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Altwaijri Y, Benjet C, Al-Habeeb A, Al-Subaie A, Akkad M, Alammar S, Bilal L, Naseem T. Suicidal thoughts and behaviors in the Kingdom of Saudi Arabia. J Affect Disord 2024; 352:429-436. [PMID: 38382818 DOI: 10.1016/j.jad.2024.02.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 02/06/2024] [Accepted: 02/16/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE Suicidal thoughts and behaviors (STB) constitute an escalating public health concern globally. Despite the growing burden of suicidal ideation, plan, and attempts, national information on the trends of STB is lacking in the Kingdom of Saudi Arabia (KSA). Therefore, we aim to report on the prevalence, correlates, and treatment-seeking behaviors associated with STB in the country using nationally representative information from The Saudi National Mental Health Survey (SNMHS). METHODS The SNMHS is a national household survey of Saudi citizens aged 15-65 (n = 4004). The adapted Composite International Diagnostic Interview (CIDI) 3.0 was administered to produce lifetime and 12-month prevalence and treatment estimates of STB in the KSA. Associated correlates were calculated using cross tabulations and logistic regressions. RESULTS Suicidal ideation, plan, and attempt had respective lifetime prevalence rates of 4.90 %, 1.78 %, and 1.46 %; 12-month prevalence rates of 1.82 %, 0.89 %, and 0.63 %. Significant correlates of STB include younger age, female gender, low education, urban rearing, and singe marital status. STB were also significantly associated with the presence of prior mental disorders, childhood adversities, and low treatment-seeking. CONCLUSIONS High unmet need and significant sociocultural and psychological risk factors have been identified in association with STB in the KSA. Given the community-based nature of the SNMHS and the limited national data on STB in the Middle East and North Africa region, our findings can extend to inform the necessary healthcare policies, treatment plans, and prevention strategies needed to alleviate the burdens of STB in the region.
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Affiliation(s)
- Yasmin Altwaijri
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia; SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Corina Benjet
- Center for Global Mental Health, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Abdulhameed Al-Habeeb
- National Center for Mental Health Promotion, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah Al-Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Psychiatry, Edrak Medical Center, Riyadh, Saudi Arabia
| | - Marya Akkad
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia; SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Sarah Alammar
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Lisa Bilal
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia; SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Talal Naseem
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia; SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Grigaitė U, Azeredo-Lopes S, Cardoso G, Pedrosa B, Aluh DO, Santos-Dias M, Silva M, Xavier M, Caldas-de-Almeida JM. Mental health conditions and utilisation of mental health services by survivors of physical intimate partner violence in Portugal: Results from the WHO world mental health survey. Psychiatry Res 2024; 334:115801. [PMID: 38402741 DOI: 10.1016/j.psychres.2024.115801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 02/27/2024]
Abstract
The aim of this article is to study mental health conditions among survivors of severe physical intimate partner violence (IPV) and their utilisation of mental health services. This study is an integrated part of the World Mental Health Survey Initiative-Portugal, for which data was collected from a nationally representative adult sample using well-validated scales. Logistic regression models were used in the analysis. The most common statistically significant mental health conditions among IPV survivors were suicide ideation, PTSD, major depressive episode, and generalised anxiety disorder. More than one in three survivors developed PTSD. Suicide ideation was likely to occur after first experiencing IPV. Almost a half of survivors received specialised mental health treatment; in most cases, delivered by a psychiatrist. Over 60 % addressed their mental health issues consulting general physicians or other healthcare professionals. Those who experienced family violence in childhood had greater odds of also experiencing IPV; survivors of IPV with this experience were more likely to receive mental health treatment. The need to promote greater awareness and competencies of not only mental health professionals but also of general physicians and other healthcare professionals to provide support more effectively to survivors of any type of IPV deserves to be emphasised.
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Affiliation(s)
- Ugnė Grigaitė
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal; National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal.
| | - Sofia Azeredo-Lopes
- Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal; Department of Statistics and Operational Research, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Graça Cardoso
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Bárbara Pedrosa
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal; National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Deborah Oyine Aluh
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal; National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal; Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria Nsukka, Nigeria
| | - Margarida Santos-Dias
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Manuela Silva
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Miguel Xavier
- Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - José Miguel Caldas-de-Almeida
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
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Huang L, Chi P, Wang E, Bu H, Chi X. Trajectories of complex posttraumatic stress symptoms among Chinese college students with childhood adversities: The role of self-compassion. Child Abuse Negl 2024; 150:106138. [PMID: 36948929 DOI: 10.1016/j.chiabu.2023.106138] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 02/26/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Complex posttraumatic stress disorder (CPTSD) is associated with severe impairments in psychosocial functions, but related longitudinal research is limited. To promote the mental health of college students with childhood adversities, it is imperative to investigate the development of CPTSD symptoms and the predictive factors. OBJECTIVES The study aimed to examine the latent trajectories of CPTSD symptoms among college students with childhood adversities and to identify the role of self-compassion in differentiating potential trajectories. METHODS A total of 294 college students with childhood adversities completed self-report questionnaires on demographic backgrounds, childhood adversities, CPTSD symptoms, and self-compassion three times with an interval of three months. Latent class growth analysis was used to determine the trajectories of CPTSD symptoms. Multinomial logistic regression was performed to examine the association between self-compassion and trajectories subgroups while adjusting for demographic variables. RESULTS Three heterogeneous groups of CPTSD symptoms among college students with childhood adversities were identified: the low-symptoms group (n = 123, 41.8 %), the moderate-symptoms group (n = 108, 36.7 %), and the high-risk group (n = 63, 21.4 %). Multinomial logistic regression showed that, after adjusting for demographic variables, students with higher levels of self-compassion were less likely to belong to the moderate-symptoms and high-risk group in comparison to the low-symptoms group. CONCLUSIONS The results suggest the trajectories of CPTSD symptoms of college students with childhood adversities were heterogeneous. Self-compassion was a protective factor against the development of CPTSD symptoms. The present study provided insights into the mental health promotion for individuals with adversities.
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Affiliation(s)
- Liuyue Huang
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau; Center for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macau
| | - Peilian Chi
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau; Center for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macau
| | - Enna Wang
- School of Education, Tianjin University, Tianjin, China
| | - He Bu
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
| | - Xinli Chi
- 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.
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Cheung CTY, Cheng CMH, Lee VWP, Lam SKK, He KL, Ling HWH, Lee K, Ross CA, Fung HW. COULD FAMILY WELL-BEING MODERATE THE RELATIONSHIP BETWEEN ADVERSE CHILDHOOD EXPERIENCES AND SOMATOFORM DISSOCIATION? A PRELIMINARY INVESTIGATION. J Trauma Dissociation 2024; 25:153-167. [PMID: 37424207 DOI: 10.1080/15299732.2023.2233095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 06/05/2023] [Indexed: 07/11/2023]
Abstract
The impacts of adverse childhood experiences (ACEs) have been well documented. One possible consequence of ACEs is dissociation, which is a major feature of post-traumatic psychopathology and is also associated with considerable impairment and health care costs. Although ACEs are known to be associated with both psychoform and somatoform dissociation, much less is known about the mechanisms behind this relationship. Little is known about whether social and interpersonal factors such as family environments would moderate the relationship between ACEs and somatoform dissociation. This paper discusses the importance of having a positive and healthy family environment in trauma recovery. We then report the findings of a preliminary study in which we examined whether the association between ACEs and somatoform dissociation would be moderated by family well-being in a convenience sample of Hong Kong adults (N = 359). The number of ACEs was positively associated with somatoform dissociative symptoms, but this association was moderated by the level of family well-being. The number of ACEs was associated with somatoform dissociation only when the family well-being scores were low. These moderating effects were medium. The findings point to the potential importance of using family education and intervention programs to prevent and treat trauma-related dissociative symptoms, but further investigation is needed.
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Affiliation(s)
- Cherry T Y Cheung
- School of Professional Education and Executive Development, The Hong Kong Polytechnic University, Hong Kong
| | | | - Vincent Wan Ping Lee
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kyle Langjie He
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Henry Wai-Hang Ling
- The Department of Social Work and Social Administration, The University of Hong Kong, Po Fok Lam, Hong Kong
| | - Kunhua Lee
- Department of Educational Psychology and Counseling, National Tsing Hua University, Hsinchu, Taiwan
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, Texas, USA
| | - Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
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Navarro-Mateu F, Salmerón D, Vilagut G, Husky M, Ballesta M, Chirlaque MD, Huerta JM, Martínez S, Navarro C, Alonso J, Nock M, Kessler RC. Childhood adversities and suicidal behavior in the general population. The cross-sectional PEGASUS-Murcia Project. Span J Psychiatry Ment Health 2024; 17:11-18. [PMID: 33099026 DOI: 10.1016/j.rpsm.2020.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The aim of the present study is to estimate the lifetime prevalence of suicidal ideation, plans, and attempts in a regional representative sample and the association of these outcomes with sociodemographic factors, prior mental disorders, and childhood adversities. MATERIAL AND METHODS The PEGASUS-Murcia project is a cross-sectional survey of a representative sample of adults in Murcia that is part of the WHO World Mental Health Survey Initiative. The Composite International Diagnostic Interview (CIDI 3.0) was administered face-to-face to 2621 participants (67.4% response rate). The main outcomes were suicidal ideation, plans, and attempts. Lifetime prevalence, age of onset, and risk factors (sociodemographic variables, mental disorders, and childhood adversities) were examined using multiple discrete-time survival models. RESULTS Lifetime prevalence of suicidal ideation, plans and attempts were 8.0% (standard error, SE: 1.1), 2.1% (SE: 0.3), and 1.2% (SE: 1.1), respectively. Prevalence of any childhood adversities was 22.1% (SE: 1.3) in the total sample and, even higher, among those with suicide related outcomes (ranging between 36.8% and 53.7%). Female sex, younger age, prior (to onset of the outcome) lifetime prevalence of mood disorders, number of mental disorders, and exposure to childhood adversity were associated with significantly increased odds of suicidal ideation and plans. CONCLUSIONS Lifetime prevalence estimates of suicidality are similar to those in community epidemiological surveys. Childhood adversities and mental disorders, especially mood disorders, are important risk factors for suicidality. Early detection of these adversities and disorders should be targeted in suicide prevention programs.
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Affiliation(s)
- Fernando Navarro-Mateu
- Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Servicio Murciano de Salud, Departamento de Psicología Básica y Metodología, Universidad de Murcia, Spain; IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Diego Salmerón
- IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain.
| | - Gemma Vilagut
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; IMIM-Institut Hospital del Mar d'Investigacions Médiques, Barcelona, Spain
| | - Mathilde Husky
- Laboratoire de Psychologie, Université de Bordeaux, Burdeos, France
| | - Mónica Ballesta
- Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain; Servicio de Epidemiología, Consejería de Sanidad y Política Social, Murcia, Spain
| | - María Dolores Chirlaque
- IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain; Servicio de Epidemiología, Consejería de Sanidad y Política Social, Murcia, Spain
| | - José María Huerta
- IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Servicio de Epidemiología, Consejería de Sanidad y Política Social, Murcia, Spain
| | | | - Carmen Navarro
- IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain; Servicio de Epidemiología, Consejería de Sanidad y Política Social, Murcia, Spain
| | - Jordi Alonso
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; IMIM-Institut Hospital del Mar d'Investigacions Médiques, Barcelona, Spain; Departamento de Salud y Ciencias Experimentales, Universidad Pompeu Fabra, Barcelona, Spain
| | - Matthew Nock
- Department of Psychology, Harvard University, Cambridge, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, USA
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Karam E, Al Barathie J, Saab D, Karam AN, Fayyad J. First Onset in Adulthood of Mental Disorders: Exposure to War vs. Non-war Childhood Adversities: A National Study. Clin Pract Epidemiol Ment Health 2023; 19:e17450179216651. [PMID: 38655552 PMCID: PMC11037514 DOI: 10.2174/0117450179216651231106072824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 04/26/2024]
Abstract
Background There is evidence that some childhood trauma increases the risk of the first onset of mental disorders and for the first time into adulthood. There are no studies that assessed whether exposure to war has this delayed long-term effect. Objectives To fill this gap by investigating the comparative roles of war and non-war trauma on the first onset of adulthood mood and anxiety disorders. Methods A nationally representative sample of 2,857 Lebanese was assessed using the World Health Organization Composite International Diagnostic Interview 3.0. with the onset of exposure to trauma and of first onset of mood and anxiety disorders. Results Non-war childhood traumata especially those belonging to family malfunctioning continue to exert their effect for the first time well beyond their occurrence as they were the most universal predictors for adult onset of both mood and anxiety disorders. War trauma during childhood predicted mood anxiety and mood (anxiety only in males) only below age 18 y. war childhood trauma predicts the first onset of mood and anxiety disorders before age 18 y in females, but only anxiety in males. Conclusion Childhood traumata are not equal in predicting the first onset of mood and anxiety disorders into adulthood. Family malfunctioning looks to carry the longest such risk and war more of shorter immediate effects. This might change though with re-exposure to war in adulthood which might unravel dormant vulnerability.
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Affiliation(s)
- Elie Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, University of Balamand Faculty of Medicine, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
| | - Josleen Al Barathie
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Dahlia Saab
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Aimee Nasser Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, University of Balamand Faculty of Medicine, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
| | - John Fayyad
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, University of Balamand Faculty of Medicine, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
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Bhattarai A, Dimitropoulos G, Bulloch AGM, Tough SC, Patten SB. Association between childhood adversities and premature and potentially avoidable mortality in adulthood: a population-based study. BMC Public Health 2023; 23:2036. [PMID: 37853382 PMCID: PMC10585893 DOI: 10.1186/s12889-023-16935-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/08/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The association of childhood adversities with mortality has rarely been explored, and even less studied is the question of whether any excess mortality may be potentially preventable. This study examined the association between specific childhood adversities and premature and potentially avoidable mortality (PPAM) in adulthood in a representative sample of the general population. Also, we examined whether the associations were potentially mediated by various adult socioeconomic, psychosocial, and behavioral factors. METHODS The study used data from the National Population Health Survey (NPHS-1994) linked to the Canadian Vital Statistics Database (CVSD 1994-2014) available from Statistics Canada. The NPHS interview retrospectively assessed childhood exposure to prolonged hospitalization, parental divorce, prolonged parental unemployment, prolonged trauma, parental problematic substance use, physical abuse, and being sent away from home for doing something wrong. An existing definition of PPAM, consisting of causes of death considered preventable or treatable before age 75, was used. Competing cause survival models were used to examine the associations of specific childhood adversities with PPAM in adulthood among respondents aged 18 to 74 years (rounded n = 11,035). RESULTS During the 20-year follow-up, 5.4% of the sample died prematurely of a cause that was considered potentially avoidable. Childhood adversities had a differential effect on mortality. Physical abuse (age-adjusted sub-hazard ratio; SHR 1.44; 95% CI 1.03, 2.00) and being sent away from home (age-adjusted SHR 2.26; 95% CI 1.43,3.57) were significantly associated with PPAM. The associations were attenuated when adjusted for adulthood factors, namely smoking, poor perceived health, depression, low perceived social support, and low income, consistent with possible mediating effects. Other adversities under study were not associated with PPAM. CONCLUSION The findings imply that the psychological sequelae of childhood physical abuse and being sent away from home and subsequent uptake of adverse health behavior may lead to increased risk of potentially avoidable mortality. The potential mediators identified offer directions for future research to perform causal mediation analyses with suitable data and identify interventions aimed at preventing premature mortality due to potentially avoidable causes. Other forms of adversities, mostly related to household dysfunction, may not be determinants of the distal health outcome of mortality.
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Affiliation(s)
- Asmita Bhattarai
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada.
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada.
| | - Gina Dimitropoulos
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Faculty of Social Work, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Andrew G M Bulloch
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Suzanne C Tough
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Scott B Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
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Biscond M, Revranche M, Navarro-Mateu F, Janota M, Kovess-Masfety V, Husky MM. The effect of childhood adversities on the persistence of suicidal ideation and plans among college students: A longitudinal study. J Affect Disord 2023; 323:354-60. [PMID: 36470554 DOI: 10.1016/j.jad.2022.11.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 10/26/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Exposure to childhood adversities (CAs) is known to be associated with the onset of suicidal ideation and plans. However, little is known regarding the contribution of CAs to their persistence. AIMS The study aims to examine the type, number and frequency of CA exposure on the persistence of suicidal ideation and plans at one-year. METHOD Data were drawn from the French portion of the World Mental Health International College Student survey. At baseline (n = 2661, response rate = 7,58 %), exposure to 12 types of CAs prior to age 18, lifetime mental disorders, lifetime and 12-month suicidal ideation and plans were assessed. At one-year follow-up (n = 1221), 12-month mental disorders, suicidal ideation and plans were assessed. Among those with a prior history of suicidal ideation, logistic regressions were performed to examine the role of CAs on the persistence of ideation and plans at one-year. RESULTS At baseline, frequency and number of CAs were associated with 12-month suicidal ideation and plans. Among lifetime ideators, 49.6 % reported 12-month suicidal ideation at follow-up. Physical abuse was associated with an increased risk of suicidal ideation and plan persistence at one year in univariate analyses. However, CAs were not associated with the persistence of suicidal ideation and plans at one-year in multivariate analyses. LIMITATIONS Retrospective report of CA exposure, and low baseline response rate. CONCLUSIONS Using a fine-grained operationalization of CA exposure, CAs were not involved in the persistence of suicidal ideation or plans, their deleterious effect more likely to occur early in the course of psychopathology.
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Fung HW, Chien WT, Ling HWH, Ross CA, Lam SKK. The mediating role of post-traumatic stress disorder symptoms in the relationship between childhood adversities and depressive symptoms in two samples. Child Abuse Negl 2022; 131:105707. [PMID: 35714440 DOI: 10.1016/j.chiabu.2022.105707] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Childhood adversities have been increasingly recognized as a significant risk factor for depression. However, the underlying mediating mechanism between childhood adversities and depression requires further investigation. The literature shows that childhood adversities are also closely associated with post-traumatic stress disorder (PTSD) symptoms and that PTSD symptoms can predict depressive symptoms. It remains unexplored whether PTSD symptoms can act as a mediator between childhood adversities and depression. OBJECTIVES The primary goal of this study was to examine whether PTSD symptoms would mediate the relationship between childhood adversities and depressive symptoms. PARTICIPANTS AND SETTING We examined in a convenience sample of Hong Kong adults aged 18 or above (N = 418) whether PTSD symptoms would mediate the relationship between childhood adversities and depressive symptoms. We then examined and compared the results with those in another convenience sample of Chinese-speaking young adults (mainly from Taiwan and Hong Kong) aged between 18 and 24 (N = 205). Participants in both samples completed online surveys that included measures of childhood adversities, PTSD symptoms and depressive symptoms. RESULTS Childhood adversities were significantly associated with depressive symptoms; and this relationship was mediated by PTSD symptoms in both samples. CONCLUSION This study is one of very few studies demonstrating that PTSD symptoms mediate the relationship between childhood adversities and depressive symptoms. Our findings suggest that addressing unresolved PTSD symptoms for adults with childhood adversities may help in preventing or treating depressive symptoms. Therefore, PTSD symptoms should be taken into account in the prevention and management of depression.
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Affiliation(s)
- Hong Wang Fung
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; The Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Henry Wai-Hang Ling
- The Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, TX, United States
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Nissinen NM, Sarkola T, Autti-Rämö I, Gissler M, Kahila H, Koponen AM. Mood and neurotic disorders among youth with prenatal substance exposure: A longitudinal register-based cohort study. J Affect Disord 2022; 308:328-336. [PMID: 35439464 DOI: 10.1016/j.jad.2022.04.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/16/2022] [Accepted: 04/09/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Prenatal substance exposure is associated with mood and neurotic disorders but this association is complex and understudied. This study investigated the recorded use of specialised healthcare services for mood and neurotic disorders among youth with prenatal substance exposure in comparison with an unexposed matched cohort. Furthermore, the influence of adverse maternal characteristics and out-of-home care (OHC) is investigated. METHODS This longitudinal register-based matched cohort study included 594 exposed and 1735 unexposed youth. Cox proportional hazard regression models were applied to study the first episode of mood and neurotic disorders in specialised healthcare from 13 years of age, and the influence of adverse maternal characteristics and OHC. Mediation analysis was applied to study the mediating effect of OHC on the association between prenatal substance exposure and the disorders. RESULTS The exposed cohort had a two-fold higher likelihood of being treated at specialised healthcare for mood and neurotic disorders compared with the unexposed cohort (HR 2.34, 95% CI 1.86-2.95), but this difference was attenuated to non-significant levels (AHR 1.29, 95% CI 0.92-1.81) following adjustments with adverse maternal characteristics and OHC. OHC mediated 61% (95% CI 0.41-0.94) of the association between prenatal substance exposure and youth's mood and neurotic disorders. LIMITATIONS Register data likely include more severe cases of disorders, and as an observational study, causality cannot be assessed. CONCLUSION Mood and neurotic disorders are more common following prenatal exposure to substances and interlinked with significant adversities in the postnatal caregiving environment and OHC.
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Affiliation(s)
- Niina-Maria Nissinen
- Folkhälsan Research Center, Helsinki, Finland; Tampere University, Faculty of Social Sciences, Health Sciences Unit, Tampere, Finland.
| | - Taisto Sarkola
- Children's Hospital, University of Helsinki, Helsinki University Hospital, Helsinki, Finland; Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Ilona Autti-Rämö
- University of Helsinki, Children's Hospital, Division of Child Neurology, Helsinki, Finland
| | - Mika Gissler
- THL Finnish Institute for Health and Welfare, Information Services Department, Helsinki, Finland; Karolinska Institute, Department of Molecular Medicine and Surgery, Stockholm, Sweden and Region Stockholm, Academic Primary Health Care Centre, Stockholm, Sweden; University of Turku, Research Centre for Child Psychiatry, Turku, Finland
| | - Hanna Kahila
- Department of Obstetrics and Gynaecology, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Anne M Koponen
- Folkhälsan Research Center, Helsinki, Finland; University of Helsinki, Department of Public Health, Helsinki, Finland
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11
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Huang Y, Zhang S, Zhong S, Gou N, Sun Q, Guo H, Lin R, Guo W, Chen H, Wang J, Zhou J, Wang X. The association of childhood adversities and mental health problems with dual-harm in individuals with serious aggressive behaviors. BMC Psychiatry 2022; 22:385. [PMID: 35672721 PMCID: PMC9175457 DOI: 10.1186/s12888-022-04027-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The coexistence of self-harm and aggression, which is referred to as dual-harm, is commonly seen in forensic population. Self-harm and aggression have often been studied separately, previous studies on risk factors of aggression or self-harm mainly focused on childhood adversities, emotional regulation, impulsivity and psychopathology, given their importance in the two behaviors. However, the factors associated with dual-harm remain unclear. This study aimed to explore potential risk factors associated with co-occurring self-harm among individuals with serious aggressive behaviors. METHODS This multi-center, cross-sectional case-control study was conducted from May 2013 to January 2016 and involved seven qualified forensic institutes located in seven provinces in China. Participants were individuals with serious aggressive behaviors and were suspected to have mental disorders. Lifetime history of self-harm was obtained by a self-report questionnaire, and serious aggressive behaviors were assessed with the use of participants' forensic archive. Sociodemographic and clinical information were collected using a self-designed standardized data collection form, and childhood adversities was assessed using a clinician-rated scale designed by our research team. The Psychopathy Checklist-Revised (PCL-R) was used to assess psychopathic traits and the Brief Psychiatric Rating Scale (BPRS) was used to assess psychiatric symptoms of the participants. Univariate and multivariate logistic regression analyses were performed to analyze the relevant factors for dual-harm. RESULTS A total of 423 individuals with serious aggressive behaviors were enrolled in the current study. Of them, 74 (17.5%) with self-harm history assigned into the dual-harm group (D-H) and 349 (82.5%) without self-harm history assigned into the aggression-only group (A-O). According to the binary logistic regression analysis, current diagnosis of mood disorder (OR = 3.2, 95%CI: 1.2-8.5), child abuse (OR = 2.8, 95%CI: 1.3-6.2), parental death (OR = 3.0, 95%CI: 1.2-7.5), and the score of the affective subscale in BPRS (OR = 1.7, 95%CI: 1.3-2.4) were significantly associated with dual-harm. CONCLUSIONS Our study suggested the necessity of integrated evaluation of self-harm among individuals with serious aggressive behaviors. Childhood adversities and psychiatric symptoms in this population require special attention.
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Affiliation(s)
- Ying Huang
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Simei Zhang
- grid.452897.50000 0004 6091 8446Shenzhen Kangning Hospital, Shenzhen, China
| | - Shaoling Zhong
- grid.410737.60000 0000 8653 1072 Department of Community Mental Health, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ningzhi Gou
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Qiaoling Sun
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Huijuan Guo
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Ruoheng Lin
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Weilong Guo
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Hui Chen
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Jizhi Wang
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Jiansong Zhou
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011, Hunan Province, China.
| | - Xiaoping Wang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011, Hunan Province, China.
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Elling C, Forstner AJ, Seib-Pfeifer LE, Mücke M, Stahl J, Geiser F, Schumacher J, Conrad R. Social anxiety disorder with comorbid major depression - why fearful attachment style is relevant. J Psychiatr Res 2022; 147:283-90. [PMID: 35114512 DOI: 10.1016/j.jpsychires.2022.01.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/17/2021] [Accepted: 01/09/2022] [Indexed: 11/22/2022]
Abstract
Individuals with social anxiety disorder (SAD) often suffer from comorbid major depressive disorder (MDD), which goes along with increased clinical and functional impairment. There has been little research on underlying differences regarding childhood adversities and attachment styles between individuals with SAD with and without comorbid MDD. In the present study, the consecutive sample comprised 612 SCID-diagnosed participants. Of these, n = 472 (62.3% women, 40.7 ± 13.8 years) showed SAD and comorbid MDD (SAD-MDD group) and n = 140 (47.9% women, 43.7 ± 14.7 years) showed just SAD (SAD group). The two groups were compared regarding SAD symptom severity (Social Phobia Inventory; SPIN), childhood adversities (Adverse Childhood Experience Questionnaire; ACE) and attachment styles (Attachment Style Questionnaire, ASQ). The SAD-MDD group reported significantly more severe SAD symptoms (p = .002, d = 0.30), more childhood adversities (p < .001, d = 0.35) and a higher level of fearful attachment style (p < .001, d = 0.30). Group significantly moderated the association between fearful attachment style and SAD symptom severity (β = .292, p < .05) but not between preoccupied attachment style and SAD symptom severity (β = -.184, p = .124; R2adj = .168, p < .05). Fearful attachment style mediated the association between childhood adversities and SAD symptom severity in the SAD-MDD group. Our study could identify a specific significance of fearful attachment style for the association between negative childhood experiences and social anxiety symptoms in SAD-MDD. Findings have specific implications for the therapeutic relationship.
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Abstract
University students routinely participate in research, including research on trauma and adversity, but the unique implications of trauma and adversity for educational and developmental outcomes for this group have received less attention. This study surveyed first year undergraduate students at an urban university located in the most ethnically diverse district in England, with the second highest poverty rate. Of 7,110 students, 858 responded; a response rate of 12%. The survey included thirteen questions about adverse events and circumstances before age 18. Four in five students (79%) reported at least one adversity, 51% reported three or more, and 20% reported at least six. Female students reported a higher mean number of adversities than men, but men were significantly more likely to report having been "attacked, stabbed, shot or robbed by threat." Where comparisons were possible, rates were higher than for the general population or for the only other UK university survey. A Latent Class Analysis produced four groupings. Besides the 'No adversity' (36%) and "Intermediate" (46%) classes, there were two "High adversity" groups, differentiated by high (12%) or moderate (6%) adversities related to cohabitation (parental separation, lived with depressed person, lived with alcohol/drug user, and lived with incarcerated person). Higher rates of adversities, and latent class membership, were related to predictions that one would not complete one's degree. Implications and next steps are discussed.
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Affiliation(s)
- Emma Davies
- School of Business and Law, University of East London, London, UK
| | - John Read
- School of Psychology, University of East London, London, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, UK
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Abstract
This study examines the relationship between childhood adversities and healthy ageing in the Chinese older population. The data come from the China Health and Retirement Longitudinal Survey (CHARLS), a national survey that collected life history and ageing-related information on 9248 older people aged over 60 in 2014 and 2015. The analysis of healthy ageing focuses on seven indicators: IADL limitations, ADL limitations, cognitive functioning, depressive symptoms, life satisfaction, self-reported health, and chronic illness. Using k-means clustering, an unsupervised learning technique, we identified four qualitatively different groups according to their achievement in healthy ageing. We studied 17 types of childhood adversities and found that experiencing multiple childhood adversities is associated with a lower probability of achieving healthy ageing. This relationship is moderated by age and gender. Women are more vulnerable than men to the negative impacts of childhood adversities. The threat of childhood adversities to healthy ageing is greatly attenuated among people aged over 80. We argue that the policy response to healthy ageing should not be confined to those services and programmes that directly target older people. Instead, healthy ageing can be better addressed by concerted efforts in different areas of social policy.
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Abstract
Major depressive disorder (MDD) is a multifactorial disorder, where multiple susceptibility genes interact with environmental factors, predisposing individuals to the development of the illness. In this article, we reviewed different gene × environment interaction (G×E) studies shifting from a candidate gene to a genome-wide approach. Among environmental factors, childhood adversities and stressful life events have been suggested to exert crucial impacts on MDD. Importantly, the diathesis-stress conceptualization of G×E has been challenged by the differential susceptibility theory. Finally, we summarized several limitations of G×E studies and suggested how future G×E studies might reveal complex interactions between genes and environments in MDD.
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Affiliation(s)
- Ming-Zhe Zhao
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, Shanghai 200240, China
| | - Xu-Sheng Song
- Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin 300060, China
| | - Jing-Song Ma
- Institute of Advanced Technology, Westlake Institute for Advanced Study, Hangzhou 310024, Zhejiang Province, China
- School of Engineering, Westlake University, Hangzhou 310024, Zhejiang Province, China
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El-Khoury F, Rieckmann A, Bengtsson J, Melchior M, Rod NH. Childhood adversity trajectories and PTSD in young adulthood: A nationwide Danish register-based cohort study of more than one million individuals. J Psychiatr Res 2021; 136:274-80. [PMID: 33621913 DOI: 10.1016/j.jpsychires.2021.02.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/05/2021] [Accepted: 02/12/2021] [Indexed: 12/18/2022]
Abstract
We examine the association between trajectories of childhood adversities and Post-Traumatic Stress Disorder (PTSD) using a register-based Danish cohort. The DANish LIFE Course (DANLIFE) cohort includes and prospectively follows all individuals born in Denmark from 1980. We estimated the rate of PTSD diagnosed from age 16, according to childhood adversity trajectories from age 0 to 16 (n = 1 277 548). Trajectories were previously defined into 5 groups: Low Adversity, Early Life Material Deprivation, Persistent Material Deprivation, Loss or Threat of Loss, And High Adversity. We then estimated adjusted relative hazard ratios (aHR), and absolute hazards differences of PTSD according to childhood adversity trajectories in adjusted survival analysis. All analyses were stratified by sex. Individuals were followed for a median of 10·1 years a fter their 16th birthday, and 4966 individuals were diagnosed with PTSD. Compared with the low adversity group, children exposed to childhood adversity were more likely to be diagnosed with PTSD. The aHR for PTSD varied from 1·4 (95% CI: 1·3-1·5) in the Early Life Material Deprivation group, to 3·7 (3·3-4·1) in the High Adversity group, which corresponds to 8·3 extra cases of PTSD per 10 000 person years. The relative associations were comparable in men and women, but approximately twice as many women compared with men were affected. We report a clear association between exposure to childhood adversities and PTSD in young adulthood. The highest burden was among women in the high adversity group.
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Yoon J, Kim JY, Kim JH, Kim SS. Role of SES on the association between childhood parental death and adulthood suicidal ideation: a mediation analysis using longitudinal dataset in South Korea. BMC Psychiatry 2021; 21:162. [PMID: 33757483 PMCID: PMC7986519 DOI: 10.1186/s12888-021-03146-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 02/17/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND We sought to examine the association between childhood experience of parental death (CEPD) and adulthood suicidal ideation, and the mediating role of adulthood SES in the association. METHODS We analyzed a nationally representative dataset of 8609 adults from the Korea Welfare Panel Study, which is a longitudinal cohort dataset in South Korea. CEPD was measured using a question: "During your childhood (0-17 years old), have you experienced the death of parents?" We classified responses of CEPD during 2006-2011 into 'yes,' and the others into 'no.' Suicidal ideation over the past year was assessed annually during 2012-2019. As a potential mediator, adulthood educational attainment and household income in 2011 were included in the analysis. Logistic regression was applied to examine the association of CEPD with adulthood suicidal ideation across age groups (early adulthood, 19-39 years old; middle adulthood, 40-59 years old; late adulthood, ≥60 years old), after excluding people who reported lifetime suicidal ideation in 2011. Causal mediation analysis using a parametric regression model was applied to examine the mediating role of adulthood SES in the association between CEPD and adulthood suicidal ideation. RESULTS After adjusting for potential confounders including childhood SES, CEPD was significantly associated with adulthood suicidal ideation among the late adulthood group (OR: 1.43; 95% CI: 1.13-1.81), while the association was not statistically significant among the early; and middle adulthood groups. In mediation analysis of adulthood household income, both indirect association (ORNIE: 1.05; 95% CI: 1.02-1.09) and direct association (ORNDE: 1.37; 95% CI: 1.09-1.73) were statistically significant among the late adulthood group. In the mediation analysis of adulthood education attainment among the late adulthood, only a direct association was statistically significant (ORNDE: 1.43; 95% CI: 1.14-1.80). CONCLUSIONS These results suggest that CEPD could be a risk factor for adulthood suicidal ideation. Furthermore, the findings imply that income security policy might be necessary to reduce suicide among the late adulthood group.
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Affiliation(s)
- Jaehong Yoon
- grid.222754.40000 0001 0840 2678Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Ja Young Kim
- Gyeonggi Public Health Policy Institute, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Ji-Hwan Kim
- grid.222754.40000 0001 0840 2678Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Seung-Sup Kim
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea. .,Interdisciplinary Program in Precision Public Health, Korea University, Seoul, South Korea. .,Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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18
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Coêlho BM, Andrade LH, Santana GL, Viana MC, Wang YP. Association between childhood adversities and psychopathology onset throughout the lifespan: Findings from a large metropolitan population. J Psychiatr Res 2021; 135:8-14. [PMID: 33406459 DOI: 10.1016/j.jpsychires.2020.12.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/03/2020] [Accepted: 12/17/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Childhood adversities (ECA) are deleterious experiences that can occur during individuals' development, which has been associated with several negative health outcomes. AIM Analyze the effect of ECA on the onset of DSM-IV disorders throughout life. METHOD The Composite International Diagnostic Interview (CIDI) was used in a stratified, multistage area probability sample of 5037 individuals aged 18 or more to assess the presence of childhood adversities, 20 psychiatric disorders and their ages of onset. Discrete-time survival models were performed to estimate the odds of disorder onset. Data are from the São Paulo Megacity Mental Health Survey, the Brazilian branch of the World Mental Health Survey Initiative. FINDINGS 53.6% of the sample experienced at least one ECA, and parental death (16.1%) and physical abuse (16%) were the most reported occurrences. Parental mental illness (OR = 1.99 to 2.27) and family violence (OR = 1.55 to 1.99) were the adversities most consistently associated with psychopathology across all age groups, while economic adversities (OR = 2.71 to 3.30) and parent criminality (OR = 1.72 to 1.77) were associated with psychopathology in individuals whose onset of disorder occurred from age 13 years on. Parental mental disorders and economic adversities were the strongest and most consistent predictors of all four classes of psychopathologies examined in multivariate models controlled for the clustering of adversities. Physical abuse was associated with externalizing disorders, while sexual abuse with internalizing disorders. INTERPRETATION Childhood adversities were consistently associated with mental disorders. Economic adversities and parent mental disorders were predictive of psychopathology even if controlled for type (additive) and type and number of adversities (interactive models). Parental mental disorder and family violence were the main predictors of psychopathology onset across all age groups. Parental mental disorder was the only adversity that predicted all classes of disorders investigated.
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Nissinen NM, Gissler M, Sarkola T, Kahila H, Autti-Rämö I, Koponen AM. Completed secondary education among youth with prenatal substance exposure: A longitudinal register-based matched cohort study. J Adolesc 2020; 86:15-27. [PMID: 33264707 DOI: 10.1016/j.adolescence.2020.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The dual impact of prenatal substance exposure (i.e. alcohol/drugs) and adverse postnatal caregiving environment on offspring secondary education completion is an understudied research area. The aim was to investigate the influence of childhood adversities, out-of-home care, and offspring's mental and/or behavioural disorders on secondary education completion among prenatally exposed offspring in comparison to matched unexposed offspring. METHODS This is a longitudinal register-based matched cohort study in Finland including offspring with a history of prenatal substance exposure and a matched unexposed cohort. The study sample included 283 exposed and 820 unexposed offspring aged 18-23 years. RESULTS The results showed a time lag in secondary education completion and lower educational attainment overall among exposed compared with unexposed (37.8% vs. 51.0%, respectively). The results from the multivariate logistic regression models showed that the differences in the secondary education completion between exposed and unexposed were diminished in the presence of covariates. A cumulative childhood adversity score and out-of-home care were not associated with secondary education completion in the multivariate models, whereas the different domains of offspring's mental and/or behavioural disorders including psychiatric disorders (AOR 0.65, 95% CI 0.45-0.96), neuropsychological disorders (AOR 0.35, 95% CI 0.23-0.54) and dual psychiatric and neuropsychological disorder (AOR 0.29, 95% CI 0.18-0.48) showed an independent negative effect on secondary education completion. CONCLUSIONS Inferior educational outcomes may not be directly linked with prenatal substance exposure but may rather reflect the extent of evolving offspring's mental and/or behavioural disorders over time influenced by childhood adversities.
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Affiliation(s)
- Niina-Maria Nissinen
- Folkhälsan Research Center, Helsinki, Finland; Tampere University, Faculty of Social Sciences, Health Sciences Unit, Tampere, Finland.
| | - Mika Gissler
- THL Finnish Institute for Health and Welfare, Information Services Department, Helsinki, Finland; Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden; University of Turku, Research Centre for Child Psychiatry, Turku, Finland
| | - Taisto Sarkola
- Children's Hospital, University of Helsinki, And Helsinki University Hospital, Helsinki, Finland; Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Hanna Kahila
- Department of Obstetrics and Gynecology, University of Helsinki, And Helsinki University Central Hospital, Helsinki, Finland
| | - Ilona Autti-Rämö
- Council for Choices in Health Care in Finland, Department for Steering of Healthcare and Social Welfare, Ministry of Social Affairs and Health, Helsinki, Finland; University of Helsinki, Children's Hospital, Division of Child Neurology, Helsinki, Finland
| | - Anne M Koponen
- Folkhälsan Research Center, Helsinki, Finland; University of Helsinki, Department of Public Health, Helsinki, Finland
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Thakur N, Hessler D, Koita K, Ye M, Benson M, Gilgoff R, Bucci M, Long D, Burke Harris N. Pediatrics adverse childhood experiences and related life events screener (PEARLS) and health in a safety-net practice. Child Abuse Negl 2020; 108:104685. [PMID: 32898839 PMCID: PMC9350954 DOI: 10.1016/j.chiabu.2020.104685] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/04/2020] [Accepted: 08/10/2020] [Indexed: 06/09/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) are associated with behavioral, mental, and clinical outcomes in children. Tools that are easy to incorporate into pediatric practice, effectively screen for adversities, and identify children at high risk for poor outcomes are lacking. OBJECTIVE To examine the relationship between caregiver-reported child ACEs and related life events with health outcomes. PARTICIPANTS AND SETTING Participants (0-11 years) were recruited from the University of California San Francisco Benioff's Children Hospital Oakland Primary Care Clinic. There were 367 participants randomized. METHODS Participants were randomized 1:1:1 to item-level (item response), aggregate-level (total number of exposures), or no screening for ACEs (control arm) with the PEdiatric ACEs and Related Life Event Screener (PEARLS). We assessed 10 ACE categories capturing abuse, neglect, and household challenges, as well as 7 additional categories. Multivariable regression models were conducted. RESULTS Participants reported a median of 2 (IQR 1-5) adversities with 76 % (n = 279) reporting at least one adversity; participants in the aggregate-level screening arm, on average, disclosed 1 additional adversity compared to item-level screening (p = 0.01). Higher PEARLS scores were associated with poorer perceived child general health (adjusted B = -0.94, 95 %CI: -1.26, -0.62) and Global Executive Functioning (adjusted B = 1.99, 95 %CI: 1.51, 2.46), and greater odds of stomachaches (aOR 1.14; 95 %CI: 1.04-1.25) and asthma (aOR 1.08; 95 %CI 1.00, 1.17). Associations did not differ by screening arm. CONCLUSION In a high-risk pediatric population, ACEs and other childhood adversities remain an independent predictor of poor health. Increased efforts to screen and address early-life adversity are necessary.
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Affiliation(s)
- Neeta Thakur
- University of California, San Francisco Departments of Medicine and Epidemiology and Biostatistics, 500 Parnassus Avenue, PO Box 0841, San Francisco CA, 94143-0841, United States.
| | - Danielle Hessler
- University of California, San Francisco Department of Family and Community Medicine, 500 Parnassus Avenue, E334, Box 0900, San Francisco, CA, 94117, United States.
| | - Kadiatou Koita
- Center for Youth Wellness, 3450 3rd St, San Francisco, CA, 94124, United States.
| | - Morgan Ye
- University of California, San Francisco Department of Medicine.
| | - Mindy Benson
- UCSF Benioff Children's Hospital Oakland, 747 52nd St, Oakland, CA, 94609, United States.
| | - Rachel Gilgoff
- Center for Youth Wellness, 3450 3rd St, San Francisco, CA, 94124, United States.
| | - Monica Bucci
- Center for Youth Wellness, 3450 3rd St, San Francisco, CA, 94124, United States.
| | - Dayna Long
- UCSF Benioff Children's Hospital Oakland, 747 52nd St, Oakland, CA, 94609, United States; California AB 340 Work Group Member, United States.
| | - Nadine Burke Harris
- Center for Youth Wellness, 3450 3rd St, San Francisco, CA, 94124, United States.
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Castro-Vale I, van Rossum EFC, Staufenbiel SM, Severo M, Mota-Cardoso R, Carvalho D. Hair Cortisol as a Marker of Intergenerational Heritage of War? A Study of Veterans and Their Offspring. Psychiatry Investig 2020; 17:976-986. [PMID: 33017887 PMCID: PMC7596280 DOI: 10.30773/pi.2020.0212] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 08/06/2020] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) has been associated with lower circulating cortisol levels in specific subgroups, which have also been found in the offspring of people with PTSD. The analysis of hair cortisol concentrations (HCC) is a recent methodology which is used to assess long-term systemic cortisol levels. We aimed to study veterans with war-related lifetime PTSD and their respective offspring with regards to HCC. We also studied the influence of lifetime major depressive disorder (MDD), war experiences, and childhood adversities on HCC in these groups. METHODS 31 male veterans with PTSD and 28 without PTSD and 69 adult offspring were studied. HCC were quantified by liquid chromatography tandem-mass spectrometry. RESULTS No differences in HCC were found between veterans with and without PTSD, or between their respective offspring. Veterans without MDD showed a positive association between total war exposure and HCC. Veterans reporting more frequent childhood physical abuse had lower HCC. Veterans-with-PTSD's offspring with MDD had increased HCC compared to offspring without MDD. Offspring's exposure to more frequent childhood physical abuse was negatively associated with HCC in those without MDD. CONCLUSION HCC did not appear to constitute a marker of intergenerational heritage of war-related PTSD, except in the case of veteranswith-PTSD's offspring with MDD. Our data suggest that HCC is a marker of adult reported childhood physical abuse.
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Affiliation(s)
- Ivone Castro-Vale
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal.,i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Sabine M Staufenbiel
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Milton Severo
- Department of Clinical Epidemiology, Predictive Medicine and Public Health and Department of Medical Education and Simulation, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rui Mota-Cardoso
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Davide Carvalho
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,Department of Endocrinology, Diabetes and Metabolism, São João University Hospital Centre, Faculty of Medicine, University of Porto, Porto, Portugal
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22
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Lorenti A, Dudel C, Hale JM, Myrskylä M. Working and disability expectancies at older ages: The role of childhood circumstances and education. Soc Sci Res 2020; 91:102447. [PMID: 32933645 DOI: 10.1016/j.ssresearch.2020.102447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 05/22/2020] [Accepted: 07/13/2020] [Indexed: 06/11/2023]
Abstract
The ability to work at older ages depends on health and education. Both accumulate starting very early in life. We assess how childhood disadvantages combine with education to affect working and health trajectories. Applying multistate period life tables to data from the Health and Retirement Study (HRS) for the period 2008-2014, we estimate how the residual life expectancy at age 50 is distributed in number of years of work and disability, by number of childhood disadvantages, gender, and race/ethnicity. Our findings indicate that number of childhood disadvantages is negatively associated with work and positively with disability, irrespective of gender and race/ethnicity. Childhood disadvantages intersect with low education resulting in shorter lives, and redistributing life years from work to disability. Among the highly educated, health and work differences between groups of childhood disadvantage are small. Combining multistate models and inverse probability weighting, we show that the return of high education is greater among the most disadvantaged.
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Affiliation(s)
| | | | - Jo Mhairi Hale
- Max Planck Institute for Demographic Research, Germany; University of St Andrews, Scotland, UK
| | - Mikko Myrskylä
- Max Planck Institute for Demographic Research, Germany; London School of Economics and Political Science, UK; University of Helsinki, Finland
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Piotrowski P, Frydecka D, Kotowicz K, Stańczykiewicz B, Samochowiec J, Szczygieł K, Misiak B. A history of childhood trauma and allostatic load in patients with psychotic disorders with respect to stress coping strategies. Psychoneuroendocrinology 2020; 115:104645. [PMID: 32171901 DOI: 10.1016/j.psyneuen.2020.104645] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/03/2020] [Accepted: 03/03/2020] [Indexed: 12/14/2022]
Abstract
Elevated allostatic load (AL) index, which is a cumulative measure of biological dysregulations associated with stress exposure, has been demonstrated in patients with psychosis. However, it remains unknown whether a history of childhood trauma (CT) might contribute to elevated AL index in psychosis. Therefore, we aimed to investigate the association between AL index, a history of CT and coping styles in patients with psychotic disorders. Participants were 65 patients with schizophrenia-spectrum disorders and 56 healthy controls (HCs). The AL index was computed based on percentile distributions of 15 biomarkers in HCs. The AL index was significantly higher in patients with psychosis. A history of parental antipathy was associated with elevated AL index in both groups of participants. A history of any categories of CT and sexual abuse were associated with higher AL index only in patients with psychosis. Social diversion (seeking social interactions in case of stressful experiences) mediated the association between sexual abuse and the AL index in the group of patients. There was a significant direct effect of sexual abuse on the AL index (this specific CT was associated with higher AL index). However, indirect effect of sexual trauma on AL through social diversion was opposite to direct effect. Childhood adversities, especially sexual abuse and parental antipathy, might contribute to elevated AL index in patients with psychosis. The effect of sexual abuse on the AL index might be specific to psychosis. Engagement in social interactions in case of stressful situations might alleviate biological dysregulations associated with CT.
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Affiliation(s)
- Patryk Piotrowski
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland
| | - Kamila Kotowicz
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland
| | - Bartłomiej Stańczykiewicz
- Department of Nervous System Diseases, Wroclaw Medical University, Bartla 5 Street, 51-618 Wroclaw, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Krzysztof Szczygieł
- Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Błażej Misiak
- Department of Genetics, Wroclaw Medical University, Marcinkowskiego 1 Street, 50-368 Wroclaw, Poland.
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24
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Berent D, Szymańska B, Kulczycka-Wojdala D, Macander M, Pawłowska Z, Wojnar M. The role of childhood adversities, FKBP5, BDNF, NRN1, and generalized self-efficacy in suicide attempts in alcohol-dependent patients. Pharmacol Rep 2020; 72:730-743. [PMID: 32157595 PMCID: PMC8217039 DOI: 10.1007/s43440-020-00080-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 10/18/2019] [Accepted: 12/30/2019] [Indexed: 11/25/2022]
Abstract
Background Alcohol-dependent (AD) patients report higher number of adverse childhood experiences (ACEs), develop poor social skills, and have a higher rate of suicide attempts than the general population. We hypothesize that the association between ACEs and lifetime suicide attempts in AD patients is mediated by generalized self-efficacy and selected functional single nucleotide polymorphisms (SNPs) in genes involved in the stress response and neuroplasticity, including: FKBP5 rs1360780, BDNF rs6265, and NRN1 rs1475157. Methods 176 AD patients and 127 healthy controls self-reported ACEs with the ACE Study questionnaire and three additional questions that inquired about ACE categories of acute stress; generalized self-efficacy—with the Generalized Self-Efficacy Scale. Genotyping for the three analysed SNPs was performed according to the manufacturer’s standard PCR protocol. Hypotheses were tested with bivariate analyses, multiple regression model, and mediation models. Results Higher levels of generalized self-efficacy were associated with a blunted effect of ACEs on the risk of suicide attempts. The prevalence of the three analyzed SNPs genotypes and alleles did not differ between AD patients with a positive vs. negative lifetime history of suicide attempt and was not associated with GSES scoring. Conclusions Generalized self-efficacy should be considered as a target for psychotherapeutic interventions aimed at reducing the risk of suicide attempts in AD patients who were exposed to childhood victimization. The negative results concerning the hypothesized role of the three analysed SNPs should be carefully interpreted due to the relatively small study sample, but represent a theoretical foundation for further research studies with larger study samples. Electronic supplementary material The online version of this article (10.1007/s43440-020-00080-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dominika Berent
- Masovian Regional Psychiatric Hospital Drewnica, Ząbki, Poland.
| | - Bożena Szymańska
- Central Scientific Laboratory, Medical University of Lodz, Lodz, Poland
| | | | - Marian Macander
- Aviation Patophysiology and Safety Flight Department, Military Institute of Aviation Medicine, Warsaw, Poland
| | - Zofia Pawłowska
- Central Scientific Laboratory, Medical University of Lodz, Lodz, Poland
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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25
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Del Valle Tena O, Benjet C, Medina-Mora ME, Borges G, Wagner FA. Chronic childhood adversity and speed of transition through stages of alcohol involvement. Drug Alcohol Depend 2019; 205:107669. [PMID: 31698324 DOI: 10.1016/j.drugalcdep.2019.107669] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND While research suggests that chronic childhood adversities may be predictors of alcohol use disorders, little is known of their influence on accelerated transitions through stages of alcohol involvement. We estimated the speed of transition from first opportunity (to first drink, regular drinking) to alcohol use disorder, by type and number of childhood adversities experienced. METHODS Nine-hundred-and-fifteen individuals participated in the Mexican Adolescent Mental Health Survey (a stratified multistage probabilistic sample), first as adolescents (12-17 years of age) and again eight years later as young adults (19-26 years of age). The WHO World Mental Health Composite International Diagnostic Interview (WMH-CIDI) assessed DSM-IV alcohol use disorders and twelve chronic childhood adversities. We calculated random coefficient models to estimate the association of childhood adversities with speed through stages of alcohol use involvement. RESULTS Mean time from opportunity to disorder was 4.08 years and the average growth rate was 1.36 years between each stage of involvement. Some, but not all, childhood adversities accelerated the growth rate, decreasing latency between each stage of alcohol use involvement from 1.36 to 0.93 years for witnessing family violence, 0.87 years for having a life-threatening illness, 0.79 years for sexual abuse to 0.77 years for physical abuse (p < 0.01). CONCLUSIONS There is a narrower window of opportunity to prevent progression through stages of alcohol involvement in youth who have experienced certain childhood adversities. Our findings are consistent with the dimensional approach of childhood adversity that distinguishes between experiences of threat and deprivation that might differentially influence neurological development.
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Schalinski I, Teicher MH, Rockstroh B. Early neglect is a key determinant of adult hair cortisol concentration and is associated with increased vulnerability to trauma in a transdiagnostic sample. Psychoneuroendocrinology 2019; 108:35-42. [PMID: 31226659 DOI: 10.1016/j.psyneuen.2019.06.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 06/11/2019] [Accepted: 06/11/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Childhood adversities and traumatic events have each been associated with hypothalamus-pituitary-adrenal (HPA) axis dysregulation and trauma-related symptoms in adulthood. Hair cortisol concentration (HCC) reflects cumulative cortisol levels over the course of months and is discussed as a potential marker between trauma-induced neuroendocrine dysfunction and trauma-related symptoms. The present study examines this hypothetical link by delineating the impact of exposure to categories of abuse and neglect during development and lifetime traumatic experiences on HCC and trauma-related symptoms. METHODS The Maltreatment and Abuse Chronology Exposure (MACE) scale, Life Events Checklist, and predictive analytics were used to evaluate the importance of type and timing of maltreatment and trauma load on HCC in inpatients (n = 183) with different psychiatric diagnoses. Additionally, a comparison group of n = 75 controls were recruited from the community. The extent to which the relationship between trauma load and trauma-related symptoms was influenced by childhood adversities and HCC was determined by analysis of variance. RESULTS Early neglect, in particular neglect at 3 years, emerged as the most important predictor of adult HCC. Post-hoc explanatory analysis showed that patients with high neglect at age 3 had lower HCC compared to patients with low neglect at age 3 and controls. Patients with high neglect at age 3 and low cortisol reported increased trauma-related symptoms upon trauma exposure. CONCLUSION Results strengthen evidence that inadequate care and neglect during critical periods alter HPA axis biology towards enduring reduction in cortisol, the latter being associated with augmented trauma-related symptoms upon trauma exposure. If validated by longitudinal assessments these cross-sectional findings suggest biological mechanisms of childhood adversities into psychopathology in adulthood.
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27
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Wang C, Wang Q, Li X, Zhang Y, Wei W, Deng W, Guo W, He L, Tang W, Chen T, Li T. Rural birth/upbringing and childhood adversities are associated with psychotic experiences in university students in China. Schizophr Res 2019; 209:105-112. [PMID: 31101515 DOI: 10.1016/j.schres.2019.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 03/28/2019] [Accepted: 05/05/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Urbanicity has been reported to associate with an increased risk of psychotic experiences (PEs) in developed countries but less is known about the situation in developing countries. The present study aimed to investigate the effects of birth/upbringing place and other environmental factors on PEs in Chinese university students. METHODS A computer-assisted cross-sectional survey was conducted on 4620 second-year undergraduates, using a stratified cluster sampling. Birth places and residential mobility before 16 years old were recorded. PEs were measured using the subscales of psychoticism and paranoid ideation in the Symptom Checklist-90-R (SCL-90-R). Six questions extracted from the childhood section of the World Mental Health Composite International Diagnostic Interview (WMH-CIDI) were used to assess childhood trauma. RESULTS Generalized ordered logit model of multiple regression analysis revealed that participants with rural birth/upbringing (e.g. rural upbringing, on graded factor score of psychoticism and paranoid ideation [GFSPPI], 0 versus 1 & 2, odds ratio [OR] 1.409, 95% CI 1.219-1.628, p < 0.00001; 0 & 1 versus 2, OR 1.584, 95% CI 1.179-2.128, p < 0.00001) and those who reported childhood trauma (e.g. on GFSPPI, 0 versus 1 & 2, OR 1.737, 95% CI 1.498-2.014, p < 0.00001; 0 & 1 versus 2, OR 1.618, 95% CI 1.224-2.140, p < 0.00001) were apt to present more severe PEs. While upbringing places and childhood trauma affected both the presence and the severity of PEs, gender affected the presence or absence of PEs only (e.g. females, on GFSPPI, 0 versus 1 & 2, OR 1.887, 95% CI 1.631-2.183, p < 0.00001; 0 & 1 versus 2, OR 0.927, 95% CI 0.702-1.223, p = 0.593). Besides, the number of risk factors was associated with the severity of PEs in the cumulative odds logistic regression analysis (e.g. 3 risk factors versus 0 risk factor, on GFSPPI, OR 4.126, 95% CI 3.075-5.537, p < 0.00001). CONCLUSIONS Female, rural birth/upbringing and childhood trauma are risk factors of PEs in university students in China. The discrepancy in the findings between developed countries and China has important implications for urbanicity as a risk factor for PEs.
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Affiliation(s)
- Chengyu Wang
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China; The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Qiang Wang
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
| | - Xiaojing Li
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yamin Zhang
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wei Wei
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wei Deng
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wanjun Guo
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lingshuang He
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wanjie Tang
- Centre for Educational and Health Psychology, Sichuan University, Chengdu, Sichuan, China
| | - Ting Chen
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Tao Li
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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McLafferty M, Ross J, Waterhouse-Bradley B, Armour C. Childhood adversities and psychopathology among military veterans in the US: The mediating role of social networks. J Anxiety Disord 2019; 65:47-55. [PMID: 31158649 DOI: 10.1016/j.janxdis.2019.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 05/01/2019] [Accepted: 05/03/2019] [Indexed: 11/15/2022]
Abstract
Childhood adversities can impact negatively on psychological health across the lifespan. Many military veterans have a history of adverse childhood experiences, which when combined with deployment related traumas, can lead to high levels of psychopathology. Social networks can however be protective. The current study aimed to identify typologies of childhood adversity in U.S. military veterans (n = 3092) and explore relationships between the adversity typologies and PTSD, mood and anxiety disorders, utilising data from the National Epidemiological Survey on Alcohol and Related Conditions-III (NESARC-III). The mediating role of quality and quantity of social networks were examined. Latent class analysis identified four adversity classes; 1) baseline, 2) household dysfunction, 3) maltreatment, and 4) multi-adversity. Individuals in the adversity classes (2-4), especially those who experienced multi-adversity had higher rates of psychopathology. The quality of social networks played an important mediating role, while quantity of networks did not. Those who experienced adversity were less likely to have supportive social networks, therefore adversity had both a direct and indirect impact on psychopathology. The findings highlight the importance of developing and maintaining social networks following military life. Recommendations include interpersonal skills training and programmes which may help them engage back into the community and enhance relationships.
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Affiliation(s)
- M McLafferty
- Ulster University, Cromore Road, Coleraine, Northern Ireland, United Kingdom.
| | - J Ross
- Ulster University, Cromore Road, Coleraine, Northern Ireland, United Kingdom
| | | | - C Armour
- Ulster University, Cromore Road, Coleraine, Northern Ireland, United Kingdom
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29
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Abstract
Childhood adversities have been reported to be more common among individuals at ultra-high risk (UHR) for psychosis. This paper systematically reviewed and meta-analysed (i) the severity and prevalence of childhood adversities (childhood trauma exposure, bullying victimisation and parental separation or loss) among the UHR, and (ii) the association between adversities and transition to psychosis (TTP). PsycINFO, PubMed and Embase databases were searched for studies reporting childhood adversities among UHR individuals. Only published articles were included. Risk of bias was assessed using Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline (von Elm et al., 2007) and the tool developed by Hoy et al. (2012). Seventeen case-control, cross-sectional and longitudinal studies were included. UHR individuals experienced significantly more severe trauma than controls, regardless of trauma subtype. UHR were 5.5, 2.5 and 3.1 times as likely to report emotional abuse, physical abuse and bullying victimisation, respectively. There was no association with parental separation. However, childhood trauma was not significantly associated with TTP (follow-up periods: 6 months to 15 years), suggesting that trauma alone may not be a sufficient risk factor. Sexual abuse was associated with TTP but this may have been driven by a single large study. Potential confounders and low rates of TTP among UHR are limitations of this review. This is the first meta-analysis that quantitatively summarises the associations between childhood adversities and TTP among UHR, and between specific abuse subtypes and TTP. Specific recommendations have been made to increase the quality of future research. PROSPERO registration no. CRD42017054884.
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Affiliation(s)
- Oon Him Peh
- Research Division,Institute of Mental Health,Singapore
| | | | - Jimmy Lee
- Research Division,Institute of Mental Health,Singapore
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30
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Yacaman-Mendez D, Hallgren M, Forsell Y. Childhood adversities, negative life events and outcomes of non-pharmacological treatments for depression in primary care: A secondary analysis of a randomized controlled trial. J Psychiatr Res 2019; 110:152-158. [PMID: 30641348 DOI: 10.1016/j.jpsychires.2019.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/19/2018] [Accepted: 01/03/2019] [Indexed: 11/27/2022]
Abstract
Non-pharmacological treatments for depression are effective and available in primary care, but useful prognostic factors are lacking. Childhood adversities (CA) and negative recent life events (RLE) increase the risk and severity of depression, though their effect on treatment outcomes remains understudied. Using a sample of 737 adult participants of a multicenter randomized controlled trial receiving physical exercise, internet based cognitive-behavioral therapy or treatment as usual, alone or in combination with antidepressants, this prospective study aimed to determine the impact of CA, RLE and their interaction as predictors of outcomes of non-pharmacological treatments for mild-moderate depression in primary care. Outcomes were depression severity (MADRS score) and response to treatment (≥50% reduction in MADRS score) after three months. Linear regression and modified Poisson regression were used, interaction was assessed with a product term (CA*RLE) and epidemiological measures of interaction. The number of CA and RLE were associated with higher depression severity at follow-up (CA: β = 0.79, 95% CI: 0.14 to 1.44 and RLE: β = 0.52, 95% CI: 0.14 to 0.72) and showed a trend towards lower rates of response to treatment (RR = 0.94, 95% CI: 0.86 to 1.03; and RLE: RR = 0.95, 95% CI: 0.90 to 0.99). Interaction between CA and RLE was not significant for depression severity (β = 0.10, 95% CI: -2.12 to 0.41) nor for response to treatment (RERI = -0.05, 95% CI = -0.33 to 0.24). CA and RLE are associated with worse outcomes of non-pharmacological treatments in primary care. Further studies to identify predictors of outcomes of non-pharmaological treatments for depression are needed.
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Affiliation(s)
- Diego Yacaman-Mendez
- Unit of Epidemiology and Public Health Intervention Research (EPHIR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Mats Hallgren
- Unit of Epidemiology of Psychiatric Conditions, Substance Use and Social Environment (EPiCS), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Yvonne Forsell
- Unit of Epidemiology and Public Health Intervention Research (EPHIR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
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31
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Salokangas RKR, Schultze-Lutter F, Schmidt SJ, Pesonen H, Luutonen S, Patterson P, Graf von Reventlow H, Heinimaa M, From T, Hietala J. Childhood physical abuse and emotional neglect are specifically associated with adult mental disorders. J Ment Health 2019; 29:376-384. [PMID: 30675805 DOI: 10.1080/09638237.2018.1521940] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Childhood adversities and trauma (CAT) are associated with adult mental disorders. Nevertheless, although CAT of different domains mostly co-occurs, and co-morbidity is common, the associations between CAT and mental disorders, when taking these interrelations into account, are not well known.Aims: We aimed to study differential associations between the five core domains of CAT and current axis-I disorders, taking into consideration their interrelations.Methods: Four hundred and fifteen outpatients attending adult primary (n = 255) and psychiatric care (n = 160) were assessed with the Trauma and Distress Scale (TADS) and the Mini International Neuropsychiatric Interview (MINI). Associations between CAT core domains and diagnostic categories were examined by path analyses.Results: At least some infrequent experience of CAT (83.6%), mostly of neglect, and current mental disorders (49.4%), mostly depression, was frequent, as were co-morbidities and co-occurrence of CAT domains. Considering these interrelations in a path model of excellent fit, physical abuse predicted depressive, manic, psychotic and anxiety disorders, whereas emotional neglect predicted depressive, anxiety and substance misuse disorders.Conclusions: Of all five CAT core domains, physical abuse and emotional neglect had the strongest association with adult psychiatric disorders and might have transmitted earlier reported main effects of other CAT domains onto mental disorders.
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Affiliation(s)
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Medical Faculty, Department of Psychiatry and Psychotherapy, Heinrich-Heine University, Düsseldorf, Germany
| | - Stefanie J Schmidt
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Henri Pesonen
- Department of Mathematics, University of Turku, Turku, Finland
| | - Sinikka Luutonen
- Department of Psychiatry, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital, Turku, Finland
| | - Paul Patterson
- Youthspace - Birmingham & Solihull Mental Health Foundation Trust, Birmingham, UK
| | | | - Markus Heinimaa
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Tiina From
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital, Turku, Finland
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Salmela J, Mauramo E, Lallukka T, Rahkonen O, Kanerva N. Associations between Childhood Disadvantage and Adult Body Mass Index Trajectories: A Follow-Up Study among Midlife Finnish Municipal Employees. Obes Facts 2019; 12:564-574. [PMID: 31484183 PMCID: PMC6876612 DOI: 10.1159/000502237] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 07/19/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Childhood disadvantage is associated with a higher risk of adult obesity, but little is known about its associations with body mass index (BMI) trajectories during adulthood. This study aimed first to identify adulthood BMI trajectories, and second to investigate how childhood disadvantage is associated with trajectory group membership. METHODS Data from the Helsinki Health Study, a longitudinal cohort study of initially 40- to 60-year-old employees of the City of Helsinki in Finland, were used. The baseline survey was conducted in 2000-2002, and similar follow-up surveys in 2007, 2012, and 2017. Based on self-reported BMI, participants' (n =5,266; 83% women) BMI trajectories, including their retrospectively reported BMI at the age of 25 years, were examined. Data on childhood disadvantage, including parental education and 7 types of childhood adversity (their own serious illness; parental divorce, death, mental disorder, or alcohol problems; economic difficulties at home; and peer group bullying) before the age of 16 years, were obtained from the baseline survey. Group-based trajectory modeling was used to identify BMI trajectories, and multinomial logistic regression to analyze the odds for trajectory group membership for the disadvantage variables. RESULTS Four ascending BMI trajectories in women and men were found: persistent normal weight (trajectory 1; women 35% and men 25%), normal weight to overweight (trajectory 2; women 41% and men 48%), normal weight to class I obesity (trajectory 3; women 19% and men 23%) and overweight to class II obesity (trajectory 4; women 5% and men 4%). Compared to trajectory 1, women with multiple adversities and repetitive peer bullying in childhood had greater odds of belonging to trajectories 3 and 4, whereas men with parental alcohol problems had greater odds of belonging to trajectory 4. For women and men, a low level of parental education was associated with a higher-level BMI trajectory. CONCLUSIONS Low parental education for both genders, multiple adversities and repetitive peer bullying in childhood among women, and parental alcohol problems among men increased the odds of developing obesity during adulthood. Further studies are needed to clarify how gender differences modify the effects of childhood disadvantage on adult BMI trajectories.
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Affiliation(s)
- Jatta Salmela
- University of Helsinki, Department of Public Health, Helsinki, Finland,
| | - Elina Mauramo
- University of Helsinki, Department of Public Health, Helsinki, Finland
| | - Tea Lallukka
- University of Helsinki, Department of Public Health, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ossi Rahkonen
- University of Helsinki, Department of Public Health, Helsinki, Finland
| | - Noora Kanerva
- University of Helsinki, Department of Public Health, Helsinki, Finland
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Bruni A, Carbone EA, Pugliese V, Aloi M, Calabrò G, Cerminara G, Segura-García C, De Fazio P. Childhood adversities are different in Schizophrenic Spectrum Disorders, Bipolar Disorder and Major Depressive Disorder. BMC Psychiatry 2018; 18:391. [PMID: 30567512 PMCID: PMC6300034 DOI: 10.1186/s12888-018-1972-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 12/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research has shown that a history of childhood adversities is common in patients with psychiatric disorders but few studies have investigated links between specific types of adversity and specific psychiatric disorders. METHODS We investigated the frequency of early childhood adversities in a sample consisting of 91 patients with diagnosis of schizophrenic spectrum disorders (SSD), 74 patients with bipolar disorder (BD), 83 patients with major depressive disorder (MDD) and 85 healthy controls and sought to identify adverse early childhood life events that predict the development of major psychiatric disorders. The Childhood Experiences of Care and Abuse questionnaire was used to collect data on traumatic experiences occurring before the age of 17 years and comprehensive demographic data were also collected. The data were analyzed with chi-squared tests, t-tests, post-hoc and logistic regression. RESULTS Maternal absence/loss and economic difficulties in the early life were more prevalent in the BD group than other groups. Escape from home, cannabis abuse, psychological abuse, physical abuse and loneliness were more frequent in the SSD group than in other groups. Paternal absence, neglect of core needs, serious familial tension and absence of adult and peer confidants were all less common in the HC group than in the other groups. The regression model confirmed that different types of adversities play a crucial role in the development of the three investigated disorders. CONCLUSIONS Our results support that SSD, BD and MDD are associated to different childhood adversities. This suggests that psychosocial interventions that reduce the incidence of these early life adversities might reduce the incidence of severe and disabling psychiatric disorders.
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Affiliation(s)
- Antonella Bruni
- 0000 0001 2168 2547grid.411489.1Psychiatry Unit, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
| | - Elvira Anna Carbone
- 0000 0001 2168 2547grid.411489.1Psychiatry Unit, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
| | - Valentina Pugliese
- 0000 0001 2168 2547grid.411489.1Psychiatry Unit, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
| | - Matteo Aloi
- 0000 0001 2168 2547grid.411489.1Psychiatry Unit, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
| | - Giuseppina Calabrò
- 0000 0001 2168 2547grid.411489.1Psychiatry Unit, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
| | - Gregorio Cerminara
- 0000 0001 2168 2547grid.411489.1Psychiatry Unit, Department of Health Sciences, University “Magna Graecia” of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
| | - Cristina Segura-García
- 0000 0001 2168 2547grid.411489.1Psychiatry Unit, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Pasquale De Fazio
- Psychiatry Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.
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Coêlho BM, Santana GL, Duarte-Guerra LS, Viana MC, Neto FL, Andrade LH, Wang YP. The role of gender in the structure of networks of childhood adversity. Psychiatry Res 2018; 270:348-356. [PMID: 30293013 DOI: 10.1016/j.psychres.2018.09.059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 08/16/2018] [Accepted: 09/25/2018] [Indexed: 11/27/2022]
Abstract
The objective of present study is to investigate the relationship between different childhood adversities. The potential impact of early adversity on prevention programs is discussed. Data on twelve childhood adversities was collected from a representative sample of 5037 members of the general population living in a large metropolitan area. Data were analyzed through network analysis, to estimate and compare network connectivity and centrality measures by gender. Over half the respondents had been exposed to at least one adversity during their earlier developmental stage. Among adversity-exposed persons, 48.4% presented simultaneous adversities, most of which were related to 'family dysfunction' and 'maltreatment' (mean = 2.9 adversities). Women reported more adversities than men (59.0% vs. 47.6%). Although the 'global' network connectivity across adversities was similar in both genders, 'regional' distinctions in the network structure were found. While 'neglect' and 'parental death' were more important for women than men, 'parental mental disorders' was more important for men. Gender-related childhood adversities were clustered experiences. Adversities related to 'early family dysfunction' and 'maltreatment' were prominent features in the networks of both boys and girls. Differential preventive and intervention programs should take into account gender-related patterns of exposure and reporting patterns of early adversity.
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Affiliation(s)
- Bruno Mendonça Coêlho
- Nucleo de Epidemiologia Psiquiatrica (LIM-23), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil; Departamento de Psiquiatria, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
| | - Geilson Lima Santana
- Nucleo de Epidemiologia Psiquiatrica (LIM-23), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Leorides Severo Duarte-Guerra
- Nucleo de Epidemiologia Psiquiatrica (LIM-23), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Maria Carmen Viana
- Department of Social Medicine Post-Graduate Program in Public Health, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Francisco Lotufo Neto
- Departamento de Psiquiatria, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Laura Helena Andrade
- Nucleo de Epidemiologia Psiquiatrica (LIM-23), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Yuan-Pang Wang
- Nucleo de Epidemiologia Psiquiatrica (LIM-23), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
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Abstract
Parental style and Cloninger's dimensions are associated with psychosis, but it is still unclear whether temperament, character and parenting variables are linked to specific psychotic symptoms. This study extends previous research exploring these issues. 78 patients with psychosis and 156 control subjects were recruited. Parental style was evaluated using the Measure of Parental Style. Temperament and character were evaluated using the Temperament and Character Inventory-Revised. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale. T-tests, correlations and moderation and mediation analyses were performed. Patients reported dysfunctional parenting and had higher scores for harm avoidance (HA) and self transcendence (ST), and lower scores for self directedness (SD) and cooperativeness (CO) than controls. Maternal indifference, abuse and overcontrol were correlated with positive symptoms (PS). Novelty seeking (NS), reward dependence, SD, CO were correlated with PS; HA and ST were correlated with negative symptoms. After adjusting for age, gender and family history of psychopathology lower CO partially mediated the relationship between maternal abuse and PS; the positive NS-maternal abuse interaction was associated with PS. Different parenting and personality variables may be associated with different psychotic symptoms. NS and CO may be part of a pathway between maternal abuse and PS.
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Affiliation(s)
- Giovanni Mansueto
- Department of Health Sciences, Psychology and Psychiatry Unit, University of Florence, Italy; Maastricht University Medical Center, Department of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, The Netherlands.
| | - Sara Palmieri
- Department of Health Sciences, Psychology and Psychiatry Unit, University of Florence, Italy
| | - Carlo Faravelli
- Department of Health Sciences, Psychology and Psychiatry Unit, University of Florence, Italy
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Rief W, Bleichhardt G, Dannehl K, Euteneuer F, Wambach K. Comparing the Efficacy of CBASP with Two Versions of CBT for Depression in a Routine Care Center: A Randomized Clinical Trial. Psychother Psychosom 2018; 87:164-178. [PMID: 29649805 DOI: 10.1159/000487893] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 02/20/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND The cognitive-behavioral analysis system of psychotherapy (CBASP) was developed for the treatment of chronic, early-onset depression. However, it is unclear whether this approach can be recommended for depression in general (episodic and chronic), and no direct comparisons between CBASP with different versions of cognitive-behavioral therapy (CBT) exist. METHODS A randomized controlled trial compared 3 treatment conditions (all lasting 16 sessions) with a waiting list group (WL): CBASP, CBT with a focus on physical exercise (CBT-E), and CBT with a focus on pleasurable, low-energy and mindful activities (CBT-M). We included 173 patients and involved 41 therapists. Assessments were at baseline, after session 8, and at the end of treatment. RESULTS Our primary outcome Beck Depression Inventory-II indicated a general advantage of the CBT arms compared to CBASP [F(6, 154.5) = 4.2, p = 0.001], with significant contrasts in particular in favor of CBT-E. Effect sizes against WL were d = 0.91 (CBT-E), 0.87 (CBT-M), and 0.47 (CBASP). A triple interaction with an additional factor "chronic versus episodic depression" [F(6, 142.7) = 2.2, p = 0.048] indicated that the treatments resulted in different outcomes, with best results again for CBT-E in particular in episodic depression. Responder rates indicated significant improvements (56% in both CBT arms, 34% in the CBASP arm, 3.4% in WL; intention-to-treat samples). As compared to CBASP, response rates were significantly higher for CBT-E (OR = 2.48; 95% CI = 1.02-6.00) and CBT-M (OR = 2.46; 95% CI = 1.01-6.01). CONCLUSIONS CBASP was more effective than WL, but less effective than the 2 CBT arms. This was mainly caused by an advantage of CBT interventions in episodic depression.
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O'Neill S, McLafferty M, Ennis E, Lapsley C, Bjourson T, Armour C, Murphy S, Bunting B, Murray E. Socio-demographic, mental health and childhood adversity risk factors for self-harm and suicidal behaviour in College students in Northern Ireland. J Affect Disord 2018; 239:58-65. [PMID: 29990663 DOI: 10.1016/j.jad.2018.06.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/04/2018] [Accepted: 06/01/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Prevalence estimates of suicidal behaviour in the college student population are consistently higher than rates for the general adult population. This study examines mental health disorders and childhood adversities as predictors of self-harm and suicidal behaviours. METHODS The Ulster University Student Wellbeing study commenced in September 2015 as part of the WHO World Mental Health Surveys International College Student Project. In Northern Ireland (NI) 739 students participated (462 female, 274 male and 3 other specified), with the WMH-CIDI used to examine psychopathology. Mean age was 21 years old. RESULTS Thirty-one percent endorsed suicidal ideation (24.3% of males and 36.9% of females) with almost 1 in 5 students having made a plan for suicide in the 12 months prior to the survey. Latent profile analysis revealed three profiles of childhood adversity (high, moderate, and low risk). Logistic regression analyses showed that there was an increased likelihood of all queried self-harm and suicidal behaviours in those who were not heterosexual orientation, and among those with either moderate or high levels of childhood adversities. Probable alcohol dependence was associated with a significantly increased likelihood of suicide attempt or self-harm with either a suicide plan or a suicide attempt. LIMITATIONS Influences of self-report measures and the generalizability of the sample are discussed. CONCLUSIONS Policies and strategies for early identification of those with mental illnesses or adversities that increase their risk, should be prioritised. It would also be useful to identify individuals at risk in secondary schools to allow for additional support to be offered to them during the key time of transitioning into higher education.
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Affiliation(s)
- Siobhan O'Neill
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, United Kingdom
| | - Margaret McLafferty
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, United Kingdom
| | - Edel Ennis
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, United Kingdom.
| | - Coral Lapsley
- Northern Ireland Centre for Stratified Medicine, Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry, United Kingdom
| | - Tony Bjourson
- Northern Ireland Centre for Stratified Medicine, Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry, United Kingdom
| | - Cherie Armour
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, United Kingdom
| | - Sam Murphy
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, United Kingdom
| | - Brendan Bunting
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, United Kingdom
| | - Elaine Murray
- Northern Ireland Centre for Stratified Medicine, Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry, United Kingdom
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Heinonen E, Knekt P, Härkänen T, Virtala E, Lindfors O. Associations of early childhood adversities with mental disorders, psychological functioning, and suitability for psychotherapy in adulthood. Psychiatry Res 2018; 264:366-373. [PMID: 29677619 DOI: 10.1016/j.psychres.2018.04.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 04/01/2018] [Accepted: 04/02/2018] [Indexed: 11/30/2022]
Abstract
Childhood adversities frequently precede adulthood depression and anxiety. Yet, how they impact needed treatment duration, type or focus in these common disorders, is unclear. For developing more individualized and precise interventions, we investigated whether specific early adversities associate with patients' distinct psychiatric problems, psychological vulnerabilities, and suitability for psychotherapy. A total of 221 depressed and anxious adult outpatients (excluding psychotic, severe personality, bipolar, and substance abuse disorders) referred from community, student, occupational, and private healthcare services filled the Childhood Family Atmosphere Questionnaire (CFAQ). They also filled self-reports on interpersonal behavior and problems, perceived competence, dispositional optimism, sense of coherence, defenses, and psychiatric history. Clinicians assessed the patients' symptomatology, personality, object relations, cognitive performance, and psychotherapy suitability. Regression analyses were conducted. Childhood adversities predicted both worse current psychological functioning (e.g., interpersonal problems), and better clinician-rated capacities for benefiting from psychotherapy (e.g. self-reflection, capacity for interaction). Parental problems had the most numerous negative associations to psychological functioning. Best capacities for psychotherapy were predicted by recollected family unhappiness. Associations with psychiatric criteria were, however, largely non-significant. In conclusion, for psychosocial treatment planning, patients' early adversities may indicate both vulnerability and resources. As childhood adversities are frequent among treatment-seekers, further studies examining how early adversities predict psychotherapy outcome are needed.
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Affiliation(s)
| | - Paul Knekt
- National Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland
| | - Tommi Härkänen
- National Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland
| | - Esa Virtala
- National Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland
| | - Olavi Lindfors
- National Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland
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Jacob G, van den Heuvel M, Jama N, Moore AM, Ford-Jones L, Wong PD. Adverse childhood experiences: Basics for the paediatrician. Paediatr Child Health 2018; 24:30-37. [PMID: 30792598 DOI: 10.1093/pch/pxy043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In 1998, the Centers for Disease Control and Prevention Adverse Childhood Experiences study established the profound effects of early childhood adversity on life course health. The burden of cumulative adversities can affect gene expression, immune system development and condition stress response. A scientific framework provides explanation for numerous childhood and adult health problems and high-risk behaviours that originate in early life. In our review, we discuss adverse childhood experiences, toxic stress, the neurobiological basis and multigenerational and epigenetic transmission of trauma and recognized health implications. Further, we outline building resilience, screening in the clinical setting, primary care interventions, applying trauma-informed care and future directions. We foresee that enhancing knowledge of the far-reaching effects of adverse childhood events will facilitate mitigation of toxic stress, promote child and family resilience and optimize life course health trajectories.
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Affiliation(s)
| | - Meta van den Heuvel
- Department of Paediatrics, Hospital for Sick Children.,Division of Paediatric Medicine, Department of Paediatrics, Faculty of Medicine, University of Toronto
| | - Nimo Jama
- Department of Paediatrics, Hospital for Sick Children
| | - Aideen M Moore
- Department of Paediatrics, Hospital for Sick Children.,Division of Neonatology, Department of Paediatrics, Faculty of Medicine, University of Toronto
| | - Lee Ford-Jones
- Department of Paediatrics, Hospital for Sick Children.,Division of Paediatric Medicine, Department of Paediatrics, Faculty of Medicine, University of Toronto.,Social Paediatrics, Hospital for Sick Children
| | - Peter D Wong
- Department of Paediatrics, Hospital for Sick Children.,Division of Paediatric Medicine, Department of Paediatrics, Faculty of Medicine, University of Toronto.,SickKids Research Institute
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McLafferty M, O'Neill S, Murphy S, Armour C, Ferry F, Bunting B. The moderating impact of childhood adversity profiles and conflict on psychological health and suicidal behaviour in the Northern Ireland population. Psychiatry Res 2018; 262:213-220. [PMID: 29459280 DOI: 10.1016/j.psychres.2018.02.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 02/02/2018] [Accepted: 02/11/2018] [Indexed: 10/18/2022]
Abstract
Childhood adversities are key etiological factors in the onset and persistence of psychopathology. In Northern Ireland the Troubles also impacted on the population's psychological health. This study used data from the Northern Ireland Study of Health and Stress a collaborative epidemiological study which used the WMH-CIDI to assess mental health disorders in a nationally representative sample (Part 2, n = 1986). The aims of the study were to assess co-occurrences of childhood adversities and investigate the impact of adversity profiles and conflict experience on psychopathology and suicidal behaviour. Latent Class Analysis uncovered 3 discrete childhood adversity profiles, a low, medium, and high risk class. Individuals from higher risk adversity profiles displayed significantly increased odds of having psychological problems, with conflict exposure also impacting on psychopathology. However, the study revealed that the impact of conflict exposure on suicidal behaviour was moderated by latent class membership and that some adversity may actually be protective. The findings highlight the need to consider that, while adversity can have a negative impact on psychopathology, a lack of adversity early in life may hinder some people from developing adequate coping strategies. Further research is required to identify adversity patterns and other interacting factors that are protective.
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Affiliation(s)
- Margaret McLafferty
- Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland BT48 7JL, UK
| | - Siobhan O'Neill
- Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland BT48 7JL, UK. sm.o'
| | - Sam Murphy
- Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland BT48 7JL, UK
| | - Cherie Armour
- Ulster University, Coleraine Campus, Cromore Road, Coleraine, Northern Ireland BT52 1SA, UK
| | - Finola Ferry
- Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland BT48 7JL, UK
| | - Brendan Bunting
- Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland BT48 7JL, UK
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Schalinski I, Teicher MH, Carolus AM, Rockstroh B. Defining the impact of childhood adversities on cognitive deficits in psychosis: An exploratory analysis. Schizophr Res 2018; 192:351-356. [PMID: 28576548 DOI: 10.1016/j.schres.2017.05.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 04/30/2017] [Accepted: 05/12/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Exposure to adverse childhood experiences (ACE) and cognitive deficits are both prevalent in psychosis. While it has been repeatedly demonstrated that ACE contribute to cognitive dysfunctions, the specific nature of this contribution remains elusive. Recent evidence suggests that types of adversities during critical periods have deleterious effects on brain structures that are important for cognitive functioning. The present study sought to clarify which types of adversities experienced at which time during development aggravate cognitive deficits in psychosis. METHODS Exposure to abuse and neglect during childhood and adolescence were retrospectively assessed in N=168 adult individuals with psychotic disorder. Conditioned random forest regression was used to define the importance of type and timing of ACE for predicting domains of the MATRICS Consensus Cognitive Battery (MCCB). RESULTS Significant importance of ACE was determined for 5 out of 7 MCCB domains. Particularly abuse at age 3 contributed to dysfunctional cognitive domains attention, learning, and working memory. Social cognition was related to neglect experienced at 11-12years, and to cumulative ACE. CONCLUSION Abuse and neglect at periods when children spend substantial time in their families affect cognitive functioning, and hence aggravate dysfunction in psychosis. Results support the neurodevelopmental perspective on psychosis and the diagnostic value of type and timing of ACE.
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Affiliation(s)
| | - Martin H Teicher
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
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Nacak Y, Morawa E, Tuffner D, Erim Y. Insecure attachment style and cumulative traumatic life events in patients with somatoform pain disorder: A cross-sectional study. J Psychosom Res 2017; 103:77-82. [PMID: 29167050 DOI: 10.1016/j.jpsychores.2017.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 08/30/2017] [Accepted: 10/06/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Current models assume somatoform pain disorder (SPD) to be the result of a complex interaction between bio- and psychosocial factors, but the etiology is still not well understood. This study aimed to investigate the distribution of attachment style and the frequency of traumatic life events, especially childhood adversities, in patients with SPD compared to healthy controls. METHODS We compared 65 patients with SPD (confirmed by Structured Clinical Interview, SCID-I) to 65 age- and gender-matched healthy controls. The following questionnaires were employed: Relationship Scale Questionnaire (RSQ), Essen Trauma Inventory (ETI), Childhood Trauma Questionnaire (CTQ) and Patient Health Questionnaire (PHQ-15). A logistic regression analysis was used to identify the association between SPD and psychological factors. RESULTS Insecure attachment was significantly more prevalent (60%) in patients with SPD compared to healthy subjects (14%; p<0.001). Overall, 70.4% of patients with SPD reported three or more traumatic events in their life, compared with healthy subjects who reported predominantly one (40%). Patients with SPD scored significantly higher in all CTQ subscales compared to the healthy controls. The factor most strongly related with SPD was the insecure attachment style (OR=11.20, 95% CI: 1.32-94.86). Other significant predictive factors were depression (OR=3.35, 95% CI: 1.84-6.11) and number of traumatic events (OR=2.04, 95% CI: 1.06-3.92). Insecure attachment, depression symptoms and the number of traumatic events explained 86.2% of the variance. CONCLUSIONS The high predictive value of insecure attachment style and cumulative traumatic events emphasize their importance as risk factors of SPD.
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Affiliation(s)
- Yeliz Nacak
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Daniela Tuffner
- Multidisciplinary Pain Center, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
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Schalinski I, Moran JK, Elbert T, Reindl V, Wienbruch C. Oscillatory magnetic brain activity is related to dissociative symptoms and childhood adversities - A study in women with multiple trauma. J Affect Disord 2017; 218:428-436. [PMID: 28505586 DOI: 10.1016/j.jad.2017.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 03/24/2017] [Accepted: 05/06/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Individuals with trauma-related disorders are complex and heterogeneous; part of this complexity derives from additional psychopathology like dissociation as well as environmental adversities such as traumatic stress, experienced throughout the lifespan. Understanding the neurophysiological abnormalities in Post-traumatic stress disorder (PTSD) requires a simultaneous consideration of these factors. METHODS Resting state magnetoencephalography (MEG) recordings were obtained from 41 women with PTSD and comorbid depressive symptoms, and 16 healthy women. Oscillatory brain activity was extracted for five frequency bands and 11 source locations, and analyzed in relation to shutdown dissociation and adversity-related measures. RESULTS Dissociative symptoms were related to increased delta and lowered beta power. Adversity-related measures modulated theta and alpha oscillatory power (in particular childhood sexual abuse) and differed between patients and controls. LIMITATIONS Findings are based on women with comorbid depressive symptoms and therefore may not be applicable for men or groups with other clinical profiles. In respect to childhood adversities, we had no reliable source for the early infancy. CONCLUSION Trauma-related abnormalities in neural organization vary with both exposure to adversities as well as their potential to evoke ongoing shutdown responses.
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Affiliation(s)
- I Schalinski
- Department of Psychology, University of Konstanz, Germany.
| | - J K Moran
- Department of Psychology, University of Konstanz, Germany
| | - T Elbert
- Department of Psychology, University of Konstanz, Germany
| | - V Reindl
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital RWTH Aachen, Germany
| | - C Wienbruch
- Department of Psychology, University of Konstanz, Germany
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Varinen A, Kosunen E, Mattila K, Koskela T, Sumanen M. The relationship between childhood adversities and fibromyalgia in the general population. J Psychosom Res 2017; 99:137-42. [PMID: 28712419 DOI: 10.1016/j.jpsychores.2017.06.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 05/31/2017] [Accepted: 06/08/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Fibromyalgia is a syndrome characterized by widespread pain and a variety of somatic symptoms. The international prevalence of fibromyalgia is 2-5%, but its current prevalence in Finland is unclear. Various adversities are linked to the onset of fibromyalgia. However, there is need for more data regarding the association between childhood physical abuse and fibromyalgia. Further, the association of childhood emotional stressors and fibromyalgia is disputed. The aim of the current study is to produce more information about that relationship using data from the Health and Social Support (HeSSup) Study. METHODS HeSSup is a postal study consisting of a random sample of the Finnish population. The study setting is cross-sectional. Participants in the study were asked if they have been diagnosed with fibromyalgia. Those responding affirmatively were classified as fibromyalgia patients. Six childhood adversities were enquired, and the relationship between fibromyalgia and these events were analysed by cross tabulation and logistic regression. RESULTS There were associations between examined adversities and fibromyalgia before and after adjustments for demographic features and depression (being afraid of a family member: odds ratio after adjustment 1.60, 95% CI 1.28-2.01; long-lasting financial difficulties 1.45, 1.18-1.77; serious conflicts in the family 1.40, 1.14-1.72; parental divorce 1.34, 1.05-1.72; serious or chronic illnesses in the family 1.27, 1.05-1.55; alcohol problems in the family 1.25, 1.02-1.53). CONCLUSION All six enquired adversities were associated with fibromyalgia after adjustments. These findings emphasize the importance of preventing adverse childhood experiences.
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Granström F, Eriksson HG, Molarius A. Economic stress and condescending treatment in childhood and adult self-rated health: results from a population study in Sweden. BMC Public Health 2017; 17:489. [PMID: 28532399 PMCID: PMC5441006 DOI: 10.1186/s12889-017-4438-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 05/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Even today, 12% of the children in Sweden live in poverty and many children are exposed to adverse experiences, such as being bullied, which may have long-term consequences on public health. This study examined the associations between economic stress and condescending treatment in childhood and self-rated health (SRH) in adulthood. METHODS The study is based on 26,706 persons who responded to a postal survey questionnaire sent to a random sample of men and women aged 25-84 years in 2012 (response rate 53%). The associations between childhood circumstances and adult SRH were analysed by logistic regression, adjusting for sex, age, economic stress in adulthood, condescending treatment in adulthood, socioeconomic status and several other known material, behavioural and psychosocial risk factors. RESULTS In total, 39% of both men and women reported economic stress in their family during childhood. 36% of the men and 41% of the women indicated that they had been treated in a condescending manner, e.g. in school or at home, during childhood. Both economic stress in childhood and condescending treatment in childhood were strongly associated with adult SRH. The associations attenuated, but were still statistically significant after adjustment for adulthood circumstances and other risk factors. CONCLUSION Economic stress in childhood and condescending treatment in childhood were associated with SRH in adulthood, both independently and through adulthood circumstances. The results underline the importance of taking into account both material and psychosocial circumstances over the whole life course when developing public health measures.
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Affiliation(s)
- Fredrik Granström
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
- Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Hans-Georg Eriksson
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Anu Molarius
- Competence Centre for Health, Region Västmanland, 721 89 Västerås, Sweden
- Department of Public Health, Karlstad University, Karlstad, Sweden
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Reigstad B, Kvernmo S. Concurrent adversities among adolescents with conduct problems: the NAAHS study. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1429-1438. [PMID: 27352358 DOI: 10.1007/s00127-016-1258-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 06/15/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Several studies have confirmed that maltreatment and abuse in childhood are related to conduct problems. Less is known about such relationships with concurrent adversities in adolescence and, also, when compared with other severe adversities and possible multiple additive effects. METHODS The study encompassed a community population of 4881 adolescents 15-16 years of age 50.1 % boys and 49.9 % girls. Youth with and without conduct problem scores within the deviant range on the Strength and Difficulties Questionnaire (SDQ) was compared on 12 concurrent adversities. RESULTS Based on self-reports, 4.4 % of the adolescents had conduct problem scores within the deviant range and more girls (5.1 %) than boys (3.7 %). In the deviant conduct problem group, 65.1 % had experienced two or more concurrent adversities compared with 26.3 % of youths in the non-deviant group (OR 5.23, 95 % CI 3.91-7.01). Likewise, the deviant conduct problem group was from 1.71 to 8.43 times more at the risk of experiencing the different adversities. Parental mental health problems and experiences of violence were multivariately strongest associated with conduct problem scores within the deviant range on the SDQ. A strong multiple additive relationship with adversities was found. CONCLUSIONS Two-thirds of youth with SDQ conduct problem scores within the deviant range reported two or more concurrent adversities. Clinicians should seek information about kinds and amount of possible traumatic adversities in youth with conduct problems and offer evidence based treatment.
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Affiliation(s)
- Bjørn Reigstad
- Division of Research and Patient Safety, Department of Research, Nordlandssykehuset, 8092, Bodø, Norway.
| | - Siv Kvernmo
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
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Paolini E, Moretti P, Compton MT. Delusions in first-episode psychosis: Principal component analysis of twelve types of delusions and demographic and clinical correlates of resulting domains. Psychiatry Res 2016; 243:5-13. [PMID: 27344587 PMCID: PMC5014642 DOI: 10.1016/j.psychres.2016.06.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 04/11/2016] [Accepted: 06/06/2016] [Indexed: 01/11/2023]
Abstract
Although delusions represent one of the core symptoms of psychotic disorders, it is remarkable that few studies have investigated distinct delusional themes. We analyzed data from a large sample of first-episode psychosis patients (n=245) to understand relations between delusion types and demographic and clinical correlates. First, we conducted a principal component analysis (PCA) of the 12 delusion items within the Scale for the Assessment of Positive Symptoms (SAPS). Then, using the domains derived via PCA, we tested a priori hypotheses and answered exploratory research questions related to delusional content. PCA revealed five distinct components: Delusions of Influence, Grandiose/Religious Delusions, Paranoid Delusions, Negative Affect Delusions (jealousy, and sin or guilt), and Somatic Delusions. The most prevalent type of delusion was Paranoid Delusions, and such delusions were more common at older ages at onset of psychosis. The level of Delusions of Influence was correlated with the severity of hallucinations and negative symptoms. We ascertained a general relationship between different childhood adversities and delusional themes, and a specific relationship between Somatic Delusions and childhood neglect. Moreover, we found higher scores on Delusions of Influence and Negative Affect Delusions among cannabis and stimulant users. Our results support considering delusions as varied experiences with varying prevalences and correlates.
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Affiliation(s)
- Enrico Paolini
- School of Psychiatry, University of Perugia, Perugia, PG, Italy; Lenox Hill Hospital, Department of Psychiatry, New York, NY, USA.
| | - Patrizia Moretti
- Department of Medicine, Division of Psychiatry, Clinical Psychology and Psychiatric Rehabilitation, University of Perugia, Perugia, PG, Italy
| | - Michael T Compton
- Lenox Hill Hospital, Department of Psychiatry, New York, NY, USA; Hofstra Northwell School of Medicine, Department of Psychiatry, Hempstead, NY, USA
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Ramos-Olazagasti MA, Bird HR, Canino GJ, Duarte CS. Childhood Adversity and Early Initiation of Alcohol Use in Two Representative Samples of Puerto Rican Youth. J Youth Adolesc 2017; 46:28-44. [PMID: 27681408 DOI: 10.1007/s10964-016-0575-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 09/14/2016] [Indexed: 10/20/2022]
Abstract
Early alcohol use is associated with multiple negative outcomes later in life, including substance use disorders. Identification of factors related to this very early risk indicator can help inform early prevention efforts. This study prospectively examined the relationship between childhood adversities and early initiation of alcohol use (by age 14) among Puerto Rican youth, the Latino subgroup at highest risk for alcohol use disorders in adulthood. The data come from the Boricua Youth Study, a longitudinal study of Puerto Rican youth in two sites (South Bronx, New York, and the standard metropolitan area of San Juan, Puerto Rico). We focus on youth who were ages 10 and older at Wave 1 [M age at Wave 1 (SE) = 11.64(0.05), N = 1259, 48.85 % females]. Twelve childhood adversities were measured at Wave 1 and include 10 adverse childhood experiences commonly studied and two additional ones (exposure to violence and discrimination) that were deemed relevant for this study's population. Early initiation of alcohol use was determined based on youth report at Waves 1 through 3 (each wave 1 year apart). Cox proportional hazards models showed that, when considered individually, adversities reflecting child maltreatment, parental maladjustment, and sociocultural stressors were related to early initiation of alcohol use. Significant gender interactions were identified for parental emotional problems and exposure to violence, with associations found among girls only. Adversities often co-occurred, and when they were considered jointly, physical and emotional abuse, parental antisocial personality, and exposure to violence had independent associations with early alcohol use, with a stronger influence of exposure to violence in girls compared to boys. The accumulation of adversities, regardless of the specific type of exposure, increased the risk for starting to drink at a young age in a linear way. The associations between childhood adversities and early alcohol use were generally consistent across sociocultural contexts, in spite of differences in the prevalence of exposure to adversity. Our findings highlight the importance of targeting multiple adversities and expanding the notion of adversity to capture the experiences of specific groups more adequately.
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Bielas H, Barra S, Skrivanek C, Aebi M, Steinhausen HC, Bessler C, Plattner B. The associations of cumulative adverse childhood experiences and irritability with mental disorders in detained male adolescent offenders. Child Adolesc Psychiatry Ment Health 2016; 10:34. [PMID: 27688799 PMCID: PMC5034668 DOI: 10.1186/s13034-016-0122-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 09/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) and psychiatric disorders are common in juvenile detainees. Emotional dysregulation resulting from cumulated ACEs may be characterized by symptoms of irritability. The present study examined whether the accumulation of ACEs, irritability, or both predicted mental disorders in incarcerated adolescents with and without controlling for one another and for socio-demographic factors. METHODS One hundred thirty male detained juvenile offenders (aged 13.8-19.5 years) were assessed by structured clinical interviews and a self-reporting scale for irritability. Univariate and multivariate regression models were used to examine the shared and distinct associations of ACEs and irritability with psychiatric diagnoses. RESULTS A total of 75 % of the participants reported more than one ACE. The ACE total score was positively related to self-reported irritability. The ACE total score predicted depressive disorders, suicidality, post-traumatic stress disorder (PTSD), and anxiety disorders. Irritability was positively related to depressive disorders, suicidality, disruptive behavior disorder (DBD), substance use disorder (SUD), and attention deficit hyperactivity disorder (ADHD). These associations remained significant in multivariate models. CONCLUSIONS This study provides evidence for the predictive impact of self-reported ACEs and irritability with regard to adolescent psychiatric disorders in young male inmates. Both variables differed in their predictive power for PTSD, internalizing, and externalizing disorders indicating the need for specific therapeutic interventions. Taking a close look at their trauma history seems to be of special importance for juveniles suffering from PTSD and anxiety disorders. For delinquent adolescents with DBD, ADHD and SUD, the training of emotion regulation techniques appears most promising. Approaches focusing on both, ACEs and emotion-focused contents may be implemented in the treatment of depressive disorders and suicidality.
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Affiliation(s)
- Hannes Bielas
- Department of Child and Adolescent Psychosomatic Medicine and Psychotherapy, Clinic Fontane, Mittenwalde, Germany ,Department of Psychosomatics and Psychiatry, Child Protection Team, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Steffen Barra
- Department of Forensic Psychiatry, Centre for Child and Youth Forensic Service, University Hospital of Psychiatry, Neptunstrasse 60, Zurich, 8032 Switzerland
| | - Christine Skrivanek
- University Clinics for Child and Adolescent Psychiatry, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Marcel Aebi
- Department of Forensic Psychiatry, Centre for Child and Youth Forensic Service, University Hospital of Psychiatry, Neptunstrasse 60, Zurich, 8032 Switzerland ,Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, Zurich, Switzerland ,Division of Clinical Psychology with Children/Adolescents & Families/Couples, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Hans-Christoph Steinhausen
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, Zurich, Switzerland ,Child and Adolescent Clinical Psychology, Institute of Psychology, University of Basel, Basel, Switzerland ,Child and Adolescent Mental Health Centre, Capital Region Psychiatry, Copenhagen, Denmark
| | - Cornelia Bessler
- Department of Forensic Psychiatry, Centre for Child and Youth Forensic Service, University Hospital of Psychiatry, Neptunstrasse 60, Zurich, 8032 Switzerland
| | - Belinda Plattner
- University Clinics for Child and Adolescent Psychiatry, Paracelsus Medical University Salzburg, Salzburg, Austria
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Egle UT, Franz M, Joraschky P, Lampe A, Seiffge-Krenke I, Cierpka M. [Health-related long-term effects of adverse childhood experiences - an update]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 59:1247-54. [PMID: 27580599 DOI: 10.1007/s00103-016-2421-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In the last decade strong empirical evidence from several long-term studies supports the conclusion that physical and sexual abuse as well as emotional deprivation in childhood make people significantly more vulnerable to mental and functional disorders across their lifetime. Additionally, an increased vulnerability to several somatic disorders (cardiovascular disorders, type-2-diabetes, hepatitis, chronic obstructive pulmonary disease (COPD), immunological and pain disorders, pharynx and lung cancer) was demonstrated - most of them with a reduced life expectancy. A review of the current research will be presented that outlines the underlying developmental neurobiological and psychological mechanisms mediating these long-term effects. There is now sufficient evidence about familial risk constellations that demonstrates the well-documented impact of specific prevention strategies by several model projects. Only by establishing these strategies, future enormous health-related burdens and high economic costs (unfitness to work, early retirement) can presumably be limited.
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Affiliation(s)
- Ulrich T Egle
- Klinik Barmelweid, Aarau, Schweiz. .,, Wiesentalstr. 48, 79111, Freiburg, Deutschland.
| | - Matthias Franz
- Klinisches Institut für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - Peter Joraschky
- Klinik für Psychotherapie und Psychosomatik, Universitätsklinikums Dresden, Dresden, Deutschland
| | - Astrid Lampe
- Klinik für Medizinische Psychologie, Universitätsklinikum Innsbruck, Innsbruck, Österreich
| | - Inge Seiffge-Krenke
- Abt. Entwicklungspsychologie, Psychologisches Institut, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Manfred Cierpka
- Institut für Psychosoziale Prävention, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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