/14/2016] [Accepted: 06/20/2016] [Indexed: 11/18/2022] Open
Abstract
The aim of the present study is to evaluate the current psychopathological problems of different forms associated with maltreatment on children's and adolescents' mental health. Ninety-five females and ninety males with a mean age of 8.8 years who have suffered in the last six months different forms of abuse (physical, sexual, and emotional) and neglect were included in the study. The current reaction to trauma as directly observed by clinical instruments was examined. Differences in gender, age at the time of medical examination, familial psychiatric disorders, neuropsychiatric status, and type of maltreatment were also taken into account. Results documented that 95.1% of abused children and adolescents developed a psychiatric disorder or a subclinical form of a Posttraumatic Stress Disorder (PTSD). Moreover, our data demonstrate a role for gender, age, and familial psychiatric comorbidity in the current psychopathological problems associated with maltreatment. Overall, our findings can help clinicians make a diagnosis and provide efficient treatment and prevention strategies for child maltreatment and abuse.
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Salum GA, DeSousa DA, Manfro GG, Pan PM, Gadelha A, Brietzke E, Miguel EC, Mari JJ, do Rosário MC, Grassi-Oliveira R. Measuring child maltreatment using multi-informant survey data: a higher-order confirmatory factor analysis. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2016; 38:23-32. [PMID: 27007940 DOI: 10.1590/2237-6089-2015-0036] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 09/17/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the validity and reliability of a multi-informant approach to measuring child maltreatment (CM) comprising seven questions assessing CM administered to children and their parents in a large community sample. METHODS Our sample comprised 2,512 children aged 6 to 12 years and their parents. Child maltreatment (CM) was assessed with three questions answered by the children and four answered by their parents, covering physical abuse, physical neglect, emotional abuse and sexual abuse. Confirmatory factor analysis was used to compare the fit indices of different models. Convergent and divergent validity were tested using parent-report and teacher-report scores on the Strengths and Difficulties Questionnaire. Discriminant validity was investigated using the Development and Well-Being Assessment to divide subjects into five diagnostic groups: typically developing controls (n = 1,880), fear disorders (n = 108), distress disorders (n = 76), attention deficit hyperactivity disorder (n = 143) and oppositional defiant disorder/conduct disorder (n = 56). RESULTS A higher-order model with one higher-order factor (child maltreatment) encompassing two lower-order factors (child report and parent report) exhibited the best fit to the data and this model's reliability results were acceptable. As expected, child maltreatment was positively associated with measures of psychopathology and negatively associated with prosocial measures. All diagnostic category groups had higher levels of overall child maltreatment than typically developing children. CONCLUSIONS We found evidence for the validity and reliability of this brief measure of child maltreatment using data from a large survey combining information from parents and their children.
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Affiliation(s)
| | | | - Gisele Gus Manfro
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, São Paulo, SP, Brazil
| | - Pedro Mario Pan
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, São Paulo, SP, Brazil
| | - Ary Gadelha
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, São Paulo, SP, Brazil
| | - Elisa Brietzke
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, São Paulo, SP, Brazil
| | | | - Jair J Mari
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, São Paulo, SP, Brazil
| | - Maria Conceição do Rosário
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, São Paulo, SP, Brazil
| | - Rodrigo Grassi-Oliveira
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, São Paulo, SP, Brazil
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Ferrara P, Corsello G, Basile MC, Nigri L, Campanozzi A, Ehrich J, Pettoello-Mantovani M. The Economic Burden of Child Maltreatment in High Income Countries. J Pediatr 2015; 167:1457-9. [PMID: 26611458 DOI: 10.1016/j.jpeds.2015.09.044] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Pietro Ferrara
- Italian Society of Pediatrics (SIP), Rome, Italy; Institute of Pediatrics, Catholic University Medical School, Rome, Italy.
| | - Giovanni Corsello
- Italian Society of Pediatrics (SIP), Rome, Italy; European Paediatric Association-Union of National European Paediatric Societies and Associations (EPA-UNEPSA), Berlin, Germany; Institute of Pediatrics, University of Palermo, Italy
| | | | - Luigi Nigri
- European Paediatric Association-Union of National European Paediatric Societies and Associations (EPA-UNEPSA), Berlin, Germany; Italian Federation of Pediatricians (FIMP), Rome, Italy
| | - Angelo Campanozzi
- Italian Society of Pediatrics (SIP), Rome, Italy; European Paediatric Association-Union of National European Paediatric Societies and Associations (EPA-UNEPSA), Berlin, Germany; Institute of Pediatrics and Residency program, University of Foggia, Italy
| | - Jochen Ehrich
- European Paediatric Association-Union of National European Paediatric Societies and Associations (EPA-UNEPSA), Berlin, Germany; Children's Hospital, Hannover Medical School, Hannover, Germany
| | - Massimo Pettoello-Mantovani
- Italian Society of Pediatrics (SIP), Rome, Italy; European Paediatric Association-Union of National European Paediatric Societies and Associations (EPA-UNEPSA), Berlin, Germany; Institute of Pediatrics and Residency program, University of Foggia, Italy
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Marques AH, Oliveira PA, Scomparini LB, Silva UMRE, Silva AC, Doretto V, de Medeiros Filho MV, Scivoletto S. Community-Based Global Health Program for Maltreated Children and Adolescents in Brazil: The Equilibrium Program. Front Psychiatry 2015; 6:102. [PMID: 26283972 PMCID: PMC4519654 DOI: 10.3389/fpsyt.2015.00102] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 07/01/2015] [Indexed: 11/13/2022] Open
Abstract
The maltreatment of children and adolescents is a global public health problem that affects high- and low-middle income countries ("LMICs"). In the United States, around 1.2 million children suffer from abuse, while in LMICs, such as Brazil, these rates are much higher (an estimated 28 million children). Exposition to early environmental stress has been associated with suboptimal physical and brain development, persistent cognitive impairment, and behavioral problems. Studies have reported that children exposed to maltreatment are at high risk of behavioral problems, learning disabilities, communication and psychiatric disorders, and general clinical conditions, such as obesity and systemic inflammation later in life. The aim of this paper is to describe The Equilibrium Program ("TEP"), a community-based global health program implemented in São Paulo, Brazil to serve traumatized and neglected children and adolescents. We will describe and discuss TEP's implementation, highlighting its innovation aspects, research projects developed within the program as well as its population profile. Finally, we will discuss TEP's social impact, challenges, and limitations. The program's goal is to promote the social and family reintegration of maltreated children and adolescents through an interdisciplinary intervention program that provides multi-dimensional bio-psycho-social treatment integrated with the diverse services needed to meet the unique demands of this population. The program's cost effectiveness is being evaluated to support the development of more effective treatments and to expand similar programs in other areas of Brazil. Policy makers should encourage early evidence-based interventions for disadvantaged children to promote healthier psychosocial environments and provide them opportunities to become healthy and productive adults. This approach has already shown itself to be a cost-effective strategy to prevent disease and promote health.
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Affiliation(s)
- Andrea Horvath Marques
- Department and Institute of Psychiatry, Medical School, University of São Paulo (USP) - The Equilibrium Program (TEP) , São Paulo , Brazil ; Department and Institute of Psychiatry, Medical School, University of São Paulo (USP-PROTOC) , São Paulo , Brazil
| | - Paula Approbato Oliveira
- Department and Institute of Psychiatry, Medical School, University of São Paulo (USP) - The Equilibrium Program (TEP) , São Paulo , Brazil
| | - Luciana Burim Scomparini
- Department and Institute of Psychiatry, Medical School, University of São Paulo (USP) - The Equilibrium Program (TEP) , São Paulo , Brazil
| | - Uiara Maria Rêgo E Silva
- Department and Institute of Psychiatry, Medical School, University of São Paulo (USP) - The Equilibrium Program (TEP) , São Paulo , Brazil
| | - Angelica Cristine Silva
- Department and Institute of Psychiatry, Medical School, University of São Paulo (USP) - The Equilibrium Program (TEP) , São Paulo , Brazil
| | - Victoria Doretto
- Department and Institute of Psychiatry, Medical School, University of São Paulo (USP) - The Equilibrium Program (TEP) , São Paulo , Brazil
| | - Mauro Victor de Medeiros Filho
- Department and Institute of Psychiatry, Medical School, University of São Paulo (USP) - The Equilibrium Program (TEP) , São Paulo , Brazil
| | - Sandra Scivoletto
- Department and Institute of Psychiatry, Medical School, University of São Paulo (USP) - The Equilibrium Program (TEP) , São Paulo , Brazil
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