RESUMO
BACKGROUND: Childhood maltreatment (CM) is linked to long-term adverse health outcomes, including accelerated biological aging and cognitive decline. This study investigates the relationship between CM and various aging biomarkers: telomere length, facial aging, intrinsic epigenetic age acceleration (IEAA), GrimAge, HannumAge, PhenoAge, frailty index, and cognitive performance. METHODS: We conducted a Mendelian randomization (MR) study using published GWAS summary statistics. Aging biomarkers included telomere length (qPCR), facial aging (subjective evaluation), and epigenetic age markers (HannumAge, IEAA, GrimAge, PhenoAge). The frailty index was calculated from clinical assessments, and cognitive performance was evaluated with standardized tests. Analyses included Inverse-Variance Weighted (IVW), MR Egger, and Weighted Median (WM) methods, adjusted for multiple comparisons. RESULTS: CM was significantly associated with shorter telomere length (IVW: ß = - 0.1, 95% CI - 0.18 to - 0.02, pFDR = 0.032) and increased HannumAge (IVW: ß = 1.33, 95% CI 0.36 to 2.3, pFDR = 0.028), GrimAge (IVW: ß = 1.19, 95% CI 0.19 to 2.2, pFDR = 0.040), and PhenoAge (IVW: ß = 1.4, 95% CI 0.12 to 2.68, pFDR = 0.053). A significant association was also found with the frailty index (IVW: ß = 0.31, 95% CI 0.13 to 0.49, pFDR = 0.006). No significant associations were found with facial aging, IEAA, or cognitive performance. CONCLUSIONS: CM is linked to accelerated biological aging, shown by shorter telomere length and increased epigenetic aging markers. CM was also associated with increased frailty, highlighting the need for early interventions to mitigate long-term effects. Further research should explore mechanisms and prevention strategies.
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Envelhecimento , Biomarcadores , Análise da Randomização Mendeliana , Humanos , Análise da Randomização Mendeliana/métodos , Biomarcadores/sangue , Envelhecimento/genética , Epigênese Genética/genética , Masculino , Feminino , Fragilidade/genética , Criança , Estudo de Associação Genômica Ampla/métodos , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Telômero/genética , Adulto , Idoso , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Nonsuicidal self-injury (NSSI) is a serious problem in the adolescent population worldwide. Childhood trauma and bullying have been identified as risk factors for NSSI. We explored the relationships among Childhood trauma, Bullying victimization and the severity of NSSI behaviours, and test the effect of Bullying victimization in mediating the association between Childhood trauma and the NSSI behaviours. METHODS: A total of 123 adolescents were recruited. They were diagnosed with depression or depressive episodes of bipolar disorder and had experienced NSSI in the last year. They were assessed using the Chinese version of the Childhood Trauma Questionnaire (CTQ-C), the Revised Olweus Bullying Victimization Questionnaire (OBVQ-R), and the Adolescent Self-Harm Questionnaire (ASHQ). RESULTS: Females presented a significantly greater prevalence of sexual abuse and relationship bullying than boys. Individuals in the younger age group (10-14 years) presented a greater incidence of emotional neglect, verbal bullying, relationship bullying, and total bullying, and their NSSI score was also higher than that of those in the older age group (15-19 years). Only children show a greater prevalence of sexual abuse than nononly children. Single-parent families scored higher on emotional abuse, emotional neglect, physical neglect and physical bullying than two-parent families. There was a significant positive correlation between each dimension of childhood trauma and all the dimensions of bullying, between childhood trauma and NSSI, and between bullying and NSSI. Childhood trauma can not only directly affect the severity of NSSI but also indirectly aggravate the severity of NSSI through bullying victimization. The mediating effects of bullying victimization on emotional abuse, physical abuse, emotional neglect and physical neglect were 14%, 21%, 20%, 13% and 20%, respectively. CONCLUSION: There was a significant positive correlation between childhood trauma and bullying, between childhood trauma and NSSI, and between bullying and NSSI. Childhood trauma can not only directly affect the severity of NSSI but also indirectly aggravate the severity of NSSI through bullying victimization. Bullying victimization played the partial mediating effects between Childhood trauma and NSSI.
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Bullying , Vítimas de Crime , Comportamento Autodestrutivo , Humanos , Adolescente , Bullying/psicologia , Masculino , Feminino , Criança , Vítimas de Crime/psicologia , Comportamento Autodestrutivo/psicologia , Comportamento Autodestrutivo/epidemiologia , Experiências Adversas da Infância/psicologia , Fatores de Risco , Adulto Jovem , Maus-Tratos Infantis/psicologia , China/epidemiologia , Prevalência , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Child maltreatment is a broadly confirmed risk factor for mental and physical illness. Some psychological treatments specifically target mental health conditions associated with child maltreatment. For example, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) focuses on maladaptive interpersonal behaviours in chronic depression. However, how the assessment of child maltreatment could inform personalised treatment is unclear. We used data from a previously published clinical trial to investigate whether a pre-established child maltreatment clustering approach predicts differential outcomes after CBASP versus non-specific supportive psychotherapy in patients with early-onset chronic depression. METHODS: We did a cluster analysis of data from a previous randomised controlled trial of unmedicated adult outpatients with early-onset chronic depression who were treated at eight university clinics and psychological institutes in Germany with 32 sessions of CBASP or non-specific supportive psychotherapy. Participants were eligible for the original trial if they were aged 18-65 years; had major depressive disorder (MDD) with an early onset and duration of at least 2 years, current MDD superimposed on a pre-existing dysthymic disorder, or recurrent MDD with incomplete remission between episodes as defined by DSM-IV; and had a score of at least 20 points on the 24-item Hamilton Rating Scale for Depression (HRSD-24). Participants were included in the current study if they had completed the short form of the Childhood Trauma Questionnaire (CTQ) at trial baseline. We used an agglomerative hierarchical clustering approach to derive child maltreatment clusters from individual patterns across the five domains of the CTQ. We used linear mixed models to investigate whether clustering could predict differential clinical outcomes (change in symptom severity on the HRSD-24) up to 2 years after treatment onset. People with lived experience were involved in the current study. FINDINGS: 253 patients (129 [51%] treated with CBASP and 124 [49%] with supportive psychotherapy) had complete CTQ records and were included in the analysis. 169 (67%) participants were women, 84 (33%) were men, and the mean age was 45·9 years (SD 11·7). We identified seven child maltreatment clusters and found significant differences in treatment effects of CBASP and supportive psychotherapy between the clusters (F(6,948·76)=2·47; p=0·023); differences were maintained over the 2-year follow-up. CBASP was superior in distinct clusters of co-occurring child maltreatment: predominant emotional neglect (change in ß -6·02 [95% CI -11·9 to -0·13]; Cohen's d=-0·98 [95% CI -1·94 to -0·02]; p=0·045), predominant emotional neglect and abuse (-6·39 [-10·22 to -2·56]; -1·04 [-1·67 to -0·42]; p=0·0011), and emotional neglect and emotional and physical abuse (-9·41 [-15·91 to -2·91]; -1·54 [-2·6 to -0·47]; p=0·0046). INTERPRETATION: CTQ-based cluster analysis can facilitate identification of patients with early-onset chronic depression who would specifically benefit from CBASP. Child maltreatment clusters could be implemented in clinical assessments and serve to develop and personalise trauma-informed care in mental health. FUNDING: The German Research Foundation and the German Federal Ministry of Education and Research.
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Terapia Cognitivo-Comportamental , Transtorno Depressivo Maior , Testes Psicológicos , Autorrelato , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/terapia , Análise por Conglomerados , Terapia Cognitivo-Comportamental/métodos , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/terapia , Psicoterapia/métodos , Inquéritos e Questionários , Resultado do TratamentoRESUMO
BACKGROUND: Cognitive deficits might contribute to the elevated risk of life-course psychopathology observed in maltreated children. Leading theories about the links between childhood maltreatment and cognitive deficits focus on documented exposures (objective experience), but empirical research has largely relied on retrospective self-reports of these experiences (subjective experience), and the two measures identify largely non-overlapping groups. We aimed to test the associations of objective and subjective measures of maltreatment with cognitive abilities within the same individuals. METHODS: We studied a cohort of individuals from the US Midwest with both objective, court-documented evidence of childhood maltreatment and subjective self-reports of individuals' histories at age 29 years. Between the ages of 29 years and 41 years, participants were assessed with a comprehensive set of cognitive tests, including tests of general verbal intelligence (Quick Test and Wide Range Achievement Test-Revised [WRAT]), non-verbal intelligence (Matrix Reasoning Test [MRT]), executive function (Stroop Test and Trail Making Test Part B [TMT-B]), and processing speed (Trail Making Test Part A [TMT-A]). Participants were also assessed for psychopathology (Center for Epidemiologic Studies Depression Scale and Beck Anxiety Inventory). We tested the associations between objective or subjective measures of childhood maltreatment with cognitive functions using ordinary least squares regression. To test whether cognitive deficits could explain previously described associations between different measures of maltreatment and subsequent psychopathology, we re-ran the analyses accounting for group differences in the Quick Test. People with lived experience were not involved in the research or writing process. FINDINGS: The cohort included 1196 individuals (582 [48·7%] female, 614 [51·3%] male; 752 [62·9%] White, 417 [34·9%] Black, 36 [3·8%] Hispanic) who were assessed between 1989 and 2005. Of the 1179 participants with available data, 173 had objective-only measures of childhood maltreatment, 492 had objective and subjective measures, 252 had subjective-only measures, and 262 had no measures of childhood maltreatment. Participants with objective measures of childhood maltreatment showed pervasive cognitive deficits compared with those without objective measures (Quick Test: ß=-7·97 [95% CI -9·63 to -6·30]; WRAT: ß=-7·41 [-9·09 to -5·74]; MRT: ß=-3·86 [-5·86 to -1·87]; Stroop Test: ß=-1·69 [-3·57 to 0·20]; TMT-B: ß=3·66 [1·67 to 5·66]; TMT-A: ß=2·92 [0·86 to 4·98]). The associations with cognitive deficits were specific to objective measures of neglect. In contrast, participants with subjective measures of childhood maltreatment did not differ from those without subjective measures (Quick Test: ß=1·73 [95% CI -0·05 to 3·50]; WRAT: ß=1·62 [-0·17 to 3·40]; MRT: ß=0·19 [-1·87 to 2·24]; Stroop Test: ß=-1·41 [-3·35 to 0·52]; TMT-B: ß=-0·57 [-2·69 to 1·55]; TMT-A: ß=-0·36 [-2·38 to 1·67]). Furthermore, cognitive deficits did not explain associations between different measures of maltreatment and subsequent psychopathology. INTERPRETATION: Previous studies based on retrospective reports of childhood maltreatment have probably grossly underestimated the extent of cognitive deficits in individuals with documented experiences of childhood maltreatment, particularly neglect. Psychopathology associated with maltreatment is unlikely to emerge because of cognitive deficits, but might instead be driven by individual appraisals, autobiographical memories, and associated schemas. FUNDING: National Institute of Justice, National Institute of Mental Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute on Aging, Doris Duke Charitable Foundation, and National Institute for Health and Care Research.
Assuntos
Disfunção Cognitiva , Humanos , Feminino , Masculino , Adulto , Estudos de Coortes , Disfunção Cognitiva/psicologia , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/etiologia , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Criança , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Estados Unidos/epidemiologia , Testes Neuropsicológicos/estatística & dados numéricos , Autorrelato , Função Executiva , Meio-Oeste dos Estados Unidos/epidemiologiaRESUMO
Background: During the post-World War II occupation of Austria, approximately 20,000-30,000 'children born of war' (CBOW), also called occupation children were born through intimate contacts between Austrian women and occupation soldiers. Research on other CBOW populations indicates that CBOW mostly grow up under difficult conditions, sometimes with strong long-term mental health consequences.Objective: To examine whether comparable psychosocial consequences can be found in Austrian occupation children (AOC), a first quantitative study was carried out.Method: Child maltreatment, post-traumatic stress disorder, depression and somatization, and general life satisfaction were assessed in a sample of 98 AOC using self-report instruments. Results were compared to a sample of German occupation children (GOC; N = 146).Results: High prevalence of above threshold full (10.2%) and partial (14.3%) PTSD, somatic (16.3%) and depressive (11.1%) symptomatology were found in AOC. They were at high risk of child maltreatment (e.g. emotional abuse: 53.6%), which was associated with current symptomatology. Notably, AOC tended to report high levels of general life satisfaction. No differences were found between GOC and AOC.Conclusions: Findings highlight the complex and long-term effects of developmental conditions and childhood maltreatment on mental health of CBOW, even decades later. Findings of high life satisfaction provide evidence of resilience and maturation processes across the lifespan.
Austrian occupation children show a notable vulnerability to childhood maltreatment and its long-term consequences, including a high prevalence of above threshold PTSD, somatic, and depressive symptomatology.Findings on the psychosocial consequences of growing up as occupation children in Austria after World War II are consistent with previous studies in similar populations and can be generalized as more or less typical common experiences of children born of war.Despite psychological distress, occupation children showed surprising levels of life satisfaction, suggesting potential resilience.
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Maus-Tratos Infantis , Depressão , Transtornos de Estresse Pós-Traumáticos , Humanos , Áustria , Feminino , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Masculino , Criança , Depressão/psicologia , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , II Guerra Mundial , Prevalência , Militares/psicologia , Militares/estatística & dados numéricos , Satisfação Pessoal , AdolescenteRESUMO
OBJECTIVES: The focus of this review was to systematically review and meta-analyse the prevalence of ACEs among university students in the UK. METHOD: The systematic searching of six electronic databases (conducted February 2024) identified ten relevant articles (peer-reviewed articles of a quantitative nature that included ACE prevalence). PROSPERO reference: CRD42022364799. RESULTS: Pooled prevalence for number of ACEs endured was 55.4% (95% CI: 32.4% - 78.4%; I2 > 99.5%) for one or more, and 31.6% (7.5% - 55.6%; I2 > 99.5%) for three or more. Pooled prevalence was: 15.9% (7.0% - 24.7%; I2 > 94.5%) for physical abuse; 27.0% (18.1% - 35.9%; I2 > 94.5%) for emotional abuse; 12.1% (5.2% - 19.0%; I2 > 94.5%) for sexual abuse; 8.4% (1.7% - 15.1%; I2 > 95.4%) for physical neglect, and 30.0% (21.5% - 38.5%; I2 > 95.4%) for emotional neglect. Pooled prevalence for household dysfunction categories were: 34.4% (22.8% - 46.0%) for parental separation; 18.4% (10.1% - 26.8%) for domestic violence; 35.2% (23.6% - 46.8%) for mental health difficulties; 21.4% (12.9% - 29.9%) for substance use; and 5.7% (2.3% - 9.1%) for incarceration (I2 > 88.8% for all household dysfunction items). Significant heterogeneity was observed between studies for most categories of adversity, and it was not possible to explain/reduce this variance by removing small numbers of influential/discrepant studies. Further analyses suggested potential influences of measurement tool used, country of data collection, and age and sex of participants. CONCLUSION: Results demonstrate considerable, largely unaccounted-for, heterogeneity in estimates of the prevalence of ACEs, impeding confidence in any summary statistics. Conclusions must be tentative due to analyses being underpowered given small numbers of papers, as well as potential confounds, meaning results may not be truly representative. However, results do suggest high prevalence rates which warrant further investigation, with appropriate support offered to students.
Assuntos
Experiências Adversas da Infância , Estudantes , Feminino , Humanos , Masculino , Experiências Adversas da Infância/estatística & dados numéricos , Maus-Tratos Infantis/estatística & dados numéricos , Maus-Tratos Infantis/psicologia , Prevalência , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Reino Unido/epidemiologia , Universidades , Adulto JovemRESUMO
ABSTRACT: Schizophrenia is a debilitating mental health disorder that imposes profound economic, societal, and personal burdens. The negative symptoms of schizophrenia ( i.e. , blunted affect, alogia, anhedonia, asociality, and avolition) are highly prevalent and pervasive in the psychotic disorder and pose significant resistance to available treatment options. Traumatic childhood experiences are strongly linked with the risk of developing schizophrenia. Most prior studies have primarily focused on positive symptoms of schizophrenia ( e.g. , hallucinations and delusions), whereas less attention has been given to negative symptoms. The current study investigated the relationship between childhood trauma ( i.e. , physical abuse, sexual abuse, and emotional abuse and neglect) and negative symptoms in a sample of schizophrenia outpatients and healthy controls ( n = 159 participants, including 99 patients with schizophrenia). The observations from the current study revealed that schizophrenia patients experienced a significantly greater degree of childhood trauma and negative symptoms than the control individuals. The results of the current study also indicated that more severe experiences of total childhood trauma ( i.e. , summation of all trauma types), physical abuse, and emotional neglect may increase the risk of schizophrenia patients reporting negative symptoms. However, childhood sexual and emotional abuse was found to have no impact on the degree of negative symptoms experienced by schizophrenia patients. Implications and limitations of the current study are discussed. In conclusion, we found that the severity of overall childhood trauma, physical abuse, and emotional neglect may play an important role in increasing the likelihood of schizophrenia patients reporting negative symptoms.
Assuntos
Experiências Adversas da Infância , Esquizofrenia , Humanos , Masculino , Feminino , Esquizofrenia/epidemiologia , Adulto , Experiências Adversas da Infância/estatística & dados numéricos , Pessoa de Meia-Idade , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Psicologia do Esquizofrênico , Maus-Tratos Infantis/psicologia , CriançaRESUMO
BACKGROUND: Existing evidence suggests that children and adolescents who had experienced childhood maltreatment (CM) are at higher suicidal risk. However, the mediation role of resilience in this association remains unclear. We aim to investigate the mediation via resilience in the associations between CM and three suicidal risk indicators (suicidal ideation, SI; suicidal plan, SP; suicidal attempt, SA) among a large sample of Chinese children and adolescents. METHODS: A population-based cross-sectional survey was conducted in southwestern China Yunnan province. A total of 9723 children and adolescents were included and analyzed by using a multi-stage stratified cluster sampling design. Univariate and multivariate logistic regression models were fitted to explore the associations between CM, resilience, and the three suicidal risk indicators, dose-response trends further elucidated by using the restricted cubic splines. Path models were adopted to estimate the mediation of resilience. RESULTS: The estimated prevalence rates for one-year SI, SP and SA were 32.86% (95% CI: 31.93-33.80%), 19.36% (95% CI: 18.57-20.16%) and 9.07% (95% CI: 8.51-9.66%). After adjustment, CM significantly associated with all 3 suicidal risk indicators, and the odds ratios (ORs) were 2.13 (95% CI: 1.91-2.37), 2.45 (95% CI: 2.13-2.81), and 3.61 (95% CI: 2.90-4.52) for one-year SI, SP, and SA, respectively. Path models revealed that resilience significantly mediated the associations between CM and the three suicidal risk indicators, and among all dimensions of resilience, family support presented the strongest mediation consistently. CONCLUSIONS: Our study results suggest that intervention measures which focusing on improving psychological resilience might be effective in reducing suicidal risk for children and adolescents who had experienced maltreatment. Prospective studies should be done to corroborate our findings.
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Maus-Tratos Infantis , Resiliência Psicológica , Ideação Suicida , Humanos , Adolescente , China/epidemiologia , Feminino , Masculino , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Criança , Estudos Transversais , Fatores de Risco , Tentativa de Suicídio/estatística & dados numéricos , Tentativa de Suicídio/psicologia , Medição de Risco , População do Leste AsiáticoRESUMO
Objective: Unwanted, intrusive thoughts (UITs) of infant-related harm are a common postpartum phenomenon and can be classified into thoughts of accidental harm (TAHs) and thoughts of intentional harm (TIHs). Our study's objective was to complete a comprehensive, comparative analysis of TAHs and TIHs by commenting on their prevalence, course, characteristics (time, distress, and impairment) and most intense period.Methods: A total of 763 English-speaking pregnant women across British Columbia were recruited to participate in a prospective cohort study. Study data were collected between February 2014 and February 2017. UITs were assessed by semistructured interviews twice during the postpartum period.Results: The prevalence of TAHs and TIHs in the postpartum period was 95.8% and 53.9%, respectively. The most common TAHs included thoughts of the baby suffocating or dying from sudden infant death syndrome; the most common TIHs included thoughts of neglect. On average, TAHs are more prevalent, time-consuming, and result in greater interference compared to TIHs. The most intense period for TAHs (5.74 weeks postpartum) and TIHs (within first 8 weeks postpartum) was identified. During this period, over 40% of participants reported moderate or extreme distress related to UITs. For most, UITs decreased in frequency or completely resolved by 6 months postpartum, and most participants did not report clinically significant symptoms.Conclusion: UITs are a normative and typically self-resolving occurrence in the postpartum period. UITs' most intense period signifies a time of heightened vulnerability. Increased education is necessary to normalize and reduce distress associated with UITs.J Clin Psychiatry 2024;85(3):23m15145. Author affiliations are listed at the end of this article.
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Período Pós-Parto , Humanos , Feminino , Adulto , Prevalência , Estudos Prospectivos , Gravidez , Período Pós-Parto/psicologia , Colúmbia Britânica/epidemiologia , Lactente , Pensamento , Adulto Jovem , Maus-Tratos Infantis/estatística & dados numéricos , Maus-Tratos Infantis/psicologiaRESUMO
This study aims to reveal the relationship between childhood traumas and emotion regulation skills of obese and non-obese individuals. The research is a comparative-descriptive and correlational study. The obese group included 52 people with a BMI ≥ 30, and the non-obese group included 58 people with a BMI ≤ 25 kg/m2. Information Form, Childhood Trauma Questionnaire (CTQ), and Emotion Regulation Skills Questionnaire (ERSQ) were used in the study data. The rates of total childhood trauma and physical neglect were significantly higher in obese individuals (53.8 % vs. 32.8 %; 50 % vs. 22.4 %, respectively) than in non-obese individuals. Obese individuals were found to have lower emotion regulation skills. While a significant inverse relationship was found between childhood trauma and emotion regulation skills total and sub-dimension scores in obese individuals, no significant relationship was found in non-obese individuals. Psychiatric-mental health nurses can play an active role in the prevention and treatment of obesity by providing emotion regulation training to individuals in their roles as counselors and educators.
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Regulação Emocional , Obesidade , Humanos , Feminino , Masculino , Obesidade/psicologia , Adulto , Inquéritos e Questionários , Índice de Massa Corporal , Criança , Maus-Tratos Infantis/psicologiaRESUMO
Increasing empirical attention has been given to the role of adverse childhood experiences (ACEs) in the development and maintenance of body dysmorphic disorder (BDD). Yet, current research has predominantly focused on adult and nonclinical BDD samples, and little is known about relevance of ACEs in adolescent BDD. The present study examined (a) the frequency of ACEs in adolescents with a primary diagnosis of BDD (n = 50) versus obsessive compulsive disorder (OCD) (n = 50) and (b) the clinical profile of ACE-exposed youth with BDD. ACEs were ascertained through a systematic search of electronic patient records, as well as through a parent- and self-report screening item for exposure to traumatic events. Results showed higher rate of peer victimisation (74% vs. 38%) and child maltreatment (44% vs. 24%) among BDD versus OCD youths; sexual abuse was the most common type of child maltreatment documented in the BDD group (28%) according to patient records. Parent-reported exposure to traumatic events was also significantly higher in the BDD than the OCD group (40% vs. 18%, respectively). Clinical presentation and treatment outcomes did not differ between those with versus without a history of ACEs. The current study is the first to demonstrate that a range of ACEs are common in adolescent BDD. Our findings highlight the importance of screening for these experiences. Although further research is needed, our findings also indicate that adolescents with BDD who have a history of ACEs are broadly similar in their clinical presentation to those without, and benefit from BDD-focused treatment.
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Experiências Adversas da Infância , Transtornos Dismórficos Corporais , Maus-Tratos Infantis , Humanos , Adolescente , Transtornos Dismórficos Corporais/psicologia , Transtornos Dismórficos Corporais/epidemiologia , Feminino , Masculino , Experiências Adversas da Infância/estatística & dados numéricos , Experiências Adversas da Infância/psicologia , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/epidemiologia , CriançaRESUMO
BACKGROUND: Child maltreatment (CM) includes neglect, and several types of abuse, including physical, emotional, and sexual. CM has been associated with a wide range of mental illnesses. Literature examining these illnesses in mid-life is scarce, and the impact of these illnesses on mental health service use is currently unknown. OBJECTIVE: To examine associations between self-reported CM and subsequent hospital admissions for mental illnesses, and/or community mental health service contacts. SETTING: Birth cohort study data linked to administrative health data, including hospital admissions and community mental health service contacts, up to the age of 40. METHODS: Associations between hospital admissions for mental health and community mental health contacts and CM subtypes (neglect, physical abuse, emotional abuse and sexual abuse) were examined using multivariate logistic regression. RESULTS: Adjusted analyses showed that all subtypes of CM were significantly (p < 0.05) associated with admissions to hospital for any type of mental illness (aOR range 1.87-3.61), non-psychotic mental disorders (aOR range 1.98-3.61), alcohol and/or substance use (aOR range 2.83-5.43), and community mental health service contacts (aOR range 2.44-3.13). Hospital admissions for psychotic mental disorders were significantly associated with physical abuse, emotional abuse, and sexual abuse (aOR range 2.14-3.93). CONCLUSIONS: The results of this study confirm the current knowledge around CM and subsequent mental health illnesses up to the age of 40, and extend this knowledge to hospital and mental health service use.
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Serviços Comunitários de Saúde Mental , Hospitalização , Transtornos Mentais , Autorrelato , Humanos , Masculino , Feminino , Transtornos Mentais/epidemiologia , Adulto , Criança , Adolescente , Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Adulto Jovem , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Maus-Tratos Infantis/psicologia , Pré-Escolar , Estudos de CoortesRESUMO
BACKGROUND: Child neglect is prevalent in western rural China, yet there is limited research among ethnic minority communities. The Salar, a Turkic-Muslim ethnic minority residing primarily in western China, also face this specific problem. The group is deeply influenced by ethnicity, Islam and Chinese Confucianism, which in turn makes women vulnerable to child marriage and IPV. These victimizations, coupled with various life stressors, further complicate the challenges of providing adequate care for their children. OBJECTIVE: This study hypothesizes a relationship between child neglect and maternal child marriage, IPV victimization, and depression symptoms. PARTICIPANTS AND SETTING: 201 married Salar women from five villages in Xunhua Salar Autonomous County, China, were randomly selected to participate in the study. METHOD: A probability proportional to size (PPS) sampling approach was used to collect a random representative multi-stage cluster sample in 2022. Random effects Poisson regression models were used to test the hypotheses. RESULTS: The participants reported a 65.6 % rate of child neglect and a 30.8 % rate of IPV in the past year. 37.6 % experienced child marriage. Results revealed significant associations between child neglect and child marriage, IPV, and depression symptoms. A two-way interaction between IPV and depression symptoms was strongly positively associated with child neglect. CONCLUSIONS: This research indicates that Salar Muslim mothers who have experienced child marriage, adulthood victimization, and depression are at a higher risk of neglecting their children. The findings represent a valuable initial step toward researching and addressing the protection needs of women and children from Muslim ethnic minorities in China.
Assuntos
Depressão , Islamismo , Casamento , Humanos , Feminino , Adulto , China/epidemiologia , China/etnologia , Depressão/epidemiologia , Depressão/etnologia , Criança , Casamento/psicologia , Pessoa de Meia-Idade , Vítimas de Crime/psicologia , Vítimas de Crime/estatística & dados numéricos , Mães/psicologia , Mães/estatística & dados numéricos , Adulto Jovem , Adolescente , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Maus-Tratos Infantis/etnologiaRESUMO
BACKGROUND: The deleterious effects of experiencing adverse childhood experiences (ACEs), especially those associated with child abuse and neglect (CM-ACEs), is well documented. Two common behavioral and emotional concerns observed in children following CM-ACEs is post-traumatic stress and aggression. While support for cognitive models explaining both of these outcomes exists, little is known about any shared cognitive vulnerabilities that may explain the presence of both. OBJECTIVE: The purpose of the current study was to evaluate a cognitive model of vulnerability/safety as a shared underlying mechanism for the development of post-traumatic stress symptoms (PTSS) and aggression following the occurrence of CM-ACEs in children. METHODS: Male youth between the ages of 6 and 14 attending school within a residential setting participated in a school-based performance improvement program. As a part of the program, data were collected on the child's history of abuse, PTSS, aggression, and feelings of safety and vulnerability. RESULTS: The results of the SEM suggested that there was a significant serial indirect effect of vulnerability and PTSS on the relation between CM-ACEs and reactive aggression. This was not true for proactive aggression. DISCUSSION: The current results suggest that that there may be a shared schema-based model in which feelings of vulnerability and cognitive models promoting the world as an unsafe place may contribute to the maintenance and development of both PTSS and reactive aggression among children who have experienced abuse/neglect.
Assuntos
Experiências Adversas da Infância , Agressão , Maus-Tratos Infantis , Transtornos de Estresse Pós-Traumáticos , Humanos , Masculino , Criança , Agressão/psicologia , Adolescente , Transtornos de Estresse Pós-Traumáticos/psicologia , Maus-Tratos Infantis/psicologia , Experiências Adversas da Infância/psicologia , Experiências Adversas da Infância/estatística & dados numéricos , Modelos PsicológicosRESUMO
BACKGROUND: Neglect is a common form of child maltreatment and profoundly affects children's mental health globally. Self-compassion may help children cope with neglect but the role of self-compassion in neglect context has been understudied. This study identifies distinct patterns of self-compassion and child neglect and explores how neglect and self-compassion profiles correlate with child mental health. METHODS: The sample includes 3342 children aged 8-16 (49.6 % female) from a national survey of 29 provinces in China using a multistage sampling method. We used latent profile analysis to identify distinct profiles of self-compassion and neglect and examine their combined effects on child mental health, including both positive indicators (hope, resilience) and negative indicators (anxiety, depression, academic burnout, and peer problems). RESULTS: We identified four neglect/self-compassion profiles: Adaptable Self-Carers (average neglect/high self-compassion), Vulnerable Languishers (high neglect/low self-compassion), Stable Self-Soothers (low neglect/average self-compassion), and Opportune Thrivers (low neglect/high self-compassion). The Vulnerable Languishers group exhibited the poorest mental health outcomes, whereas the Opportune Thrivers showed the best outcomes. Adaptable Self-Carers, although experiencing more neglect than Stable Self-Soothers, had better mental health than the latter, possibly due to their greater self-compassion. LIMITATIONS: The cross-sectional design limits our ability to determine causality, and the use of self-reported measures increases response bias risk. CONCLUSIONS: More self-compassion and less neglect are associated with more positive mental health outcomes. Moreover, self-compassion is a potential protective factor against the adverse effects of neglect on child mental health. Fostering self-compassion may boost positive adjustment in children who have experienced neglect.
Assuntos
Maus-Tratos Infantis , Empatia , Saúde Mental , Autoimagem , Humanos , Feminino , Masculino , Criança , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Adolescente , China , Depressão/psicologia , Resiliência Psicológica , Ansiedade/psicologia , Adaptação PsicológicaRESUMO
BACKGROUND: It is well documented that childhood abuse increases the likelihood of emotional disorders particularly depressive symptoms. Childhood abuse might disrupt individuals' inhibitory control of emotional stimuli to increase the risk of depressive symptoms, and may differ in individuals' sensory processing sensitivity to the environment. OBJECTIVE: The current study aimed to examine the associations between childhood abuse and depressive symptoms among Chinese adolescents and test the mediating role of affective inhibitory control and the moderating role of sensory processing sensitivity in the relationship. METHODS: The childhood trauma questionnaire (CTQ), the highly sensitivity child scale (HSCS) and the center for epidemiological studies depression scale (CES-D) were administered to 234 junior school students who underwent the face-word Stroop task during which intraindividual reaction time variability (IIV) was calculated to assess affective inhibitory control. RESULTS: Childhood abuse was positively related to depressive symptoms. In addition, IIV under negative conditions partially mediated the relationship between childhood abuse and depressive symptoms. Sensory processing sensitivity moderated the mediation model, such that poor affective inhibitory control indexed by greater IIV under negative conditions was related to greater depressive symptoms in adolescents with high sensory processing sensitivity, but not in those with low sensory processing sensitivity. CONCLUSION: These findings suggest that disrupted affective inhibitory control of negative emotional stimuli serves as a potential mechanism linking childhood abuse with depressive symptoms, and is subjected to adolescent sensory processing sensitivity.
Assuntos
Maus-Tratos Infantis , Depressão , Inibição Psicológica , Humanos , Adolescente , Feminino , Masculino , Maus-Tratos Infantis/psicologia , Depressão/psicologia , Criança , Inquéritos e Questionários , Tempo de ReaçãoRESUMO
BACKGROUND: The cycle of violence highlights a strong correlation between child maltreatment and aggression. However, there remains a significant gap in the pathway models of the cycle of violence. Given the exceptionally high rates of child maltreatment and violent crime among Chinese drug users, it is essential to examine the mechanisms of the cycle of violence within this group. OBJECTIVE: The current study incorporates drug craving and impulsivity into the child maltreatment-aggression mechanism. We explore the potential mediating and moderating roles of these variables and further examine the heterogeneity. PARTICIPANTS AND SETTING: A total of 894 participants (Meanage = 38.30, SDage = 8.38) were recruited as the final sample. METHODS: We employed moderated mediation and serial mediation models to explore the roles of drug craving and impulsivity. The Johnson-Neyman method was utilized to investigate moderating effects. Rich demographic variables and depression were controlled. RESULTS: There was no direct relationship between child maltreatment and aggression. The moderated mediation model indicated that drug craving played a mediating role, and there was a substitutive relationship between impulsivity and drug craving. The serial mediation model showed that child maltreatment could only affect drug craving (not impulsivity) and could ultimately influence aggression through a chain relationship. Heterogeneity tests revealed that the mechanisms might differ among various types of maltreatment. CONCLUSION: Drug craving holds a significant position in the cycle of violence. Compared to impulsivity, it is a more proximal factor to child mistreatment. Future research should also focus on the heterogeneity of child maltreatment for targeted interventions.
Assuntos
Agressão , Maus-Tratos Infantis , Fissura , Comportamento Impulsivo , Humanos , Masculino , Agressão/psicologia , Feminino , Adulto , China , Maus-Tratos Infantis/psicologia , Criança , Usuários de Drogas/psicologia , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem , Análise de Mediação , População do Leste AsiáticoRESUMO
OBJECTIVE: This study aimed to assess perceptions and actions taken by Finnish dental professionals in suspected cases of child physical abuse (CPA) and to describe changes over 10 years. MATERIAL AND METHODS: Data collected from two child abuse and neglect (CAN) surveys among Finnish dental professionals, working in public health care, covering suspicions of CPA and actions taken as well as training on CPA issues, were compared. The chi-squared (χ2) test was used to analyze associations. RESULTS: In total, 625 (2008) and 1,025 (2019) questionnaires were completed. Respondents reported that they suspected CPA more frequently in 2008 than in 2019 (21.0% vs. 8.7%, p < 0.001). Out of all respondents, 1.1% had reported their concern to the police in 2019. Worries about the report's negative consequences to the child at home (44.5% vs. 56.4%, p < 0.001) and to the informer (30.2% vs. 36.3%, p = 0.016) increased between the surveys. The proportion of respondents with previous training on CPA issues increased between the surveys (5.9% vs. 36.4%, p < 0.001). CONCLUSIONS: Recognition of CPA was low and decreased over the years. Furthermore, mandatory reporting to the police was low. Additional education on issues related to CPA is needed.
Assuntos
Maus-Tratos Infantis , Odontólogos , Humanos , Finlândia , Maus-Tratos Infantis/psicologia , Inquéritos e Questionários , Masculino , Feminino , Criança , Odontólogos/psicologia , Adulto , Pessoa de Meia-Idade , Atitude do Pessoal de SaúdeRESUMO
Background: Although childhood maltreatment is associated with later self-harm, the mechanism through which it might lead to self-harm is not completely understood. The purpose of this study was to examine the roles of alexithymia, dissociation, internalizing and posttraumatic symptoms in the association between exposure to childhood maltreatment and subsequent self-harm.Methods: A total of 360 adolescents were asked to complete the Childhood Trauma Questionnaire, the Toronto Alexithymia Scale, the Dissociative Experience Scale, the Somatoform Dissociation Questionnaire-20, the Posttraumatic Stress Checklist for DSM-5, and the Deliberate Self-Harm Inventory.Results: Results of structural equation modelling analysis revealed the significant mediation effects of alexithymia and dissociative symptoms in the relationship between childhood maltreatment and self-harm, while internalizing and posttraumatic symptoms did not significantly mediate.Conclusion: The findings indicate that alexithymia and dissociative symptoms may be proximal mechanisms linking maltreatment exposure and adolescence self-harm.
Self-harm can be used as a maladaptive coping strategy in response to both hyper- and hypo-arousal symptoms.Alexithymia and dissociative symptoms may be proximal mechanisms linking maltreatment exposure and adolescent self-harm.Posttraumatic symptoms did not mediate the relationship between a history of childhood maltreatment and self-harm.
Assuntos
Sintomas Afetivos , Maus-Tratos Infantis , Transtornos Dissociativos , Comportamento Autodestrutivo , Transtornos de Estresse Pós-Traumáticos , Humanos , Sintomas Afetivos/psicologia , Feminino , Masculino , Comportamento Autodestrutivo/psicologia , Adolescente , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Transtornos Dissociativos/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários , Criança , Escalas de Graduação PsiquiátricaRESUMO
Importance: Child physical and emotional abuse and neglect may affect epigenetic signatures of accelerated aging several years after the exposure. Objective: To examine the longitudinal outcomes of early-childhood and midchildhood exposures to maltreatment on later childhood and adolescent profiles of epigenetic accelerated aging. Design, Setting, and Participants: This cohort study used data from the Future of Families and Child Wellbeing Study (enrolled 1998-2000), a US birth cohort study with available DNA methylation (DNAm) data at ages 9 and 15 years (assayed between 2017 and 2020) and phenotypic data at birth (wave 1), and ages 3 (wave 3), 5 (wave 4), 9 (wave 5), and 15 (wave 6) years. Data were analyzed between June 18 and December 10, 2023. Exposures: Emotional aggression, physical assault, emotional neglect, and physical neglect via the Parent-Child Conflict Tactics Scale at ages 3 and 5 years. Main Outcomes and Measures: Epigenetic accelerated aging (DNAmAA) was measured using 3 machine learning-derived surrogates of aging (GrimAge, PhenoAge, and DunedinPACE) and 2 machine learning-derived surrogates of age (Horvath and PedBE), residualized for age in months. Results: A total of 1971 children (992 [50.3%] male) representative of births in large US cities between 1998 and 2000 were included. Physical assault at age 3 years was positively associated with DNAmAA for PhenoAge (ß = 0.073; 95% CI, 0.019-0.127), and emotional aggression at age 3 years was negatively associated with PhenoAge DNAmAA (ß = -0.107; 95% CI, -0.162 to -0.052). Emotional neglect at age 5 years was positively associated with PhenoAge DNAmAA (ß = 0.051; 95% CI, 0.006-0.097). Cumulative exposure to physical assault between ages 3 and 5 years was positively associated with PhenoAge DNAmAA (ß = 0.063; 95% CI, 0.003-0.123); emotional aggression was negatively associated with PhenoAge DNAmAA (ß = -0.104; 95% CI, -0.165 to -0.043). The association of these measures with age 15 years PhenoAge DNAmAA was almost fully mediated by age 9 years PhenoAge DNAm age acceleration. Similar patterns were found for GrimAge, DunedinPACE, and PhenoAge, but only those for PhenoAge remained after adjustments for multiple comparisons. Conclusions and Relevance: In this cohort study, altered patterns of DNAmAA were sensitive to the type and timing of child maltreatment exposure and appeared to be associated with more proximate biological embedding of stress.