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Whitehead R, Hopkins L, Dight S, Kennard M, McGrath B. Adolescent Violence in the Home Among Youth Presenting to an Early Psychosis Service: An Exploration of Contributing Factors. Community Ment Health J 2024:10.1007/s10597-024-01268-5. [PMID: 38607463 DOI: 10.1007/s10597-024-01268-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 03/14/2024] [Indexed: 04/13/2024]
Abstract
Adolescent violence in the home is a growing public health issue and remains under reported and under-researched. The focus of the present research is to investigate factors that may contribute to adolescent violence in the home, among acohort of young people with co-occurring early psychosis. Data relates to 50 young people (16 females, 33 males, 1 nonbinary) aged from 16-25 who were clients at a youth early psychosis service in Melbourne, Australia. Results from a discriminant function analysis revealed the two major contributing factors to whether someone used violence in the home, were whether a young person had a coexisting neurodevelopmental or intellectual disability and whether they used violence outside the home. The findings provide preliminary evidence that engaging in violence outside the home and the presence of a neurodevelopmental or intellectual disability may make it more likely for young people with early psychosis to use violence in the home.
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Affiliation(s)
- Richard Whitehead
- Alfred Health Child and Youth Mental Health Service, Melbourne, Australia.
- School of Psychology, Deakin University, Melbourne, Australia.
| | - Liza Hopkins
- Alfred Health Child and Youth Mental Health Service, Melbourne, Australia
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Andreo-Jover J, Wootton O, Fernández-Jiménez E, Muñoz-Sanjosé A, Mediavilla R, Bravo-Ortiz MF, Susser E, Gur RC, Stein DJ. Adverse childhood experiences and cognition: A cross-sectional study in Xhosa people living with schizophrenia and matched medical controls. Compr Psychiatry 2024; 130:152459. [PMID: 38330854 DOI: 10.1016/j.comppsych.2024.152459] [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] [Received: 10/02/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with impaired cognitive function in adult life in the general population as well as in people living with schizophrenia (PLS). Research on cognitive function in PLS in low- and middle-income countries (LMIC) is, however, limited. The objectives of this study were to investigate the association between ACE types and various cognitive domains in a sample of PLS and matched medical controls, and to determine the moderating effect of group membership (PLS vs. medical controls) on these associations, in the South African setting. METHODS Participants (n PLS = 520; n medical controls = 832) completed the Childhood Trauma Questionnaire-Short Form, the Structured Clinical Interview for DSM-IV (SCID-I), and the University of Pennsylvania Computerized Neurocognitive Battery (PennCNB). An efficiency or speed score was used to assess performance across 9 cognitive domains. The association between exposure to different ACE types and 9 cognitive domains was examined using partial correlations and multiple linear regression models, adjusting for sex, age and education years. Finally, potential moderating effects of group membership (PLS vs. medical controls) on the association between ACEs and cognitive domains were tested. RESULTS In the entire sample, emotional and physical abuse predicted worse performance on sensorimotor and emotion identification domains. Also, emotional abuse was negatively associated with motor function, physical abuse was negatively associated with spatial processing, and physical neglect was negatively associated with face memory and emotion identification. In contrast, emotional neglect was related to better performance on abstraction and mental flexibility. No moderating effect of group membership was found on any of these associations. CONCLUSION Exposure to ACEs was associated with social and non-social cognition in adulthood, although the magnitude of these relationships was small and similar between PLS and matched medical controls. The nature of these associations differed across ACE subtype, suggesting the need for a nuanced approach to studying a range of mechanisms that may underlie different associations. However, a number of ACE subtypes were associated with worse performance on emotional identification, indicating that some underlying mechanisms may have more transversal impact. These findings contribute to the sparse body of literature on ACEs and cognition in PLS in LMIC.
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Affiliation(s)
- Jorge Andreo-Jover
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Olivia Wootton
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Eduardo Fernández-Jiménez
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain; Universidad Europea de Madrid, Faculty of Social Sciences and Communication, Madrid, Spain.
| | - Ainoa Muñoz-Sanjosé
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Princesa (IIS-Princesa), Madrid, Spain
| | - María Fe Bravo-Ortiz
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ezra Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, United States; Department of Psychiatry, New York State Psychiatric Institute, New York, United States
| | - Ruben C Gur
- Brain Behavior Laboratories, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, United States
| | - Dan J Stein
- South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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Zhang L, Zhao N, Zhu M, Tang M, Liu W, Hong W. Adverse childhood experiences in patients with schizophrenia: related factors and clinical implications. Front Psychiatry 2023; 14:1247063. [PMID: 37701095 PMCID: PMC10493314 DOI: 10.3389/fpsyt.2023.1247063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/15/2023] [Indexed: 09/14/2023] Open
Abstract
The relationship between adverse childhood experiences (ACEs) and the development of psychotic symptoms is not well understood. Therefore, this study aimed to investigate the frequency and distribution of ACEs among patients with schizophrenia and their potential correlation with symptomatology and personality pathology. We conducted a cross-sectional study involving 571 patients with schizophrenia in Shanghai, China. Symptomatology was assessed using the Positive and Negative Symptoms Scale (PANSS) and personality pathology was assessed using the Personality Diagnostic Questionnaire Fourth Edition Plus (PDQ-4+). ACEs were assessed using the Child Trauma Questionnaire-Short Form (CTQ-SF). ACEs were highly prevalent, with 80.8% of the patients with schizophrenia reporting at least one ACE. The three most common types of ACE were physical neglect (69.8%), emotional neglect (28.2%), and emotional abuse (22.9%). For specific ACE, emotional abuse was significantly associated with PD traits, whereas emotional and physical neglect types of ACE was significantly associated with negative symptoms. A higher level of physical abuse was more commonly reported by men, younger individuals, and those with a higher level of antisocial PD traits. Higher levels of physical neglect were associated with more severe negative symptoms. ACEs are commonly observed in patients with schizophrenia. Therefore, it is strongly recommended that this clinical population be provided with a comprehensive assessment and individualized intervention for those exposed to specific ACEs.
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Affiliation(s)
| | | | | | | | | | - Wenjuan Hong
- Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
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Saunders KRK, McGuinness E, Barnett P, Foye U, Sears J, Carlisle S, Allman F, Tzouvara V, Schlief M, Vera San Juan N, Stuart R, Griffiths J, Appleton R, McCrone P, Rowan Olive R, Nyikavaranda P, Jeynes T, K T, Mitchell L, Simpson A, Johnson S, Trevillion K. A scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health care. BMC Psychiatry 2023; 23:567. [PMID: 37550650 PMCID: PMC10405430 DOI: 10.1186/s12888-023-05016-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/10/2023] [Indexed: 08/09/2023] Open
Abstract
Experiences of trauma in childhood and adulthood are highly prevalent among service users accessing acute, crisis, emergency, and residential mental health services. These settings, and restraint and seclusion practices used, can be extremely traumatic, leading to a growing awareness for the need for trauma informed care (TIC). The aim of TIC is to acknowledge the prevalence and impact of trauma and create a safe environment to prevent re-traumatisation. This scoping review maps the TIC approaches delivered in these settings and reports related service user and staff experiences and attitudes, staff wellbeing, and service use outcomes.We searched seven databases (EMBASE; PsycINFO; MEDLINE; Web of Science; Social Policy and Practice; Maternity and Infant Care Database; Cochrane Library Trials Register) between 24/02/2022-10/03/2022, used backwards and forwards citation tracking, and consulted academic and lived experience experts, identifying 4244 potentially relevant studies. Thirty-one studies were included.Most studies (n = 23) were conducted in the USA and were based in acute mental health services (n = 16). We identified few trials, limiting inferences that can be drawn from the findings. The Six Core Strategies (n = 7) and the Sanctuary Model (n = 6) were the most commonly reported approaches. Rates of restraint and seclusion reportedly decreased. Some service users reported feeling trusted and cared for, while staff reported feeling empathy for service users and having a greater understanding of trauma. Staff reported needing training to deliver TIC effectively.TIC principles should be at the core of all mental health service delivery. Implementing TIC approaches may integrate best practice into mental health care, although significant time and financial resources are required to implement organisational change at scale. Most evidence is preliminary in nature, and confined to acute and residential services, with little evidence on community crisis or emergency services. Clinical and research developments should prioritise lived experience expertise in addressing these gaps.
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Affiliation(s)
- Katherine R K Saunders
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK.
| | - Elizabeth McGuinness
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK
| | - Phoebe Barnett
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational, & Health Psychology, University College London, London, UK
- National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK
| | - Una Foye
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK
| | - Jessica Sears
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Sophie Carlisle
- Section of Women's Mental Health, King's College London, London, UK
| | - Felicity Allman
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
- School of Medical Education, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Vasiliki Tzouvara
- Care for Long Term Conditions Research Division, King's College London, London, UK
| | - Merle Schlief
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
| | - Norha Vera San Juan
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK
| | - Ruth Stuart
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK
| | - Jessica Griffiths
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK
| | - Rebecca Appleton
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
| | - Paul McCrone
- Institute for Lifecourse Development, University of Greenwich, London, UK
- School of Health Sciences, University of Greenwich, London, UK
| | - Rachel Rowan Olive
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, UK
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| | - Patrick Nyikavaranda
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, UK
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| | - Tamar Jeynes
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, UK
| | - T K
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, UK
| | - Lizzie Mitchell
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, UK
| | - Alan Simpson
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK
- School of Medical Education, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Sonia Johnson
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
| | - Kylee Trevillion
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK
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Rosa M, Scassellati C, Cattaneo A. Association of childhood trauma with cognitive domains in adult patients with mental disorders and in non-clinical populations: a systematic review. Front Psychol 2023; 14:1156415. [PMID: 37425159 PMCID: PMC10327487 DOI: 10.3389/fpsyg.2023.1156415] [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] [Received: 02/01/2023] [Accepted: 06/01/2023] [Indexed: 07/11/2023] Open
Abstract
Although the association between cognitive performances and the onset of psychiatric disorders has been widely investigated, limited research on the role of childhood trauma or early life stress (CT/ELS), and whether this role differs between clinical and non-clinical cohorts is available. This systematic review aims at filling this gap, testing whether the occurrence of CT/ELS and its subtypes are associated with cognitive domains (general cognitive ability, executive functions, working memory, attention, processing speed, verbal/visual memory) in patients with psychiatric disorders and in non-clinical populations. This study followed the PRISMA 2020 guidelines and the Newcastle-Ottawa scale for quality assessment. The search was performed until May 2022. Seventy-four studies were classified as eligible. The graphical representations of the results reported an association between exposure to CT/ELS and worse general cognitive ability, verbal/visual memory, processing speed and attention in patients affected by anxiety, mood and psychotic disorders, and that specific CT/ELS subtypes (physical neglect, physical/sexual abuse) can differentially influence specific cognitive abilities (executive functions, attention, working memory, verbal/visual memory). In non-clinical cohorts we found associations between CT/ELS exposure and impairments in executive functions, processing speed and working memory, while physical neglect was related to general cognitive ability and working memory. Concerning the emotional abuse/neglect subtypes in both populations, the results indicated their involvement in cognitive functioning; however, the few studies conducted are not enough to reach definitive conclusions. These findings suggest an association of CT/ELS with specific cognitive deficits and psychopathology.
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Affiliation(s)
- Melissa Rosa
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Catia Scassellati
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Annamaria Cattaneo
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
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