Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 819
Filtrar
1.
J Trauma Stress ; 37(1): 178-186, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37908028

RESUMO

Trauma exposure is strongly linked to maternal posttraumatic stress disorder (PTSD) and depressive symptoms during the perinatal period; however, childhood trauma exposure is often assessed without accounting for adult exposure. This study tested the unique impacts of childhood and adulthood trauma exposure on PTSD and depressive symptoms among pregnant women (N = 107, 82.9% Latina) enrolled in a nonrandomized intervention study. Regression analyses at baseline showed positive associations between trauma exposure and PTSD symptoms irrespective of trauma timing, childhood: B = 1.62, t(91) = 2.11, p = .038; adulthood: B = 2.92, t(91) = 3.04, p = .003. However only adulthood trauma exposure, B = 1.28, t(94) = 2.94, p = .004, was positively associated with depressive symptoms. Mixed-effects analyses of variance revealed interaction effects of time and adulthood trauma exposure, indicating that women with high degrees of adulthood trauma exposure had higher baseline levels of PTSD, F(1, 76.4) = 6.45, p = .013, and depressive symptoms, F(1, 87.2) = 4.88, p = .030, but showed a more precipitous decrease posttreatment than women with lower levels of adulthood trauma exposure. These findings support the clinical relevance of assessing both childhood and adulthood trauma exposure during the perinatal period given their impacts on baseline symptoms and psychotherapy response.


Assuntos
Saúde Mental , Transtornos de Estresse Pós-Traumáticos , Adulto , Feminino , Humanos , Gravidez , Psicoterapia , Análise de Regressão , Transtornos de Estresse Pós-Traumáticos/psicologia , Adultos Sobreviventes de Eventos Adversos na Infância
2.
J Evid Based Soc Work (2019) ; 21(1): 117-139, 2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-37847740

RESUMO

PURPOSE: Most youth with delinquency histories experience childhood adversity leaving them vulnerable to poor adult well-being. Previous research indicates that self-regulation difficulties could explain how childhood adversity affects adult well-being. Yet, very few studies target adult self-regulation intervention. Therefore, this study examined the intervening effects of emerging adult self-regulation on the association between childhood adversity and adult well-being. METHOD: Using data from the first four waves of the Add Health Study, the researchers conducted structural equation modeling for mediation with bootstrapping. The researchers tested the mediation effects of emerging adult self-regulation on the association between childhood adversity (child maltreatment and violent victimization) and later adult well-being (mental health problems, alcohol and drug use, criminal behaviors) among people with delinquency histories and/or arrest prior to age 18 (N = 1,792). RESULTS: Several significant direct effects and one partial mediation effect were found. For example, child maltreatment significantly predicted adult mental health problems and criminal behaviors. Self-regulation (via the dissatisfaction with life and self subscale) mediated the association between child maltreatment and adult mental health problems. DISCUSSION: Findings highlight the need for social workers to focus on prevention services and trauma-informed treatment for people with delinquency histories. In addition, evidence-based practice requires self-regulation interventions for adults with histories of childhood adversity and delinquency to focus on their emotional and cognitive functioning as well as self-esteem. CONCLUSION: Implementing self-regulation interventions during emerging adulthood can be useful to mitigate later adult mental health problems among people with histories of childhood adversity and delinquency.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância , Experiências Adversas da Infância , Autocontrole , Adulto , Humanos , Experiências Adversas da Infância/estatística & dados numéricos , Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Análise de Classes Latentes
3.
PLoS One ; 18(10): e0292233, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37851620

RESUMO

BACKGROUND: Multiple sclerosis (MS) is a progressive, autoimmune disease of the central nervous system that affects nearly one million Americans. Despite the existence of immunomodulatory therapies to slow physical and cognitive disability progression, interventions to ameliorate common symptoms of MS, including fatigue and pain, remain limited. Poor understanding of risk factors for these symptoms may contribute to treatment challenges. In recent years, childhood stress has been investigated as a risk factor for chronic autoimmune conditions including MS; yet remarkably few studies have investigated the relationship between childhood stressors and chronic MS symptoms. Our aim was to examine clusters of stressors and three key features of MS: fatigue, pain interference, and psychiatric morbidity. METHODS: Cross-sectional data were collected from a sample of People with MS (PwMS) via a national web-based survey that assessed the presence and type of childhood stressors and MS clinical features. Hierarchical block regression was used to assess associations among emotional, physical, and environmental childhood stressors and three clinical features commonly experienced by PwMS. RESULTS: N = 719 adults with MS (aged 21-85) completed the survey. Childhood emotional and physical stressors were significantly associated with overall presence of fatigue (p = 0.02; p<0.03) and pain interference (p<0.001; p<0.001) in adulthood, as well as the magnitude of both outcomes. Environmental stressors (p<0.001), in addition to emotional (p<0.001) and physical (p<0.001) stressors were significantly associated with psychiatric morbidity in PwMS. CONCLUSION: Childhood stress may predict fatigue, psychiatric morbidity, and pain in adults with MS. Further research is needed to show cause and effect; however, if an association exists, strategies to mitigate the impact of childhood stress could offer new pathways to reduce the severity of these symptoms. Broadly, this work adds to the body of evidence supporting upstream preventive measures to help address the stress on children and families.


Assuntos
Esclerose Múltipla , Adulto , Humanos , Doença Crônica , Estudos Transversais , Fadiga/etiologia , Morbidade , Esclerose Múltipla/complicações , Esclerose Múltipla/epidemiologia , Esclerose Múltipla/psicologia , Dor/complicações , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adultos Sobreviventes de Eventos Adversos na Infância
4.
Behav Sleep Med ; 21(6): 659-670, 2023 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-36409021

RESUMO

OBJECTIVES: Exposure to traumatic stress in childhood increases the risk of sleep disturbances. Preliminary evidence suggests that the relationship between childhood trauma and sleep may depend on trauma chronicity. Additionally, little is known about the relationship between sleep and dissociation, a common symptom in post-traumatic stress disorder. This study examined sleep quality, sleep-related experiences, and dissociation in survivors of childhood trauma with different trauma chronicity. METHOD: Nine-hundred-and-fourteen community-dwelling adults completed an online survey. They were divided into three groups: no childhood trauma, short-term childhood trauma, and chronic childhood trauma. RESULTS: We found that survivors of chronic childhood trauma had poorer sleep quality than survivors of short-term childhood trauma and individuals without a history of childhood trauma, controlling for age, number of trauma types experienced, psychological distress, and PTSD symptoms. The relationship between dissociation and sleep quality was moderated by trauma chronicity such that dissociation was associated with better sleep quality only in the chronic trauma group. Dissociation was positively associated with sleep-related experiences regardless of trauma exposure and trauma chronicity. CONCLUSION: Our findings highlighted the differential impact of acute and chronic traumatic stress on sleep, and suggested that the relationship between dissociation and sleep could depend on trauma chronicity.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância , Experiências Adversas da Infância , Transtornos de Estresse Pós-Traumáticos , Adulto , Humanos , Qualidade do Sono , Transtornos de Estresse Pós-Traumáticos/psicologia , Sobreviventes/psicologia
5.
Radiother Oncol ; 176: 118-126, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36063983

RESUMO

PURPOSE: The purposes of this study were to develop and integrate a colorectal model that incorporates anatomical variations of pediatric patients into the age-scalable MD Anderson Late Effects (MDA-LE) computational phantom, and validate the model for pediatric radiation therapy (RT) dose reconstructions. METHODS: Colorectal contours were manually derived from whole-body non-contrast computed tomography (CT) scans of 114 pediatric patients (age range: 2.1-21.6 years, 74 males, 40 females). One contour was used for an anatomical template, 103 for training and 10 for testing. Training contours were used to create a colorectal principal component analysis (PCA)-based statistical shape model (SSM) to extract the population's dominant deformations. The SSM was integrated into the MDA-LE phantom. Geometric accuracy was assessed between patient-specific and SSM contours using several overlap metrics. Two alternative colorectal shapes were generated using the first 17 dominant modes of the PCA-based SSM. Dosimetric accuracy was assessed by comparing colorectal doses from test patients' CT-based RT plans (ground truth) with reconstructed doses for the mean and two alternative models in age-matched MDA-LE phantoms. RESULTS: When using all 103 PCA modes, the mean (min-max) Dice similarity coefficient, distance-to-agreement and Hausdorff distance between the patient-specific and reconstructed contours for the test patients were 0.89 (0.85-0.91), 2.1 mm (1.7-3.0), and 8.6 mm (5.7-14.3), respectively. The average percent difference between reconstructed and ground truth mean and maximum colorectal doses for the mean (alternative 1, 2) model were 6.3% (8.1%, 6.1%) and 4.4% (4.3%, 4.7%), respectively. CONCLUSIONS: We developed, validated and integrated a colorectal PCA-based SSM into the MDA-LE phantom and demonstrated its dosimetric performance for accurate pediatric RT dose reconstruction.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância , Sobreviventes de Câncer , Neoplasias Colorretais , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Adulto Jovem , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/radioterapia , Imagens de Fantasmas , Radiometria/métodos , Tomografia Computadorizada por Raios X/métodos
7.
BMC Pregnancy Childbirth ; 22(1): 129, 2022 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-35172776

RESUMO

BACKGROUND: Being born before full gestation can have short-term and life-long health implications, yet it remains difficult to determine the risk of preterm birth among expectant mothers. Across different health settings, increasing attention is given to the health and behavioural consequences of adverse childhood experiences (ACEs) such as child abuse or neglect, or exposure to harmful household environments (e.g. in which caregivers abuse alcohol), and the potential value of understanding these hidden harms when supporting individuals and families. A large international evidence base describes the association between childhood adversity and early years outcomes for mothers and children. However, the relationship between maternal ACEs and preterm birth has received far less attention. METHODS: Secondary analysis was carried out on anonymised cross-sectional data from health visiting services in south and west Wales that had previously captured information on mothers' ACEs during routine contacts. Demographic data and information on mothers' health were extracted from the Healthy Child Wales Programme. RESULTS: Half of all mothers sampled had experienced at least one ACE, with a history of ACEs more common among younger, white British mothers and those residing in deprived areas. Preterm birth was significantly independently associated with retrospective reports of childhood sexual abuse (adjusted odds ratio [AOR] = 3.83, 95% confidence interval [CI] = 1.19-12.32, p = 0.025), neglect (AOR = 7.60, 95%CI = 1.81-31.97, p = 0.006) and overall ACE exposure (AOR = 2.67, 95%CI = 1.14-6.23, p = 0.024), with one in ten mothers (10.0%) who experienced ≥4 ACEs having preterm birth. Sub-analyses revealed a more pronounced relationship among mothers with no known chronic health conditions, with those with ≥4 ACEs and no known chronic condition four times more likely to give birth preterm (AOR = 3.89, 95%CI = 1.40-10.80, p = 0.009). CONCLUSIONS: Findings highlight the importance of the entire maternal experience. The experience of childhood adversity can have a lasting impact into and beyond the prenatal period, potentially increasing the risk of preterm birth, even among otherwise healthy women. Increasing our understanding of the potential perinatal outcomes associated with ACEs can help to inform how maternity services and partners offer trauma-sensitive support to mitigate some of the risks of early parturition, as well as target intergenerational cycles of adversity and poor health.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Experiências Adversas da Infância , Mães/estatística & dados numéricos , Nascimento Prematuro/epidemiologia , Adolescente , Adulto , Estudos Transversais , Coleta de Dados/métodos , Feminino , Humanos , Gravidez , País de Gales , Adulto Jovem
8.
BMC Pregnancy Childbirth ; 22(1): 10, 2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-34983417

RESUMO

BACKGROUND: Women and men having been exposed to childhood trauma would be at high risk of various mental health symptoms while awaiting a child. This study aimed to evaluate the association between cumulative childhood trauma and the accumulation of symptoms belonging to different psychiatric problems in pregnant women and expecting men. METHODS: We first examined prevalence rates of childhood trauma across our samples of 2853 pregnant women and 561 expecting men from the community. Second, we evaluated the association between cumulative childhood trauma and symptom complexity (i.e., the simultaneous presentation of symptoms belonging to multiple psychiatric problems) using subsamples of 1779 pregnant women and 118 expecting men. Participants completed self-reported measures of trauma (Childhood Trauma Questionnaire) and psychiatric symptoms (PTSD Checklist for DSM-5; Kessler Psychological Distress Scale; State-Trait Anger Expression Inventory-2; Self and Interpersonal Functioning Scale). RESULTS: Trauma was more frequent in pregnant women than in expecting men and in participants reporting sociodemographic risk factors than in those not reporting any. A dose-response relationship was observed between the number of different traumas reported by pregnant women and expecting men and the complexity of their psychiatric symptoms, even when controlling for the variance explained by other risk factors. Women having been exposed to cumulative childhood trauma were 4.95 times more at risk of presenting comorbid psychiatric problems during pregnancy than non-exposed women. CONCLUSIONS: Childhood trauma is frequent in the general population of pregnant women and expecting men and is associated with symptom complexity during the antenatal period. These findings call for delivering and evaluating innovative trauma-informed antenatal programs to support mental health and adaptation to parenthood in adults having been exposed to childhood trauma.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Pai/psicologia , Transtornos Mentais/epidemiologia , Gestantes/psicologia , Adulto , Experiências Adversas da Infância/estatística & dados numéricos , Comorbidade , Feminino , Humanos , Masculino , Saúde Mental , Gravidez , Escalas de Graduação Psiquiátrica , Quebeque , Autorrelato
9.
Dev Psychopathol ; 34(1): 157-170, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-33023709

RESUMO

Child sexual abuse (CSA) is a notable risk factor for depressive disorders. Though multiply determined, increased sensitivity to stress (stress sensitization) and difficulty managing distress (emotion regulation) may reflect two pathways by which CSA confers depression risk. However, it remains unclear whether stress sensitization and emotion regulation deficits contribute to depression risk independently or in a sequential manner. That is, the frequent use of maladaptive emotion regulation responses and insufficient use of those that attenuate distress (adaptive emotion regulation) may lead to stress sensitization. We tested competing models of CSA, stress sensitization, and emotion regulation to predict depression symptoms and depressive affects in daily life among adults with and without histories of CSA. Results supported a sequential mediation: CSA predicted greater maladaptive repertoires that, in turn, exacerbated the effects of stress on depression symptoms. Maladaptive responses also exacerbated the effects of daily life stress on contemporaneous negative affect (NA) levels and their increase over time. Independent of stress sensitization, emotion regulation deficits also mediated CSA effects on both depressive outcomes, though the effect of maladaptive strategies was specific to NA, and adaptive responses to positive affect. Our findings suggest that emotion regulation deficits and stress sensitization play key intervening roles between CSA and risk for depression.


Assuntos
Abuso Sexual na Infância , Depressão , Regulação Emocional , Estresse Psicológico , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Criança , Abuso Sexual na Infância/psicologia , Depressão/psicologia , Humanos , Fatores de Risco , Estresse Psicológico/psicologia
10.
Obstet Gynecol ; 138(5): 770-776, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34619717

RESUMO

OBJECTIVE: To examine the association between adverse childhood experiences and adverse pregnancy outcomes. METHODS: This cohort study included individuals who enrolled in a perinatal collaborative mental health care program (COMPASS [the Collaborative Care Model for Perinatal Depression Support Services]) between 2017 and 2021. Participants completed psychosocial self-assessments, including an adverse childhood experiences screen. The primary exposure was adverse childhood experiences measured by the ACE (adverse childhood experience) score, which was evaluated as a dichotomized variable, with a high ACE score defined as greater than three. Secondary analyses used the ACE score as a continuous variable. Adverse pregnancy outcomes including gestational diabetes, hypertensive disorders of pregnancy, preterm birth, and small-for-gestational-age (SGA) births were abstracted from the electronic health record. Bivariable and multivariable analyses were performed, including mediation analyses. RESULTS: Of the 1,274 women with a completed adverse childhood experiences screen, 904 (71%) reported one or more adverse childhood experiences, and 290 (23%) reported a high ACE score (more than three adverse childhood experiences). Adverse childhood experience scores were not associated with gestational diabetes or SGA births. After controlling for potential confounders, individuals with high ACE score had 1.55-fold (95% CI 1.06-2.26) increased odds of having hypertensive disorders of pregnancy and 2.03-fold (95% CI 1.38-2.99) increased odds of preterm birth. Each point increase in ACE score was not associated with a statistically increased odds of hypertensive disorders of pregnancy (adjusted odds ratio [aOR] 1.07, 95% CI 0.99-1.15); however, each additional point on the adverse childhood experiences screen was associated with increased odds of preterm birth (aOR 1.13, 95% CI 1.05-1.22). Mediation analyses demonstrated tobacco use, chronic medical problems, and obesity each partially mediated the observed association between high ACE scores and hypertensive disorders of pregnancy. Having chronic medical comorbidities partially mediated the observed association between high ACE scores and preterm birth. CONCLUSION: One in four individuals referred to a perinatal mental health program who were pregnant or postpartum had a high ACE score. Having a high ACE score was associated with an increased risk of hypertensive disorders of pregnancy and preterm birth. These results underscore how remote events may reverberate through the life course.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Hipertensão Induzida pela Gravidez/epidemiologia , Complicações na Gravidez , Nascimento Prematuro/epidemiologia , Reabilitação Psiquiátrica , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Experiências Adversas da Infância/psicologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Estudos de Coortes , Feminino , Humanos , Serviços de Saúde Mental/estatística & dados numéricos , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/psicologia , Resultado da Gravidez/epidemiologia , Reabilitação Psiquiátrica/métodos , Reabilitação Psiquiátrica/estatística & dados numéricos , Medição de Risco , SARS-CoV-2 , Autoavaliação (Psicologia) , Estados Unidos/epidemiologia
11.
Pharmacol Biochem Behav ; 211: 173291, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34695507

RESUMO

Inflammation, as a neurobiological consequence of childhood trauma, has frequently been reported across research, however, recent investigations suggest this relationship may be dependent on specificities such as type of trauma, type of inflammatory marker, and additional mediatory variables - such as body mass index (BMI), age, and sex. As an updated version of a previous review by Baumeister et al., the current review comprised a search of PubMed, which identified 37 articles that collectively assessed 4 inflammatory markers (CRP, IL-6, TNFα and IL-1ß). A review of the studies revealed predominantly non-significant associations between childhood trauma and elevated levels of all inflammatory markers in adulthood. However, in line with previous research, discrepancies in significance arose when considering type of trauma, type of inflammatory marker, and additional variables. Compared to neglect, abuse showed greater significant associations with elevated inflammatory markers in adulthood, though this was dependent on the individual subtypes (emotional, physical or sexual). Mediation analyses reported BMI as a significant mediator, though, when controlled for, no significant differences were found. Sex differences were reported but investigations were sparse. Future research should investigate the mediatory role of sex differences in the inflammatory effects of childhood trauma. Many studies in the review were restricted by use of the same trauma measure - the Childhood Trauma Questionnaire. To assess greater variety of trauma types, future studies should utilize other standardized measures to explore these avenues.


Assuntos
Experiências Adversas da Infância , Proteína C-Reativa/metabolismo , Inflamação/etiologia , Interleucina-1beta/metabolismo , Interleucina-6/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância , Biomarcadores/metabolismo , Índice de Massa Corporal , Criança , Maus-Tratos Infantis/psicologia , Pré-Escolar , Feminino , Humanos , Inflamação/metabolismo , Masculino , Inquéritos e Questionários
12.
J Clin Psychiatry ; 82(5)2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34496464

RESUMO

Background: Childhood trauma (CT) is associated with an increased risk of major depressive disorder, but little is known about the impact of CT on depression during pregnancy and the early and late postpartum period. The present study assesses whether CT is associated with perinatal depression, considering different types of CT.Methods: This study used data from the Interaction of Gene and Environment of Depression in PostPartum (IGEDEPP), a French multicenter prospective cohort study, including 3,252 women who completed the Childhood Trauma Questionnaire at the maternity department between November 2011 and June 2016. Depression during pregnancy was assessed retrospectively at the maternity department using DSM-5 criteria. Early- and late-onset postpartum depression were assessed at 2 months and 1 year postpartum, respectively.Results: Among the 3,252 women, 298 (9.2%) reported at least 1 CT. Women with CT had a higher risk of depression (OR = 2.2; 95% CI, 1.7-2.7), anxiety (OR = 2.3; 95% CI, 1.7-3.0), and suicide attempts (OR = 5.4; 95% CI, 3.5-8.4) than women without CT. Perinatal depression was more frequent in women with CT than in women without CT, after adjustment for sociodemographic characteristics and personal history of major depressive episode and consideration of the timing of onset (pregnancy, early or late postpartum) (P < .001). There was a dose effect between the number of CT types and the risk of perinatal depression.Conclusions: These results show that CT is associated with a depressive episode during adulthood, specifically in the perinatal period. These findings may lead to special prenatal care for women abused or neglected during childhood, to better screen and treat perinatal depression.Trial registration: ClinicalTrials.gov identifier: NCT01648816.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Depressão Pós-Parto/etiologia , Complicações na Gravidez/psicologia , Adulto , Ansiedade/etiologia , Feminino , Humanos , Gravidez , Complicações na Gravidez/etiologia , Estudos Prospectivos , Fatores de Risco , Tentativa de Suicídio/psicologia , Adulto Jovem
13.
Pediatrics ; 148(3)2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34413250

RESUMO

CONTEXT: A growing body of research has examined the role of maternal adverse childhood experiences (ACEs) on child behavior problems. OBJECTIVE: To summarize the literature examining the association between maternal ACEs and child behavior problems via a systematic review. DATA SOURCES: Electronic searches were conducted in Medline, PsycINFO, and Embase (1998-June 2020). Reference lists were reviewed. In total, 3048 records were screened. STUDY SELECTION: Studies were included if an association between maternal ACEs and child externalizing (eg, aggression) and/or internalizing (eg, anxiety) problems was reported. In total, 139 full-text articles were reviewed for inclusion. DATA EXTRACTION: Data from 16 studies met full inclusion criteria. Studies were synthesized by child externalizing and internalizing outcomes. RESULTS: Maternal ACEs were significantly associated with child externalizing problems across all studies (number of studies synthesized per outcome [k] = 11). Significant associations were also found for inattention, hyperactivity, and impulsivity (k = 4), and aggression (k = 2). For internalizing problems (k = 11), significant associations were identified across 8 studies and nonsignificant associations were reported for 3 studies. Maternal ACEs were consistently associated with child anxiety and depression (k = 5). However, inconsistent findings were reported for somatization (k = 2). LIMITATIONS: Results are limited to mother-child dyads and questionnaire measures of behavior problems in primarily North American countries. CONCLUSIONS: Mothers' ACEs demonstrated largely consistent associations with children's behavior problems. Future research is needed to determine if specific types of maternal ACEs (eg, household dysfunction) are more strongly associated with child behavior problems.


Assuntos
Experiências Adversas da Infância , Transtornos do Comportamento Infantil , Mães , Adultos Sobreviventes de Eventos Adversos na Infância , Agressão , Ansiedade , Criança , Depressão , Feminino , Humanos , Transtornos Somatoformes
15.
J Clin Psychiatry ; 82(5)2021 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-34383391

RESUMO

Objective: US military veterans have high rates of suicide relative to civilians. However, little is known about the prevalence and correlates of suicidal behaviors in the general US veteran population.Methods: Data were from the National Health and Resilience in Veterans Study, a representative survey of US veterans conducted in 2019-2020 (n = 4,069). Analyses (1) estimated the prevalence of current suicidal ideation, lifetime suicide plans, and lifetime suicide attempts; (2) identified associated sociodemographic, military, DSM-5 psychiatric, and other risk correlates; and (3) examined mental health treatment utilization among veterans with suicidal ideation, suicide plans, or suicide attempts.Results: The prevalence of current suicidal ideation, lifetime suicide plans, and lifetime suicide attempts was 9.0%, 7.3%, and 3.9%, respectively. Suicidal behaviors were most prevalent among veterans aged 18-44 years, with 18.2%, 19.3%, and 11.1%, respectively, endorsing suicidal ideation, suicide plans, and suicide attempts. Major depressive disorder (MDD), age, posttraumatic stress disorder, and adverse childhood experiences (ACEs) emerged as the strongest correlates of suicidal ideation and suicide plans, while MDD, age, alcohol use disorder, and ACEs were the strongest correlates of suicide attempts. Only 35.5% of veterans with current suicidal ideation were engaged in mental health treatment, with veterans who used the US Veterans Administration (VA) as their primary source of health care more than twice as likely as VA non-users to be engaged in such treatment (54.7% vs 23.8%).Conclusions: Suicidal behaviors are highly prevalent among US veterans, particularly among young veterans. Results suggest that nearly two-thirds of veterans with current suicidal ideation are not engaged in mental health treatment, signaling the need for enhanced suicide prevention and outreach efforts.


Assuntos
Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , Veteranos/psicologia , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Alcoolismo/complicações , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/complicações , Tentativa de Suicídio/psicologia , Estados Unidos/epidemiologia , Veteranos/estatística & dados numéricos , Adulto Jovem
16.
J Forensic Sci ; 66(5): 1818-1828, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34196016

RESUMO

Maternal filicide is defined as the murder of a child by its mother. Many classifications have been elaborated based on underlying motives such as altruism, mental pathology, fatal maltreatment, spousal revenge, or an unwanted child. Pathological filicide refers to cases in which the perpetrator has a major psychiatric illness. Related literature is sparse. The present work proposes to identify the main characteristics of mentally ill filicidal mothers. This study was based on data gathered through a retrospective chart review of all filicidal women admitted to the Henri Colin secure unit (France) between 1996 and 2019 (N = 17). Most filicidal mothers had a dysfunctional childhood marked by emotional neglect, intrafamilial violence, or social isolation. They were often married, on average about 32 years old. We found a history of attempted filicide in 3 cases, and abuse or neglect in 3 other cases. The victim's average age was 6.2 years old, and in several cases, multiple siblings were murdered. Half of the filicidal mothers had a history of psychiatric disorders. Three different diagnoses were found in our study: bipolar or depressive disorders (41.2%); schizophrenia or other psychotic disorders (41.2%); personality disorders (17.6%). We identified two subgroups, as having different motivational profiles. In the first group, filicide is a defensive reaction to a perceived threat: The murder is committed under the influence of hallucinations or delusions. In the second group, filicide is linked to a context of separation, real or imagined. Several forensic and psychopathologic features associated with each profile are detailed.


Assuntos
Internação Compulsória de Doente Mental , Vítimas de Crime/estatística & dados numéricos , Criminosos/estatística & dados numéricos , Homicídio/estatística & dados numéricos , Mães/psicologia , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Criança , Feminino , França/epidemiologia , Homicídio/psicologia , Humanos , Estado Civil/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Motivação , Estudos Retrospectivos , Adulto Jovem
17.
J Forensic Leg Med ; 80: 102180, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33991929

RESUMO

BACKGROUND: Prisoners have higher rates of suicide attempts compared with general population. A history of childhood trauma (CT) is common among incarcerated subjects and it is a well-known risk factor for lifetime suicide attempts. Therefore, the purpose of the study was to investigate whether lifetime suicide attempts may be related to the exposition to CT among male prisoners. METHOD: We conducted a cross sectional study recruiting newly arrived inmates in an Italian jail, between January 2017 and June 2018. Prisoners were interviewed to collect socio-demographic and clinical information. Moreover, inmates completed the Childhood Trauma Questionnaire. We excluded prisoners unable to speak or read Italian, with learning disabilities or current severe psychiatric symptoms. RESULTS: A total of 215 consecutive male inmates were included. Fifty-one prisoners (23.7%) had a history of attempted suicide. The most reported CT was physical neglect. Multivariate logistic regression analysis showed that a history of childhood sexual abuse, emotional neglect and psychiatric diagnosis significantly increased the likelihood of lifetime suicide attempt. CONCLUSIONS: A previous history of suicide attempt is highly prevalent among inmates. In agreement with previous findings, lifetime suicide attempts seem to be associated with the presence of CT and psychiatric diagnosis. Therefore, CT should be considered as a relevant variable to improve the programs for the prevention of suicide in prison.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Prisioneiros/estatística & dados numéricos , Tentativa de Suicídio/estatística & dados numéricos , Adulto , Estudos Transversais , Humanos , Itália , Masculino , Projetos Piloto
18.
Schizophr Bull ; 47(5): 1495-1508, 2021 08 21.
Artigo em Inglês | MEDLINE | ID: mdl-33876249

RESUMO

BACKGROUND: Between unaffected mental health and diagnosable psychiatric disorders, there is a vast continuum of functioning. The hypothesized link between striatal dopamine signaling and psychosis has guided a prolific body of research. However, it has been understudied in the context of multiple interacting factors, subclinical phenotypes, and pre-postsynaptic dynamics. METHOD: This work investigated psychotic-like experiences and D2/3 dopamine postsynaptic receptor availability in the dorsal striatum, quantified by in vivo [11C]-raclopride positron emission tomography, in a sample of 24 healthy male individuals. Additional mediation and moderation effects with childhood trauma and key dopamine-regulating genes were examined. RESULTS: An inverse relationship between nondisplaceable binding potential and subclinical symptoms was identified. D2/3 receptor availability in the left putamen fully mediated the association between traumatic childhood experiences and odd beliefs, that is, inclinations to see meaning in randomness and unfounded interpretations. Moreover, the effect of early adversity was moderated by a DRD2 functional variant (rs1076560). The results link environmental and neurobiological influences in the striatum to the origination of psychosis spectrum symptomology, consistent with the social defeat and diathesis-stress models. CONCLUSIONS: Adversity exposure may affect the dopamine system as in association with biases in probabilistic reasoning, attributional style, and salience processing. The inverse relationship between D2/3 availability and symptomology may be explained by endogenous dopamine occupying the receptor, postsynaptic compensatory mechanisms, and/or altered receptor sensitivity. This may also reflect a cognitively stabilizing mechanism in non-help-seeking individuals. Future research should comprehensively characterize molecular parameters of dopamine neurotransmission along the psychosis spectrum and according to subtype profiling.


Assuntos
Experiências Adversas da Infância , Antagonistas dos Receptores de Dopamina D2/farmacocinética , Dopamina/metabolismo , Neostriado/metabolismo , Trauma Psicológico/metabolismo , Transtornos Psicóticos/metabolismo , Receptores de Dopamina D2/metabolismo , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância , Feminino , Humanos , Masculino , Neostriado/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Trauma Psicológico/diagnóstico por imagem , Trauma Psicológico/fisiopatologia , Transtornos Psicóticos/diagnóstico por imagem , Transtornos Psicóticos/fisiopatologia , Racloprida/farmacocinética , Receptores de Dopamina D2/genética , Receptores de Dopamina D3/metabolismo
20.
Nat Rev Neurosci ; 22(6): 372-384, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33911229

RESUMO

Childhood socio-economic status (SES), a measure of the availability of material and social resources, is one of the strongest predictors of lifelong well-being. Here we review evidence that experiences associated with childhood SES affect not only the outcome but also the pace of brain development. We argue that higher childhood SES is associated with protracted structural brain development and a prolonged trajectory of functional network segregation, ultimately leading to more efficient cortical networks in adulthood. We hypothesize that greater exposure to chronic stress accelerates brain maturation, whereas greater access to novel positive experiences decelerates maturation. We discuss the impact of variation in the pace of brain development on plasticity and learning. We provide a generative theoretical framework to catalyse future basic science and translational research on environmental influences on brain development.


Assuntos
Encéfalo/crescimento & desenvolvimento , Meio Ambiente , Classe Social , Adolescente , Adultos Sobreviventes de Eventos Adversos na Infância , Experiências Adversas da Infância , Animais , Bibliometria , Encéfalo/embriologia , Córtex Cerebral/citologia , Córtex Cerebral/crescimento & desenvolvimento , Córtex Cerebral/ultraestrutura , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Aprendizagem/fisiologia , Estudos Longitudinais , Masculino , Grupos Minoritários , Rede Nervosa , Plasticidade Neuronal , Neurociências , Tamanho do Órgão , Gravidez , Estresse Fisiológico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...