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Guo J, Liu X, Huang N, Yang F, Bai Y, Zhang B, Lodder P. School-based Psychosocial interventions on mental health among Chinese rural children with traumatic experiences: a protocol using cluster randomized controlled trial. BMC Psychol 2023; 11:148. [PMID: 37143099 PMCID: PMC10157979 DOI: 10.1186/s40359-023-01182-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND The first aim of this study is to test the effectiveness of school-based psychosocial interventions for improving mental health in rural Chinese children with traumatic experiences. The second aim is to examine which individual, family and school related factors could explain the effectiveness of school-based psychosocial interventions. Third, we will investigate whether individual, family, and school related conditions play a moderator role on the effectiveness of school-based psychosocial interventions. METHODS This study will conduct a cluster randomized controlled trial (RCT) in a large sample of Chinese rural children. Four rural counties in Shandong (Central China), Henan (Central China), Inner Mongolia (Northern China), and Xinjiang (Western China) will be selected as study settings from which schools will be sampled. Each sampled school will be randomly allocated either the intervention groups or a control group. Randomization will be performed by the research member who is not involved in the intervention stage. In each school students in grade 5 or higher will be recruited to ensure that approximately 50 children aged 10 to 18 years will be included. In each county, one high school, one middle school, and one primary school will be randomly chosen as the intervention group, and the other three similar schools will be chosen as control (waiting list) groups. A standardized and uniform research protocol will be applied in all intervention schools. All school social workers and psychological teachers would receive one week of in-person training following procedures. School-based psychosocial interventions included 14 group sessions for 14 consecutive weeks. DISCUSSION This study would develop school-based mental health promotion policy recommendations to improve Chinese rural children's mental health. This study can provide solid evidence for the promotion of school-based intervention in general. TRIAL REGISTRATION ChiCTR2300069405, Registered on 15 March 2023.
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Affiliation(s)
- Jing Guo
- Department of Health Policy and Management, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, P. R. China.
| | - Xiaohan Liu
- Department of Health Policy and Management, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, P. R. China
| | - Ning Huang
- Department of Health Policy and Management, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, P. R. China
| | - Fan Yang
- Department of Health Policy and Management, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, P. R. China
| | - Yashuang Bai
- Department of Health Policy and Management, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, P. R. China
| | - Bo Zhang
- Department of Neurology and ICCTR Biostatistics and Research Design Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Paul Lodder
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
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Lipsky RK, Garrett ME, Dennis MF, Hauser MA, Beckham JC, Ashley-Koch AE, Kimbrel NA; VA Mid-Atlantic MIRECC Workgroup. Impact of traumatic life events and polygenic risk scores for major depression and posttraumatic stress disorder on Iraq/Afghanistan Veterans. J Psychiatr Res 2023; 158:15-9. [PMID: 36542982 DOI: 10.1016/j.jpsychires.2022.12.014] [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: 02/15/2022] [Revised: 10/29/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
Traumatic experiences and genetic heritability are among the most widely acknowledged risk factors leading to the development of psychopathology; including posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). The purpose of this study was to investigate if polygenic risk scores (PRS) among Veterans interacted with traumatic stress to predict PTSD and MDD. 1,389 Iraq-Afghanistan military service Veterans from the Mental Illness Research Education and Clinical Center dataset were analyzed. Genome-wide association study (GWAS) statistics were utilized to generate PRS for PTSD (PRSPTSD) and PRS for MDD (PRSMDD) in order to analyze PRS-by-environment (PRSxE) with trauma exposure to predict PTSD and MDD diagnoses. Trauma exposure and PRSPTSD, were independently associated with a current PTSD diagnosis (p < 0.001 and p < 0.001, respectively). The interaction between trauma exposure and PRSMDD to predict a current diagnosis of PTSD trended towards significance (p = 0.053). Stratifying by trauma thresholds, among those within the lowest trauma load, the association of PRSMDD with PTSD was found to be nominally significant (p = 0.03). For a MDD diagnosis, there was a significant association with trauma exposure (p < 0.001); and the association with PRSMDD was found to be nominally significant (p = 0.03). No significant PRSxE effects were found with MDD. Our findings corroborate previous research highlighting trauma exposure, and genetic heritability, as risk factors for the development of PTSD and MDD in a Veteran population. Additionally, findings suggest that genetic vulnerability may be less important as trauma exposure increases, with high levels of trauma likely to result in PTSD and MDD, regardless of genetic vulnerability.
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Murakami K, Ishikuro M, Obara T, Ueno F, Noda A, Onuma T, Matsuzaki F, Kikuchi S, Kobayashi N, Hamada H, Iwama N, Metoki H, Kikuya M, Saito M, Sugawara J, Tomita H, Yaegashi N, Kuriyama S. Traumatic experiences of the Great East Japan Earthquake and postpartum depressive symptoms: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. J Affect Disord 2023; 320:461-467. [PMID: 36191647 DOI: 10.1016/j.jad.2022.09.139] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/21/2022] [Accepted: 09/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Natural disasters can have serious mental health consequences. We aimed to examine the long-term effects of the 2011 Great East Japan Earthquake (GEJE) on postpartum depressive symptoms (PDS). METHODS The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study recruited pregnant women in Miyagi Prefecture from 2013 to 2016. Data from 11,403 participants were used in this study. Women were asked about their traumatic experiences of the GEJE with questions addressing threat, witness, and loss. PDS were defined as Edinburgh Postnatal Depression Scale score ≥9 at 1 month after delivery. Multiple logistic regression analyses were conducted to examine the associations of different traumatic experiences of the GEJE and number of traumatic experiences with PDS, after adjustment for age, parity, feelings toward pregnancy, education, income, social isolation, house damage caused by the GEJE, and survey year. RESULTS About two-fifths of women had at least one traumatic experience of the GEJE. The prevalence of PDS at 1 month after delivery was 13.3 %. Life-threatening experience and witnessing another person's actual or threatened death were associated with PDS: the odds ratios (ORs) were 1.40 (95 % confidence interval [CI], 1.24-1.59) and 1.28 (95 % CI, 1.08-1.53), respectively. Loss of close person was not associated with PDS: the OR was 1.13 (95 % CI, 0.99-1.30). Larger number of traumatic experiences of the GEJE was associated with increased risk of PDS (p for trend <0.001). LIMITATIONS PDS was self-reported. CONCLUSIONS Traumatic experiences of the GEJE prior to pregnancy were associated with increased risks of PDS.
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Affiliation(s)
- Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Fumihiko Ueno
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Aoi Noda
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Tomomi Onuma
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Fumiko Matsuzaki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Saya Kikuchi
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Natsuko Kobayashi
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Hirotaka Hamada
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Noriyuki Iwama
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi 983-8536, Japan
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan
| | - Masatoshi Saito
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Junichi Sugawara
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Hiroaki Tomita
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Nobuo Yaegashi
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
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Koyama Y, Fujiwara T, Doi S, Isumi A, Morita A, Matsuyama Y, Tani Y, Nawa N, Mashiko H, Yagi J. Heart rate variability in 2014 predicted delayed onset of internalizing problems in 2015 among children affected by the 2011 Great East Japan Earthquake. J Psychiatr Res 2022; 151:642-648. [PMID: 35661521 DOI: 10.1016/j.jpsychires.2022.05.039] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 04/22/2022] [Accepted: 05/20/2022] [Indexed: 10/18/2022]
Abstract
Experience of natural disaster was related to an increased risk of long-term child internalizing problems. Initial traumatic experiences are hypothesized to work as disaster-related stresses and sensitize neural circuitry, leading to heightened reactivity to subsequent stressful experiences, which in turn results in delayed onset of internalizing problems. However, empirical evidence is lacking. Thus, we aimed to examine the association between heart rate variability (HRV) and internalizing problems among children exposed to the disaster. The Great East Japan Earthquake Follow-up for Children (GEJE-FC) study followed children aged 4-6 years old and their siblings and parents from three affected prefectures (Miyagi, Fukushima, and Iwate) and one unaffected prefecture (Mie) in Japan over four periods: from August 2012 to June 2013 (= T1), August 2013 to April 2014 (= T2), July 2014 to December 2014 (= T3), and August 2015 to December 2015 (= T4) (n = 155). HRV was assessed at T2 and T3 as a biomarker of autonomic nervous system activity. Child internalizing problems were assessed by caregivers at T3 and T4, using the Child Behavior Checklist. HRV measurements at T2 were not associated with child internalizing problems at T3. However, HRV in low frequency domains at T3 showed an inverse association with child internalizing problems at T4 (B = -1.72, 95% CI = -3.12 to -0.31). The findings indicated that later exacerbation of internalizing problems could be predicted by dysfunction of autonomic nervous system measured by HRV.
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Affiliation(s)
- Yuna Koyama
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan; Japan Society of the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan
| | - Ayako Morita
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Yusuke Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Nobutoshi Nawa
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan; Department of Medical Education Research and Development, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Hirobumi Mashiko
- Fukushima Rehabilitation Center for Children, 1 Hikarigaoka, Fukushima, 960-1247, Japan
| | - Junko Yagi
- Department of Neuropsychiatry, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-0023, Japan
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Abstract
BACKGROUND Refugees are considered a high-risk population for developing mental health disorders. Yet little research has been conducted on suicidal ideation among refugees resettled in Western high-income countries. In the present hstudy, suicidal ideation and its association with different socio-demographic, flight-related, and mental health-related factors were analyzed in recently arrived refugees in Germany. METHODS The study was conducted in a reception facility for asylum-seekers in Leipzig, where 564 newly arrived adult residents participated. The questionnaire included socio-demographic and flight-related questions as well as standardized instruments for assessing suicidal ideation (item 9 from PHQ-9), a variety of traumatic experiences (LEC-5), posttraumatic stress disorder (PCL-5), depression (PHQ-8), and somatic symptoms (SSS-8). Multiple logistic regression models were run to predict suicidal ideation in relation to different socio-demographic, flight, and mental health-related factors. RESULTS In total, 171 (30.3%) participants who had just or very recently arrived in Germany reported having experienced suicidal ideation within the two weeks prior to being assessed. Those who reported suicidal ideation also reported higher prevalence of somatic symptoms, posttraumatic stress disorder, depression, and experiences of sexual violence, as well as worse self-rated mental and physical health. In addition, there were significant independent associations between suicidal ideation and (1) younger age, (2) longer flight duration, (3) experiences of sexual violence, (4) symptoms of posttraumatic stress disorder, and (5) symptoms of depression. CONCLUSIONS The results emphasize the association between suicidal ideation and different clinically relevant mental health symptoms among newly arrived refugees in Germany. Special attention should not only be given to refugees suffering from symptoms of poor mental health, but also to those of younger age as well as refugees who have experienced sexual violence, as they might be affected by suicidal ideation whether or not they suffer from other mental health problems.
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Affiliation(s)
- Yuriy Nesterko
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany.
| | - Elisa Haase
- grid.9647.c0000 0004 7669 9786Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Antje Schönfelder
- grid.9647.c0000 0004 7669 9786Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Heide Glaesmer
- grid.9647.c0000 0004 7669 9786Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
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Raemen L, Luyckx K, Palmeroni N, Verschueren M, Gandhi A, Grobler A, Claes L. Trauma and self-harming behaviors in high school students: The mediating role of identity formation. J Adolesc 2021; 92:20-29. [PMID: 34388608 DOI: 10.1016/j.adolescence.2021.08.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION This study investigated the link between trauma and self-harming behaviors in South African high school students, and examined the mediating role of identity formation. Traumatic experiences have been commonly associated with self-harming behaviors in adolescents. However, research addressing this association in non-Western countries is limited. METHODS A total of 552 South African high school students aged 13-21 (60.4% female; Mage = 16 years) were included in the study. Students completed self-report questionnaires on traumatic experiences, identity formation, and self-harming behaviors (disturbed eating behaviors and suicidal thoughts and behaviors). RESULTS Structural equation modelling indicated that the association between traumatic experiences and self-harming behaviors was partially mediated by identity formation. Traumatic experiences were associated with more identity diffusion, bulimia, and suicidal thoughts and behaviors. Identity diffusion, in turn, was associated with more drive for thinness, bulimia, body dissatisfaction, and suicidal thoughts and behaviors. Identity consolidation was positively associated with drive for thinness and negatively with body dissatisfaction and suicidal thoughts and behaviors. No moderation effects by gender or age were found. CONCLUSIONS Traumatic experiences were associated with higher levels of identity diffusion, which, in turn, were associated with more self-harming behaviors in South African high school students. These findings suggest the importance of focusing on identity diffusion in prevention and intervention programs targeting self-harming behaviors.
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Affiliation(s)
- Leni Raemen
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; UNIBS, University of the Free State, Bloemfontein, South Africa
| | - Nina Palmeroni
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | | | - Amarendra Gandhi
- Leuven Biostatistics and Statistical Bioinformatics Centre, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Adelene Grobler
- UNIBS, University of the Free State, Bloemfontein, South Africa
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
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Croissant M, Glaesmer H, Klucken T, Kirschbaum C, Gao W, Stalder T, Sierau S. Endocannabinoid concentrations in hair and mental health of unaccompanied refugee minors. Psychoneuroendocrinology 2020; 116:104683. [PMID: 32353812 DOI: 10.1016/j.psyneuen.2020.104683] [Citation(s) in RCA: 19] [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: 11/20/2019] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 01/28/2023]
Abstract
Altered activity of the endocannabinoid (EC) system has been linked to dysregulated stress-reactivity and the development of trauma-related psychopathology. The EC system, with its main components anandamide (AEA), 2-arachidonoyl-glycerol (2-AG) and other N-acyl-ethanolamides, is considered to be a buffer system that protects against the negative effects of traumatic experiences on mental health. Recently, the use of hair analyses, a method to gain information on long-term cumulative system activity, has been introduced to the study of ECs. Here, we seek to extend current knowledge on the potential use of hair EC concentrations as a marker of trauma-related psychological symptoms as well as psychological resources. Ninety-one male URM from Syria and Afghanistan (mean age = 17.4 years) living in group homes of the Child Protection Services in Leipzig, Germany, completed assessments on traumatic life events (TLE), PTSD symptoms, depression, anxiety and somatic symptoms as well as on self-efficacy and prosocial behavior. Scalp-near 3 cm hair segments were obtained and EC concentrations quantified using liquid chromatography tandem mass spectrometry. Analyses revealed relatively week and inconsistent associations of hair ECs and psychological symptoms, with only a positive correlation between 2-AG and depression. Concerning prosocial behavior and self-efficacy positive relationships were found with oleoylethanolamide (OEA), stearoylethanolamide (SEA), and palmitoylethanolamide (PEA). Our findings add data concerning the utility of hair EC analyses for PNE research but on a whole fail to reveal a clear association pattern between hair ECs and mental health in URM.
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Affiliation(s)
| | - Heide Glaesmer
- Department for Medical Psychology and Medical Sociology, University of Leipzig, Germany
| | - Tim Klucken
- Clinical Psychology, University of Siegen, Germany
| | | | - Wei Gao
- Biological Psychology, Technical University Dresden, Germany
| | | | - Susan Sierau
- Department for Medical Psychology and Medical Sociology, University of Leipzig, Germany
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Pierazzuoli F, Gatti E, Castelli MR, Primerano G, Oasi O, Tognasso G, Finos L, Santona A. Psychological factors of sibling caregivers of patients with severe mental disorders: an observational study. Res Psychother 2020; 23:412. [PMID: 32913821 PMCID: PMC7451338 DOI: 10.4081/ripppo.2020.412] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 02/24/2020] [Indexed: 12/02/2022]
Abstract
The goal of the present study is to explore the perception of the relationship with parental figures, traumatic experiences, personality traits and psychosocial characteristics of the participant sibling caregivers. The sample was composed of 30 sibling caregivers recruited at psychiatric facilities in Italy, and of 30 control siblings. The battery of instruments administered included Parental Bonding Instrument (PBI), Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and The Inventory of Traumatic Experiences (TEC). This research found that sibling caregivers of patients with severe psychiatric pathologies are distinctly different from the siblings of the control group with respect to the perception of their relationship with parental figures more frequently regarded as dysfunctional, and were also characterized by a higher presence of traumatic experiences. The problematic relationship with parental figures, some traumatic experiences, and the burden of taking care of a sibling with psychiatric disorders are probably important variables with regards to the individual's overall psychological condition.
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Affiliation(s)
| | - Elisa Gatti
- Department of Psychology, University of Milano-Bicocca, Milan
| | | | | | - Osmano Oasi
- Department of Psychology, Catholic University of the Sacred Heart, Milan
| | | | - Livio Finos
- Department of Developmental Psychology and Socialisation, University of Padua, Italy
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Liang Y, Zhou Y, Liu Z. Traumatic experiences and posttraumatic stress disorder among Chinese rural-to-urban migrant children. J Affect Disord 2019; 257:123-129. [PMID: 31301612 DOI: 10.1016/j.jad.2019.07.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 03/14/2019] [Revised: 06/01/2019] [Accepted: 07/04/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND Children and adolescents are in the developmental periods with the highest risk of experiencing multiple types of traumatic experiences (TEs). Immigrant children are more likely than other children to be exposed to TEs and have a higher risk of mental health problems. However, no epidemiological study has reported the prevalence of TEs and the associated development of posttraumatic stress disorder (PTSD) among Chinese children. METHODS The present study focused on trauma exposure among rural-to-urban migrant Chinese children. A large-scale (N = 16,140) cross-sectional survey of rural-to-urban migrant workers' children in grades 4 to 9 was conducted in Beijing. Lifetime exposure to accidents and injuries, interpersonal violence, and trauma within the social network or witnessing traumatic events were measured along with PTSD. RESULTS Nearly half of the participants (47.06%) had experienced TEs, and 6.68% of those children met the cutoff for PTSD. Trauma exposure was associated with gender, age, quality of life, parents' marital status, caregivers before the child started school and father's education level. Overall, interpersonal violence was associated with the highest rates of PTSD, and disasters were associated with the lowest rates of PTSD. LIMITATIONS The cross-sectional survey design limited the ability to document temporal ordering, and the assessment of lifetime TEs was based on retrospective recall. CONCLUSIONS The present study is the first epidemiological study of TEs in Chinese rural-to-urban migrant children. TEs are potentially fairly common among this population. Interventions designed to prevent PTSD should target different TE types according to the victim's gender.
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Affiliation(s)
- Yiming Liang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yueyue Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China.
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10
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Müller LRF, Büter KP, Rosner R, Unterhitzenberger J. Mental health and associated stress factors in accompanied and unaccompanied refugee minors resettled in Germany: a cross-sectional study. Child Adolesc Psychiatry Ment Health 2019; 13:8. [PMID: 30719070 PMCID: PMC6352340 DOI: 10.1186/s13034-019-0268-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [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: 11/09/2018] [Accepted: 01/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies throughout Europe have shown that asylum-seeking children and adolescents (ASC) are at risk of developing mental disorders. The most common mental-health problems in ASC include posttraumatic stress symptoms (PTSS), internalizing symptoms such as depression and anxiety, and externalizing behaviour. Being an unaccompanied refugee minor (URM) was found to be highly predictive for higher levels of psychological distress within ASC. Nevertheless, and even though Germany is Europe's biggest host country for ASC, studies that reliably examine the mental health of both URM and accompanied refugee minors (ARM) in Germany with psychometrically tested measures are still lacking. METHODS A cross-sectional survey in 19 facilities for minor refugees in Bavaria, Germany, screening for PTSS, depression, anxiety, externalizing behaviour, and post-migration factors was conducted. Participants were 98 ASC (URM, n = 68; ARM, n = 30) primarily from Afghanistan, Syria, and Eritrea. In 35.7% of interviews, interpreters were involved. RESULTS Both URM and ARM reported high levels of psychological distress and large numbers of potentially traumatic events, with 64.7% of URM and 36.7% of ARM scoring above the clinical cut-off for PTSS, 42.6% of URM and 30% of ARM for depression, and 38.2% of URM and 23.3% of ARM for anxiety. The total number of traumatic experiences was found to be the most robust predictor for PTSS, depression, and anxiety. Lower levels of individual resources, lower levels of social support in the host country, and poorer German language proficiency were associated with higher levels of psychological distress within both groups. URM reported significantly more traumatic events than ARM. CONCLUSIONS ASC in Germany are severely distressed and burdened by the experiences of various types of potentially traumatic events. The levels of distress found in the current study correspond with rates that have been reported in previous studies with ASC throughout Europe. Limitations of the present study include the convenience sample and the cross-sectional nature of findings.
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Affiliation(s)
| | - Karl Phillipp Büter
- 0000 0001 1245 5350grid.440923.8Catholic University of Eichstätt-Ingolstadt, Ostenstraße 25, 85072 Eichstätt, Germany
| | - Rita Rosner
- 0000 0001 1245 5350grid.440923.8Catholic University of Eichstätt-Ingolstadt, Ostenstraße 25, 85072 Eichstätt, Germany
| | - Johanna Unterhitzenberger
- 0000 0001 1245 5350grid.440923.8Catholic University of Eichstätt-Ingolstadt, Ostenstraße 25, 85072 Eichstätt, Germany
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11
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Abstract
Extensive research has reported a dose-response relationship between exposure to trauma and the severity of both dissociation and psychopathology. However, certain types of trauma may co-occur more frequently than others and specific combinations of traumatic experiences may relate differently to dissociative processes and psychiatric symptoms. In the current study, 359 adult participants completed questionnaires on traumatic experiences, dissociation, and psychopathology. A correlation network analysis showed that some types of trauma are more likely to co-occur and that especially traumatic experiences in attachment relationships during childhood were significantly associated with other trauma in life. A latent class analysis identified four classes of participants (namely, extremely traumatized, resilient to the impact of abuse, exposed to impersonal and social trauma, and reporting low levels of traumatization) who showed different profiles on trauma exposure, dissociation, and psychopathology. Mediation analyses further showed that dissociation partially mediated the relationship between different types of traumatic experiences and the severity of psychiatric symptoms. The findings of this study support the view that a comprehensive assessment of traumatic experiences and dissociation is needed in trauma research and clinical practice.
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Affiliation(s)
- Adriano Schimmenti
- a Faculty of Human and Social Sciences , UKE - Kore University of Enna , Italy
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12
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Rambau S, Forstner AJ, Wegener I, Mücke M, Wissussek CTS, Staufenbiel SM, Geiser F, Schumacher J, Conrad R. Childhood adversities, bonding, and personality in social anxiety disorder with alcohol use disorder. Psychiatry Res 2018; 262:295-302. [PMID: 29477673 DOI: 10.1016/j.psychres.2018.02.006] [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: 04/06/2017] [Revised: 01/30/2018] [Accepted: 02/02/2018] [Indexed: 10/18/2022]
Abstract
Social anxiety disorder (SAD) is frequently associated with alcohol use disorders (abuse/dependence). However, there has been little research on the characteristics of this subgroup so far. In the current study we investigated individuals with SAD and comorbid alcohol use disorder (AUD) with regard to socialization experiences and personality. The sample comprised 410 individuals diagnosed with SAD by the Structured Clinical Interview of DSM-IV. 108 participants with comorbid AUD were compared to 302 participants without comorbid AUD concerning traumatic experiences during childhood and adolescence (Adverse Childhood Experiences Questionnaire; ACE), parental bonding (Parental Bonding Instrument; PBI), and personality (Temperament and Character Inventory; TCI). MANCOVA with covariates sex and depression displayed that individuals with SAD plus AUD reported significantly more traumatic events during childhood and adolescence, lower levels of maternal care, as well as lower cooperativeness. Our results highlight that adverse childhood experiences and unfavourable maternal bonding characterize individuals suffering from SAD plus AUD. These experiences might be reflected in a personality-based tendency to distance themselves from others, which corresponds to low scores on the character dimension cooperativeness. A deeper understanding of personality and specific socialization experiences is necessary to develop new treatment options in this clinically challenging subgroup.
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Affiliation(s)
- Stefanie Rambau
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, Bonn, Germany; Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany; Department of Psychiatry (UPK), University of Basel, Basel, Switzerland; Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland.
| | - Ingo Wegener
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
| | - Martin Mücke
- Department of Palliative Medicine, University of Bonn, Bonn, Germany.
| | | | - Sabine M Staufenbiel
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
| | - Johannes Schumacher
- Institute of Human Genetics, University of Bonn, Bonn, Germany; Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany.
| | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
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13
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Jesuthasan J, Sönmez E, Abels I, Kurmeyer C, Gutermann J, Kimbel R, Krüger A, Niklewski G, Richter K, Stangier U, Wollny A, Zier U, Oertelt-Prigione S, Shouler-Ocak M. Near-death experiences, attacks by family members, and absence of health care in their home countries affect the quality of life of refugee women in Germany: a multi-region, cross-sectional, gender-sensitive study. BMC Med 2018; 16:15. [PMID: 29391012 PMCID: PMC5793395 DOI: 10.1186/s12916-017-1003-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 08/21/2017] [Accepted: 12/28/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The year 2016 has marked the highest number of displaced people worldwide on record. A large number of these refugees are women, yet little is known about their specific situation and the hurdles they have to face during their journey. Herein, we investigated whether sociodemographic characteristics and traumatic experiences in the home country and during the flight affected the quality of life of refugee women arriving in Germany in 2015-2016. METHODS Six hundred sixty-three women from six countries (Afghanistan, Syria, Iran, Iraq, Somalia, and Eritrea) living in shared reception facilities in five distinct German regions were interviewed by native speakers using a structured questionnaire. Sociodemographic data and information about reasons for fleeing, traumatic experiences, symptoms, quality of life, and expectations towards their future were elicited. All information was stored in a central database in Berlin. Descriptive analyses, correlations, and multivariate analyses were performed. RESULTS The most frequent reasons cited for fleeing were war, terror, and threat to one's life or the life of a family member. Eighty-seven percent of women resorted to smugglers to make the journey to Europe, and this significantly correlated to residence in a war zone (odds ratio (OR) = 2.5, 95% confidence interval (CI) = 1.4-4.6, p = 0.003) and homelessness prior to fleeing (OR = 2.1, 95% CI = 1-4.3, p = 0.04). Overall the described quality of life by the women was moderate (overall mean = 3.23, range of 1-5) and slightly worse than that of European populations (overall mean = 3.68, p < 0.0001). The main reasons correlating with lower quality of life were older age, having had a near-death experience, having been attacked by a family member, and absence of health care in case of illness. CONCLUSIONS Refugee women experience multiple traumatic experiences before and/or during their journey, some of which are gender-specific. These experiences affect the quality of life in their current country of residence and might impact their integration. We encourage the early investigation of these traumatic experiences to rapidly identify women at higher risk and to improve health care for somatic and mental illness.
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Affiliation(s)
- Jenny Jesuthasan
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Große Hamburger Straße 5 - 11, 10115, Berlin, Germany
| | - Ekin Sönmez
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Große Hamburger Straße 5 - 11, 10115, Berlin, Germany.,Department of Psychiatry, Marmara University, School of Medicine, Istanbul, Turkey
| | - Ingar Abels
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Große Hamburger Straße 5 - 11, 10115, Berlin, Germany
| | - Christine Kurmeyer
- Office of the Equal Opportunities Officer, Charité-Universitätsmedizin, Berlin, Germany
| | - Jana Gutermann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Frankfurt, Germany
| | - Renate Kimbel
- Insitute of Occupational, Social and Environmental Medicine, University Medical Center of the University of Mainz, Mainz, Germany
| | - Antje Krüger
- Insitute of General Practice, University Medical Center Rostock, Rostock, Germany
| | - Guenter Niklewski
- University Clinic for Psychiatry and Psychotherapy, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Kneginja Richter
- University Clinic for Psychiatry and Psychotherapy, Paracelsus Medical University Nuremberg, Nuremberg, Germany.,Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany.,Faculty for Medical Sciences, UGD University Stip, Stip, Macedonia
| | - Ulrich Stangier
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Frankfurt, Germany
| | - Anja Wollny
- Insitute of General Practice, University Medical Center Rostock, Rostock, Germany
| | - Ulrike Zier
- Insitute of Occupational, Social and Environmental Medicine, University Medical Center of the University of Mainz, Mainz, Germany
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen (117), The Netherlands. .,Institute of Legal Medicine, Charité-Universitätsmedizin, Turmstr. 21, Haus N, 10559, Berlin, Germany.
| | - Meryam Shouler-Ocak
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Große Hamburger Straße 5 - 11, 10115, Berlin, Germany.
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14
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Schimmenti A, Passanisi A, Caretti V, La Marca L, Granieri A, Iacolino C, Gervasi AM, Maganuco NR, Billieux J. Traumatic experiences, alexithymia, and Internet addiction symptoms among late adolescents: A moderated mediation analysis. Addict Behav 2017; 64:314-20. [PMID: 26586032 DOI: 10.1016/j.addbeh.2015.11.002] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 11/02/2015] [Accepted: 11/02/2015] [Indexed: 12/22/2022]
Abstract
The association between traumatic experiences, alexithymia, and substance abuse is well established. Less is known about the role of traumatic experiences and alexithymia in the onset and maintenance of Internet-related disorders. In the present study, self-report measures on traumatic experiences, alexithymia, and problematic Internet use were administered to 358 high school students (57% females) aged 18-19years old, to test whether alexithymic traits mediated the relationship between traumatic experiences and Internet addiction symptoms, and whether gender moderated the proposed mediation in the sample. While partial mediation occurred in the entire sample, gender directly affected the relationship between the investigated constructs: Internet addiction symptoms were independently related to traumatic experiences among males, and to alexithymic traits among females. Therefore, the results of this study suggest that trauma memories among males, and problems with affect regulation among females, may increase the risk of problematic Internet use during late adolescence. Such findings might have relevant implications to inform any treatment plan for late adolescent students who are overinvolved with online activities, pointing out that tailored approaches to their problems and difficulties are particularly needed in clinical practice.
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15
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Netto LR, Pereira JL, Nogueira JF, Cavalcanti-Ribeiro P, Santana RC, Teles CA, Koenen KC, Quarantini LC; Trauma and Anxiety Disorders Study Group – UFBA. Impulsivity is relevant for trauma exposure and PTSD symptoms in a non-clinical population. Psychiatry Res 2016; 239:204-11. [PMID: 27016879 DOI: 10.1016/j.psychres.2016.03.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 07/19/2015] [Revised: 02/08/2016] [Accepted: 03/12/2016] [Indexed: 11/22/2022]
Abstract
Impulsivity is a relevant construct for explaining both normal individual differences in personality and more extreme personality disorder, and is often investigated within clinical populations. This study aims to explore the college students' impulsivity patterns and to investigate the association across levels of impulsivity with trauma exposure and PTSD development in a non-clinical population. A one-phase census survey of seven college institutions assessed 2213 students in three metropolitan regions of Northeastern Brazil. All subjects anonymously completed a self-applied protocol consisting of: a socio-demographic questionnaire, Trauma History Questionnaire (THQ), PTSD Checklist (PCL-C), and Barratt Impulsiveness Scale (BIS-11). The median for frequency of trauma exposure was 4 events for people with low and normal impulsivity, and 6 for highly impulsive ones. Individuals with higher impulsivity presented earlier exposition than non-impulsive ones, and worst outcome: 12.4% with PTSD, against 8.4% and 2.3% (normal and low impulsivity). Of the three factors of impulsivity, the Attentional factor conferred the strongest association with PTSD development. Results suggest that impulsivity is also a relevant trait in a non-clinical population and is associated with trauma exposure and PTSD. Strategies to promote mental health in adolescents may be pertinent, especially with the aim of managing impulsivity.
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16
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van Duijl M, Kleijn W, de Jong J. Unravelling the spirits' message: a study of help-seeking steps and explanatory models among patients suffering from spirit possession in Uganda. Int J Ment Health Syst 2014; 8:24. [PMID: 24940355 PMCID: PMC4060147 DOI: 10.1186/1752-4458-8-24] [Citation(s) in RCA: 27] [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: 03/12/2014] [Accepted: 05/27/2014] [Indexed: 11/25/2022] Open
Abstract
As in many cultures, also in Uganda spirit possession is a common idiom of distress associated with traumatic experiences. In the DSM-IV and -5, possession trance disorders can be classified as dissociative disorders. Dissociation in Western countries is associated with complicated, time-consuming and costly therapies. Patients with spirit possession in SW Uganda, however, often report partial or full recovery after treatment by traditional healers. The aim of this study is to explore how the development of symptoms concomitant help-seeking steps, and explanatory models (EM) eventually contributed to healing of patients with spirit possession in SW Uganda. Illness narratives of 119 patients with spirit possession referred by traditional healers were analysed using a mixed-method approach. Treatments of two-thirds of the patients were unsuccessful when first seeking help in the medical sector. Their initially physical symptoms subsequently developed into dissociative possession symptoms. After an average of two help-seeking steps, patients reached a healing place where 99% of them found satisfactory EM and effective healing. During healing sessions, possessing agents were summoned to identify themselves and underlying problems were addressed. Often-mentioned explanations were the following: neglect of rituals and of responsibilities towards relatives and inheritance, the call to become a healer, witchcraft, grief, and land conflicts. The results demonstrate that traditional healing processes of spirit possession can play a role in restoring connections with the supra-, inter-, intra-, and extra-human worlds. It does not always seem necessary to address individual traumatic experiences per se, which is in line with other research in this field. The study leads to additional perspectives on treatment of trauma-related dissociation in Western countries and on developing effective mental health services in low -and middle-income countries.
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Affiliation(s)
- Marjolein van Duijl
- Netherlands Institute for Forensic Psychiatry, The Hague, The Netherlands ; Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Wim Kleijn
- Leiden University Medical Center, Leiden, The Netherlands ; Centrum '45, Oegstgeest, The Netherlands
| | - Joop de Jong
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands ; Boston University School of Medicine, Boston, USA
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17
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Mazur VML, Chahraoui K, Bissler L. [Psychopathology of asylum seekers in Europe, trauma and defensive functioning]. Encephale 2014; 41:221-8. [PMID: 24661581 DOI: 10.1016/j.encep.2013.11.001] [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: 03/25/2013] [Accepted: 11/26/2013] [Indexed: 10/25/2022]
Abstract
Refugees seeking asylum are a particularly vulnerable population. It has been observed that among the most commonly-occurring disorders exhibited in this population, there is a high incidence of post-traumatic stress disorder, generalized anxiety disorder, and depression. These disorders may be linked to the difficult paths that refugees are forced to undertake, as well as to different traumatic events which are particularly destructive psychologically (deliberate physical, sexual and/or psychological violence, traumatic bereavements in the context of war, or social and political instability, socio-economic, familial or administrative difficulties), which compromise their view of their short-term futures. In the face of the weight of these life events, the question of the psychological resources of the individual is at the forefront of our understanding of mental health and the capacity to adjust to trauma. Our study aims to apprehend in a dynamic way, the different strategies used by asylum seekers in our western countries to adjust psychologically to traumatic and stressful events. The aim of this research is to study the links between mental health and anxious and depressive psychopathologies as well as the defensive modalities of these subjects. One hundred and twenty adult asylum seekers, living in refugee centres in Slovakia, France and Norway have agreed to participate in this study. We tried to assess the psychopathological disorders manifesting in these populations, notably PTSD, major depression and generalized anxiety disorder. Using the DSQ-60 we also tried to establish the links between the psychopathologies observed in this population and the defence mechanisms employed. Our results reveal that 60% of subjects do indeed suffer from psychopathological disorders with an important comorbidity of PTSB and depression (64.2%). Furthermore, the seriousness of the symptoms is correlated with less adaptive defence mechanisms (a higher incidence of defence mechanisms such as acting-out and distorted self-image). The recourse to mechanisms such as affiliation, repression and idealization is found to be used less by the study's target group. Rather, they tend to resort to defence mechanisms such as projection, low self-esteem, withdrawal, acting-out and hypochondria. Our results highlight the importance of the affiliation mechanism, which holds the potential to facilitate adaptation and resilience in these vulnerable subjects. It could also be offered as part of a therapeutic care proposal.
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Affiliation(s)
- V M-L Mazur
- Laboratoire de psychologie médicale et de psychopathologie, pôle AAFE, université de Bourgogne, Esplanade Erasme, 21000 Dijon, France
| | - K Chahraoui
- Laboratoire de psychologie médicale et de psychopathologie, pôle AAFE, université de Bourgogne, Esplanade Erasme, 21000 Dijon, France.
| | - L Bissler
- Laboratoire de psychologie médicale et de psychopathologie, pôle AAFE, université de Bourgogne, Esplanade Erasme, 21000 Dijon, France
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18
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Savolainen K, Eriksson JG, Kananen L, Kajantie E, Pesonen AK, Heinonen K, Räikkönen K. Associations between early life stress, self-reported traumatic experiences across the lifespan and leukocyte telomere length in elderly adults. Biol Psychol 2014; 97:35-42. [PMID: 24530884 DOI: 10.1016/j.biopsycho.2014.02.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [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: 04/18/2013] [Revised: 02/04/2014] [Accepted: 02/04/2014] [Indexed: 11/26/2022]
Abstract
Early life stress (ELS) poses a risk for mental disorders and aging-related diseases. Accelerated biological aging, reflected in shorter leukocyte telomere length (LTL), may underlie these risks. We examined whether objectively recorded ELS and retrospectively self-reported traumatic experiences across the lifespan are associated with LTL in later adulthood. Of 1486 participants, 215 had been exposed to ELS, namely to temporary separation from both parents in childhood. Participants self-reported emotionally or physically traumatic experiences across the lifespan at a mean age of 63.2 years. LTL was measured using a quantitative PCR method at a mean age of 61.5 years. Separation or self-reported traumatic experiences were not associated with LTL. However, separated participants who self-reported traumatic experiences had shorter LTL. Our results suggest that while ELS or self-reported traumatic experiences are not per se associated with LTL measured decades later, ELS may in combination with self-reported traumatic events be associated with accelerated biological aging.
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Affiliation(s)
- Katri Savolainen
- Institute of Behavioural Sciences, University of Helsinki, Finland.
| | - Johan G Eriksson
- Diabetes Prevention Unit, Department of Chronic Disease Prevention, National Institution for Health and Welfare, Helsinki, Finland; Folkhälsan Research Centre, Helsinki, Finland; Unit of General Practice, Helsinki University Central Hospital, Finland; Vaasa Central Hospital, Vaasa, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Finland
| | - Laura Kananen
- Research Programs Unit, Molecular Neurology, Biomedicum-Helsinki, University of Helsinki, Finland; Department of Medical Genetics, Haartman Institute, Faculty of Medicine, University of Helsinki, Finland
| | - Eero Kajantie
- Diabetes Prevention Unit, Department of Chronic Disease Prevention, National Institution for Health and Welfare, Helsinki, Finland; Hospital for Children and Adolescents, Helsinki University Central Hospital, Finland
| | | | - Kati Heinonen
- Institute of Behavioural Sciences, University of Helsinki, Finland
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Finland
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Cristofaro SL, Cleary SD, Wan CR, Broussard B, Chapman C, Haggard PJ, Jananeh S, Myers NL, Compton MT. Measuring trauma and stressful events in childhood and adolescence among patients with first-episode psychosis: initial factor structure, reliability, and validity of the Trauma Experiences Checklist. Psychiatry Res 2013; 210:618-25. [PMID: 23850437 PMCID: PMC3816125 DOI: 10.1016/j.psychres.2013.06.015] [Citation(s) in RCA: 13] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 05/22/2013] [Accepted: 06/13/2013] [Indexed: 11/29/2022]
Abstract
Past trauma and stressful events, especially in childhood and adolescence, are common among individuals with serious mental illnesses like schizophrenia. Traumatic experiences are thought to be a socio-environmental risk factor not only for poorer outcomes, but also potentially for the onset of these disorders. Because improved measurement tools are needed, we developed and studied, among 205 first-episode psychosis patients, the factor structure, internal consistency reliability, and initial validity of the Trauma Experiences Checklist (TEC), our measure of trauma and stressful events during childhood/adolescence. We assessed validity of subscales using correlations with Childhood Trauma Questionnaire-Short Form, Parental Harsh Discipline, Violence Exposure, and TEC-Informant Version scores. Exploratory factor analysis resulted in two internally consistent subscales (Cronbach's α=0.79 and 0.80, respectively), interpersonal abuse and family stress, and violence, death, and legal involvement. Scores from the former subscale were substantially associated with CTQ-SF physical, emotional, and sexual abuse (r=0.42-0.57, all p<0.001) and Violence Exposure (r=0.49, p<0.001). On the other hand, violence, death, and legal involvement scores were most highly correlated with Violence Exposure (r=0.49, p<0.001), and not with most CTQ-SF subscales. The TEC is a potentially useful tool in assessing diverse traumatic life events across various social contexts during childhood and adolescence.
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Affiliation(s)
- Sarah L. Cristofaro
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia, USA
| | - Sean D. Cleary
- The George Washington University School of Public Health and Health Services, Department of Epidemiology and Biostatistics, Washington, DC, USA
| | - Claire Ramsay Wan
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia, USA
| | - Beth Broussard
- The George Washington University School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Sciences, Washington, DC, USA
| | - Colby Chapman
- The George Washington University School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Sciences, Washington, DC, USA
| | - Patrick J. Haggard
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia, USA
| | - Sara Jananeh
- University of Georgia, Department of Psychology, Athens, GA, USA
| | - Neely L. Myers
- The George Washington University School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Sciences, Washington, DC, USA
| | - Michael T. Compton
- The George Washington University School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Sciences, Washington, DC, USA
,Corresponding author. Tel.: +202 741 3554; fax: 202 741 2891.
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