The Indirect Effect of Child Maltreatment Severity on Adult PTSD Symptoms through Anxiety Sensitivity

Experiences of maltreatment in childhood are associated with increasing anxiety and lower body acceptance over pregnancy

OBJECTIVE

Prior studies have established that childhood sexual abuse (CSA) survivors are at increased risk for anxiety during pregnancy. Less is known about the course of anxiety throughout pregnancy for CSA survivors as well as underlying mechanisms linking CSA and perinatal anxiety. We assessed change in anxiety over the course of pregnancy for CSA survivors and examined whether acceptance and awareness of pregnancy-related body changes mediated this change.

METHODS

299 pregnant participants from two larger longitudinal cohort studies were grouped into CSA (n = 67), "other Maltreatment" (OM; n = 111); and "no abuse" (NA; n = 121) based on responses to the Adverse Childhood Events scale. We used a general linear mixed model with repeated measures to examine change in anxiety (Hamilton Anxiety Scale) at two time points (MEGA = 26.2 weeks and 34.9) by abuse/maltreatment group and then examined whether group differences in anxiety were mediated by body awareness/acceptance (from Maternal Fetal Attachment Scale) using structural equation modeling.

RESULTS

The CSA group demonstrated higher anxiety at both gestational time-points and significantly greater increase in anxiety over gestation compared to OM and NA groups (F(1, 280) p = .046). CSA and OM groups reported significantly lower body acceptance than those without abuse/maltreatment (F(2, 287) = 3.486, p = .032). A small proportion of the total effect of CSA on change in anxiety (0.5%) was attributable to body acceptance.

CONCLUSION

Pregnant CSA survivors experienced a greater increase in anxiety over pregnancy compared to other groups. Both abuse/maltreatment groups exhibited lower body acceptance, yet this contributed little to the association between CSA and anxiety.

The Role of Anxiety Sensitivity in the Association Between Childhood Maltreatment and Sleep Disturbance Among Adults in Psychiatric Inpatient Treatment

The present investigation examined associations of childhood maltreatment, anxiety sensitivity (AS), and sleep disturbance among a diverse sample of adults in psychiatric inpatient treatment. We hypothesized that childhood maltreatment would be indirectly associated with greater sleep disturbance through elevated AS. Exploratory analyses examined the indirect effect models with three AS subscales (i.e., physical, cognitive, and social concerns) as parallel mediators. A sample of adults in acute-care psychiatric inpatient treatment (N = 88; 62.5% male; Mage = 33.32 years, SD = 11.07; 45.5% White) completed a series of self-report measures. After accounting for theoretically relevant covariates, childhood maltreatment was indirectly associated with sleep disturbance through AS. Parallel mediation analyses revealed that no individual subscale of AS significantly accounted for this association. These findings suggest that heightened levels of AS may explain the association between childhood maltreatment and sleep disturbance among adults in psychiatric inpatient treatment. Interventions targeting AS can be brief and efficacious and have the potential to improve clinical outcomes among psychiatric populations.

Post-Traumatic Orientation to Bodily Signals: A Systematic Literature Review

Theoretical literature suggests that trauma and (PTSD) may instigate changes in the interpretation of bodily signals. Some findings support these inquiries, revealing that exposure to traumatic events and PTSD are associated with pain catastrophizing, body vigilance, fear of pain, and other manifestations of bodily perceptions and interpretations. However, these findings are not integrated into an inclusive empirically based conceptualization, thus leading to a limited comprehension of this phenomenon. This systematic literature review was conducted to synthesize the existing literature referring to orientation to bodily signals. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the review included a final of 48 manuscripts that addressed orientation to bodily signals among participants (aged 18 and above) and its potential associations with PTSD. The review revealed that most studies assessed one orientation manifestation, which was tested for its link to PTSD. The majority of the manuscripts were cross-sectional and included participants who faced combat, vehicle accidents, or various types of traumas. Only five manuscripts focused on interpersonal trauma and abuse. Most manuscripts reported significant correlations, revealing that trauma and PTSD are associated with a negative, catastrophic and frightful interpretation of bodily signals. These findings emphasize the need to encapsulate the various manifestations of orientation to bodily signals under a unified construct, as proposed by the term post-traumatic orientation to bodily signals. Further research is needed to illuminate the circumstances and processes by which trauma is implicated in post-traumatic orientation to bodily signals.

Deconstructing pathways to resilience: A systematic review of associations between psychosocial mechanisms and transdiagnostic adult mental health outcomes in the context of adverse childhood experiences

Adverse childhood experiences (ACEs) are identified with increased risk of adult mental health difficulties and negative impacts on well-being. However, there is a need to go beyond simple associations and identify candidate mechanisms underpinning the ACEs-mental health relationship. Further methodological heterogeneity points to issues around the operationalization of ACEs and the importance of modelling data using robust research designs. The aim of the current review was to synthesize studies that utilized formal mediation and/or moderation analyses to explore psychological and social variables on the pathway between clearly defined ACEs (as measured by the ACE questionnaire and Childhood Trauma Questionnaire [CTQ]) and common mental health outcomes (depressive, anxiety and post-traumatic stress disorder [PTSD] symptoms) across community samples aged over 18. A total of 31 papers were retrieved for critical appraisal. The majority of the studies explored factors mediating/moderating the link between child adversity and depression and less on anxiety and trauma. Most mechanisms were tested in only single studies, limiting the consistency of evidence. Evidence indicated that the mechanisms underlying associations between ACEs and adult mental health are likely to reflect multiple intervening variables. Further, there are substantial methodological limitations in the extant literature including the proliferation of causal inferences from cross-sectional designs and both measurement and conceptual issues in operationalizing adversity. Consistent transdiagnostic mechanisms relevant to common mental health problems were identified, including perceived social support, emotion regulation and negative cognitive appraisals/beliefs. Further research using longitudinal design is required to delineate the potential contribution of the identified mechanisms.

Traumatic Effects of the COVID-19 Outbreak in Middle School Students and Caregivers

OBJECTIVE

To investigate the traumatic effects of the COVID-19 pandemic on middle-school students and their parents.

METHODS

This epidemiological cross-sectional study was conducted with middle-school students in Denizli. A questionnaire consisting of the IES-R, CRIES-13 and a sociodemographic data form was delivered online. A total of 1059 participants who fully completed the questionnaire were included for analysis.

RESULTS

The IES-R total and subdimension scores and the CRIES-13 scores were found to be significantly higher in families with an income level of ≤2,500 TL. The CRIES-13 scores of children were found to be significantly higher in divorced families. No statistically significant difference was determined between the IES-R total and subdimension scores of the parents who were healthcare workers and the CRIES-13 scale scores of their children.

CONCLUSION

A statistically significant, positive, moderate relationship was found between the IES-R scale total and subdimension scores of parents and the CRIES-13 scale scores of children. A low socioeconomic level was seen to increase the prevalence of anxiety in adults and adolescents. The children of divorced families were found to be at higher risk of PTSD. Successful management of mental health symptoms in parents will reflect positively on the mental health status of their children.

South Korean mothers' childhood abuse experience and their abuse of their children with intellectual and developmental disabilities: Moderating effect of parenting self-efficacy

BACKGROUND

A history of childhood abuse has been found to adversely affect the transition to motherhood. Compared to other children, children with intellectual and developmental disabilities are at higher risk of being maltreated at home. However, maternal parenting self-efficacy has been found to improve mothers' positive interactions with their children.

OBJECTIVE

Given that, this study examined the moderating effect of maternal parenting self-efficacy on the relationship between mothers' childhood abuse experience and their abuse of their children with IDDs.

PARTICIPANTS AND SETTING

Participants include 134 South Korean mothers with children between 2 and 8 years of age with intellectual and developmental disabilities.

METHOD

Mothers' childhood abuse experience was assessed using the Childhood Trauma Questionnaire, which measures the extent of mothers' exposure to parental abuse in their childhood. Parenting self-efficacy was measured using the Echelle Globle du Sentiment de Competence Parentale (EGSCP). The Abusive Parenting scale was used to assess mothers' abusive parenting; it measured the degree to which mothers had ever either physically or emotionally abused their children.

RESULTS

The moderating effects of parenting self-efficacy on the relationships between childhood emotional abuse and abusive parenting (B = -.06, t(126) = -2.33, p = .022, 95 % CI[-.1142, -.0092]) and between childhood physical abuse and abusive parenting (B = -.07, t(126) = -2.64, p = .009, 95 % CI[-.1283, -.0184]) were significant.

CONCLUSIONS

These findings emphasize the importance of helping mothers with a history of abuse alleviate parental stress arising from raising children with IDDs by enhancing their parenting self-efficacy.