From childhood trauma to alcohol use disorder severity - significance of depressive symptoms and expectations towards analgesic effects of alcohol.

AIMS: The objective of the current study was to describe and analyse associations between childhood emotional abuse, severity of depressive symptoms, and analgesic expectations of drinking in individuals with alcohol use disorder (AUD). METHODS: A total of 240 individuals aged 43.85 ± 11.0 with severe AUD entering an inpatient, abstinence-based, and drug-free treatment program were assessed. The data on AUD severity, depressive symptoms, expectations towards the analgesic effects of alcohol and childhood emotional trauma was collected using questionnaire measures. The PROCESS SPSS macro for serial mediation with bootstrapping was used to test whether current severity of depressive symptoms and expectations towards analgesic effects of alcohol use serially mediated the association between childhood emotional abuse on AUD symptom severity. RESULTS: There was evidence for two simple mediated effects, whereby the severity of depressive symptoms mediated the association between childhood emotional abuse on AUD symptom severity, and expectations towards analgesic effects of alcohol mediated the association between childhood emotional abuse on AUD symptom severity. There was also evidence to support serial mediation whereby both severity of depressive symptoms and expectations towards analgesic effects of alcohol mediated the association between childhood emotional abuse on AUD symptom severity. CONCLUSIONS: It might be clinically relevant to address experiences of childhood emotional trauma, as well as individual expectations of analgesic effects of alcohol, in AUD treatment programs.

The association between emotional abuse in childhood and healthcare utilization in adulthood among sami and non-sami: the SAMINOR 2 questionnaire survey.

BACKGROUND: Emotional abuse in childhood is the most common type of childhood abuse worldwide and is associated with a variety of somatic and mental health issues. However, globally and in indigenous contexts, research on the associations between emotional abuse in childhood and somatic and mental specialist healthcare utilization in adulthood is sparse. AIM: The main aim of this study was to investigate the association between emotional abuse in childhood and somatic and mental specialist healthcare utilization in adulthood in Sami and non-Sami populations, and to examine whether this association differs between the two ethnic groups. METHOD: This study used cross-sectional data from the SAMINOR 2 Questionnaire Survey - a population-based study on health and living conditions in areas with Sami and non-Sami populations in Middle and Northern Norway. In total, 11 600 individuals participated in SAMINOR 2. Logistic regression was used to present the association between emotional abuse in childhood and somatic and mental specialist healthcare utilization. RESULTS: Emotional abuse in childhood was significantly associated with somatic specialist healthcare utilization in adulthood (fully adjusted odds ratio [OR] 1.31, 95% confidence interval [CI] 1.15-1.49), with no differences observed between ethnic groups. Emotional abuse in childhood was also associated with mental specialist healthcare utilization (fully adjusted OR 3.99, 95% CI 3.09-5.14), however this association was weaker among Sami (crude OR 2.38, 95% CI 1.37-4.13) compared with non-Sami (crude OR 5.40, 95% Cl 4.07-7.15) participants. CONCLUSIONS: Emotional abuse in childhood is associated with somatic and mental specialist healthcare utilization in adulthood, with a stronger association to mental healthcare utilization. The association between emotional abuse in childhood and mental specialist healthcare utilization was weaker among Sami than non-Sami participants. Future studies should investigate the reason for this ethnic difference. Our results highlight the need to strengthen efforts to prevent childhood abuse and develop strategies to reduce its societal and personal burden.

Effect of childhood emotional abuse on depression and anxiety in adulthood is partially mediated by neuroticism: Evidence from a large online sample.

Childhood trauma is widely recognized as a potential risk factor for psychiatric illness in adulthood, yet the precise mechanisms underlying this relationship remain incompletely understood. One proposed mechanism involves the impact of childhood trauma on personality development, particularly in relation to neuroticism, which may subsequently heighten susceptibility to psychiatric disorders. In this study, we aimed to investigate this hypothesis through an online survey involving 1116 participants (232 male, 21 %). Participants completed the Childhood Trauma Questionnaire (CTQ), assessing emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect, along with the Trait Self-Description Inventory (TSDI) for personality assessment and the PHQ-9 and GAD-7 clinical questionnaires for depression and anxiety symptoms evaluation, respectively. Our analyses revealed significant positive correlations between all facets of childhood trauma and neuroticism (all p < .01). Linear regression analysis demonstrated that emotional abuse significantly contributed to neuroticism (ß = 0.267, p < .05), openness (ß = 0.142, p < .05), and agreeableness (ß = 0.089, p < .05), while sexual abuse was associated with agreeableness (ß = 0.137, p < .01) Emotional neglect was negatively correlated with conscientiousness (ß = -0.090, p < .01), extroversion (ß = -0.109, p < .01) and agreeableness (ß = -0.154, p < .01). Furthermore, linear regression analysis revealed that emotional abuse was positively and significantly correlated with PHQ-9 and GAD-7 scores (r = 0.330, p < .01 and r = 0.327, p < .01, respectively). Mediation analysis supported a significant mediating role of neuroticism in the association between childhood emotional abuse and both depression (PHQ-9) (z = 8.681, p < .01) and anxiety (GAD-7) (z = 9.206, p < .01). Notably, the correlation between childhood emotional abuse and psychiatric symptoms was attenuated but not eliminated after controlling for neuroticism, suggesting partial mediation. While our cross-sectional design precludes causal inference, our findings support the notion that childhood emotional abuse may contribute to increased neuroticism, thereby elevating vulnerability to affective disorders in adulthood. These results underscore the importance of considering personality factors in understanding the long-term consequences of childhood trauma on mental health outcomes.

Aberrant salience mediates the interplay between emotional abuse and positive symptoms in schizophrenia.

INTRODUCTION: Childhood trauma and adversities (CTA) and aberrant salience (AS) have a pivotal role in schizophrenia development, but their interplay with psychotic symptoms remains vague. We explored the mediation performed by AS between CTA and psychotic symptomatology in schizophrenia. METHODS: We approached 241 adults suffering from schizophrenia spectrum disorders (SSDs), who have been in the unit for at least 12 consecutive months, excluding the diagnosis of dementia, and recent substance abuse disorder, and cross-sectional evaluated through the Aberrant Salience Inventory (ASI), Childhood Trauma Questionnaire Short-Form (CTQ-SF), and Positive and Negative Symptom Scale (PANSS). We tested a path-diagram where AS mediated the relationship between CTA and psychosis, after verifying each measure one-dimensionality through confirmatory factor analysis. RESULTS: The final sample comprised 222 patients (36.9% female), with a mean age of 42.4 (± 13.3) years and an average antipsychotic dose of 453.6 (± 184.2) mg/day (chlorpromazine equivalents). The mean duration of untreated psychosis was 1.8 (± 2.0) years while the mean onset age was 23.9 (± 8.2) years. Significant paths were found from emotional abuse to ASI total score (ß = 0.39; p < .001) and from ASI total score to PANSS positive (ß = 0.17; p = .019). Finally, a statistically significant indirect association was found from emotional abuse to PANSS positive mediated by ASI total score (ß = 0.06; p = .041; CI 95% [0.01, 0.13]). CONCLUSION: Emotional abuse has an AS-mediated effect on positive psychotic symptomatology. AS evaluation could allow a better characterization of psychosis as well as explain the presence of positive symptoms in adults with SSDs who experienced CTA.

Maternal childhood emotional abuse increases cardiovascular responses to children's emotional facial expressions.

Parents with a history of childhood maltreatment may be more likely to respond inadequately to their child's emotional cues, such as crying or screaming, due to previous exposure to prolonged stress. While studies have investigated parents' physiological reactions to their children's vocal expressions of emotions, less attention has been given to their responses when perceiving children's facial expressions of emotions. The present study aimed to determine if viewing facial expressions of emotions in children induces cardiovascular changes in mothers (hypo- or hyper-arousal) and whether these differ as a function of childhood maltreatment. A total of 104 mothers took part in this study. Their experiences of childhood maltreatment were measured using the Childhood Trauma Questionnaire (CTQ). Participants' electrocardiogram signals were recorded during a task in which they viewed a landscape video (baseline) and images of children's faces expressing different intensities of emotion. Heart rate variability (HRV) was extracted from the recordings as an indicator of parasympathetic reactivity. Participants presented two profiles: one group of mothers had a decreased HRV when presented with images of children's facial expressions of emotions, while the other group's HRV increased. However, HRV change was not significantly different between the two groups. The interaction between HRV groups and the severity of maltreatment experienced was marginal. Results suggested that experiences of childhood emotional abuse were more common in mothers whose HRV increased during the task. Therefore, more severe childhood experiences of emotional abuse could be associated with mothers' cardiovascular hyperreactivity. Maladaptive cardiovascular responses could have a ripple effect, influencing how mothers react to their children's facial expressions of emotions. That reaction could affect the quality of their interaction with their child. Providing interventions that help parents regulate their physiological and behavioral responses to stress might be helpful, especially if they have experienced childhood maltreatment.

Health service providers experience of psycho-emotional violence and associated factors among urban hospitals in Eastern Ethiopia.

Background: Psycho-emotional violence, a type of workplace violence targeting healthcare workers, varies across countries, occasions, and professions in the healthcare sector. Unfortunately, there is a scarcity of comprehensive studies focusing on violence against healthcare workers in Ethiopia, which may also encompass psycho-gender-based emotional violence against healthcare workers. Therefore, there is a compelling need for in-depth research to address this gap and develop effective strategies to mitigate psycho-emotional violence in the healthcare sector in Ethiopia, especially in the eastern region. Hence, we aimed to identify the prevalence of and factors associated with workplace psycho-emotional violence against healthcare providers in eastern Ethiopia. Methods: This institution-based cross-sectional study was conducted among 744 health professionals working in urban public hospitals in eastern Ethiopia. Multistage stratified random sampling was used, and data were collected using a standardized structured tool adopted from the WHO workplace violence assessment tool. Binary and multivariable logistic regression analyses were employed to identify factors associated with psycho-emotional workplace violence. Adjusted odds ratio (OR) with 95% confidence interval (CI) was reported, and a p-value of 0.05 was used as the cut-off point to declare significance. Results: Workplace psycho-emotional violence was reported by 57.39% of the healthcare workers. The absence of guidelines for gender-based abuse [AOR = 35.62, 95% CI:17.47, 72.64], presence of measures that improve surroundings (class lighting and privacy) [AOR = 0.58, 95% CI: 0.35, 0.98], training on workplace violence coping mechanism [AOR = 0.16, 95%CI: 0.26, 0.98], spending more than 50% of their time with HIV/AIDS patients [AOR = 1.96, 95%CI:1.05, 3.72], and spending more than 50% of their time with psychiatric patients [AOR = 1.92, 95%CI:1.08, 3.43] were factors significantly associated with workplace violence against health professionals. Conclusion: The prevalence of workplace psycho-emotional violence against health professionals in eastern Ethiopia was relatively high. Improving the working environment decreases the chance of workplace violence; however, there is a lack of guidelines for gender-based violence, the absence of training on coping mechanisms, and spending more time with psychiatric and HIV/AIDS patients' increases workplace violence. We recommend that health institutions develop gender abuse mitigation guidelines and provide training on coping mechanisms.

Relationship Between Exposure to Emotional Neglect and the Inflammatory Biomarkers Neutrophil-to-Lymphocyte, Monocyte-to-Lymphocyte, and Platelet-to-Lymphocyte Ratios in Patients With First-Episode Psychosis.

Aim: To assess whether exposure to childhood traumatic experiences is linked to the inflammatory markers neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) in people with a first-episode psychosis.Methods: A cross-sectional study was performed in 83 patients (21 females and 62 males) with a diagnosis of a first psychotic episode. All participants completed the self-reported Spanish version of the Childhood Trauma Questionnaire (CTQ). NLR, MLR, and PLR were calculated in each patient.Results: Highest CTQ scores were noted on the emotional neglect and abuse domains (mean ± SD = 10.92 ± 4.41; mean ± SD = 10.93 ± 4.78, respectively), being lowest for the sexual abuse domain (mean ± SD = 6.12 ± 2.41). Backward stepwise linear regressions showed that high emotional neglect significantly predicted increased PLR (ß = 0.452, P = .036), older age and high emotional neglect predicted increased NLR (ß = 0.483, P = .036; ß = 0.442, P = .06, respectively), and high emotional neglect, low physical neglect, high total Positive and Negative Syndrome Scale (PANSS) score, and cannabis and alcohol use predicted increased MLR (ß = 0.698, P = .003; ß = 0.672, P = .033; ß = 0.296, P = .027; ß = 0.390, P = .069; ß = 0.560, P = .078, respectively).Conclusions: Our results highlight the relationship between the exposure to emotional neglect and the inflammatory biomarkers NLR, MLR, and PLR in patients with a first-episode psychosis. This study has benefitted from controlling for confounders such as body mass index, smoking status, symptom severity, and alcohol and cannabis use.

The effect of exposure to emotional violence on sexual function, sexual quality of life and psychological well-being in women: Structural equation modeling.

Emotional violence is all of the destructive behaviors that humiliate the individual and cause him/her to feel under pressure to disrupt mental health. These destructive behaviors can affect women's sexuality. In this study, it was aimed to determine the effect of exposure to emotional violence on sexual function, sexual life quality, and psychological well-being in women. The study was conducted in a descriptive and relational screening model. The sample of the study consisted of 213 women. Personal information forms, the female sexual function index, the sexual quality of life questionnaire, the exposure to emotional violence scale, and the psychological well-being scale were used in the study. Structural equation modeling was used to determine the direct and indirect predictive power of the independent variable on the dependent variable. The effect of exposure to emotional violence on psychological well-being (ß = -0.323; p < 0.001), and the effect of quality of sexual life on psychological well-being were statistically significant (ß =0.315; p < 0.001). Moreover, the effect of exposure to emotional violence on sexual life quality was determined to be statistically significant (ß = -0.665; p < 0.001). The effect of quality of sexual life on female sexual function was statistically significant (ß = -0.288; p = 0.002). Furthermore, while the effect of psychological well-being on the female sexual function index was not statistically significant (ß = -0.101; p = 0.266), the effect of exposure to emotional violence scale on the female sexual function index was statistically significant (ß = -0.087; p = 0.373). The mediating role of exposure to emotional violence in the relationship between sexual life quality and psychological well-being was high. Furthermore, the sexual life quality of 43.6 % of women was explained by exposure to emotional violence. On the other hand, 28.7 % of psychological well-being score was explained by the sexual life quality and exposure to emotional violence.

The relationship between childhood maltreatment subtypes and adolescent internalizing problems: The mediating role of maladaptive cognitive emotion regulation strategies.

BACKGROUND: While childhood maltreatment is understood to be a significant risk factor for adolescent internalizing problems (depression and anxiety), underlying mechanisms linking each type of maltreatment to internalizing problems in adolescents remain unclear. Moreover, the current state of knowledge regarding the associations between maladaptive cognitive emotion regulation strategies and each type of maltreatment, as well as their impact on adolescent internalizing problems, is limited. Additionally, it remains unclear whether these maladaptive strategies mediate this relationship. OBJECTIVE: This study sought to investigate the effects of childhood maltreatment types on adolescent internalizing problems and to explore whether the overall and specific types of maladaptive strategies mediate these associations. METHODS: Using a cross-sectional design, adolescents (N = 7071, Mage = 14.05 years, SDage = 1.54) completed online questionnaires assessing childhood maltreatment, maladaptive cognitive emotion regulation strategies (including rumination, catastrophizing, self-blame, and other-blame), anxiety, and depression. The hypothesized mediating effects were tested using the Lavaan package in R software (4.1.2). RESULTS: Different maltreatment types had varying effects on adolescent internalizing problems. Emotional neglect, emotional abuse, and sexual abuse significantly affected anxiety and depression, whereas physical neglect and physical abuse did not. Other than physical neglect and physical abuse, overall maladaptive strategies mediated the relationship between the other three types of maltreatment (emotional abuse, emotional neglect, and sexual abuse) and internalizing problems (anxiety and depression). For specific maladaptive strategies, rumination mediated the effects of physical abuse, emotional abuse, emotional neglect, and sexual abuse on internalizing problems (anxiety and depression). In contrast, catastrophizing mediated the relationship between physical neglect, emotional abuse, emotional neglect, sexual abuse and internalizing problems (anxiety and depression). CONCLUSIONS: These results suggest that the effects of maltreatment types on internalizing problems are different and that maladaptive strategies, particularly rumination and catastrophizing, are important mechanisms through which childhood maltreatment affects internalizing problems. This is a reminder that mental health workers need to consider the different effects of maltreatment types when intervening and recognize the importance of prioritizing interventions for rumination and catastrophizing.

Prevalence, pattern and predictors of intimate partner violence amongst female undergraduates in Abia State, Nigeria; public health implications.

BACKGROUND: Intimate Partner Violence (IPV) is the range of sexually, psychologically and physically coercive acts used against adult and adolescent women by a current or former male partner. It is a major public health problem globally. This study determined the prevalence, patterns and predictors of IPV amongst female undergraduates in Abia State. METHODS: A cross-sectional study was conducted from January - February 2022 amongst 306 female undergraduates in Abia State. A mixed method of an online structured questionnaire created on Google forms & onsite self-administered questionnaire were deployed for data collection. Descriptive, bivariate and multivariate analyses were done using IBM SPSS Version 26.0. The level of significance was set at 5%. RESULTS: A total of 306 respondents participated in the survey. The overall prevalence of IPV amongst female undergraduates was 51.2% (95% CI: 44.8-57.6%). Emotional abuse was the most common form of abuse 78.9%, followed by Physical abuse 42.0% and Sexual abuse 30.8%. Predictors of IPV reported include female earning/receiving more than their partner monthly (aOR = 2.30; 95% CI: 1.20-4.41); male (partner) alcohol consumption (aOR = 5.17; 95% CI: 2.46-10.88), being a smoker of cigarette/marijuana (aOR = 11.01; 95% CI: 1.26-96.25) and having witnessed domestic violence as a child (aOR = 3.55; 95% CI: I.56-8.07). Adverse effects such as unwanted pregnancies (12%), miscarriages (10%), eating/sleeping disorders (21%) and bruises (23%) amongst others were noted in some of the victims. CONCLUSION: Over half of all female undergraduates in Abia State have experienced IPV with emotional abuse being the commonest. Some Individual and relationship factors were identified as predictors of IPV. We recommend intensifying primary prevention campaigns against risk factors identified like smoking and alcohol consumption.

Associations between emotional maltreatment, depression and self-harm among Chinese adolescents: A three-wave longitudinal mediation model.

BACKGROUND: Self-harm seriously endangers adolescents' physical and mental health. However, the longitudinal mechanism of self-harm is not yet clear. OBJECTIVE: This study explored the inconsistent relationships between two types of emotional maltreatment and self-harm across three waves, regarding depression as a potential mediator and gender as a moderator of these associations. PARTICIPANTS AND SETTING: A sample of 588 Chinese adolescents (Mage at T1 = 12.79 years) in a middle school completed the assessment of demographic information, emotional maltreatment, depression and self-harm within one year. METHODS: Path analysis models were created to estimate the relationship of emotional maltreatment with self-harm and the mediating effect of depression. A multi-group analysis was applied to investigate the moderating effect of gender. RESULTS: There existed positive associations between emotional abuse at T1 and self-harm at T2 and T3 (ß = 0.12, SE = 0.05, p = 0.006; ß = 0.09, SE = 0.05, p = 0.054), and the mediating effect of emotional abuse at T1 on self-harm at T3 via depression at T2 was significant (Indirect effect = 0.05, SE = 0.02, 95 % CI [0.02, 0.08]). Multi-group analysis of gender revealed no significant differences in the cross-lagged pathways, but there were stronger links for girls than boys among self-harm at T1, T2, and T3 (p < 0.001). CONCLUSIONS: Emotional abuse but not emotional neglect could significantly predict self-harm. Furthermore, depression played a mediating role in the longitudinal relationship between emotional abuse and self-harm. Girls who had high levels of self-harm at a previous time point were more inclined than boys to harm themselves at a subsequent time point. These findings provide a different perspective to develop effective prevention and intervention measures.

The mediating role of trait mindfulness and dissociative experiences in the relationship between childhood emotional abuse and problematic internet use in Italian adolescents.

There is clear evidence linking trauma, mindfulness, dissociation and problematic internet use (PIU). Nonetheless, little is known about the role trait mindfulness and dissociative experiences may have in the relationship between childhood emotional abuse (CEA) and PIU, as well as the role that gender may have in such relationships. In the current research, self-report questionnaires on CEA, trait mindfulness, dissociative experiences and PIU were administered to 1074 Italian adolescents (50% females) aged 14-17 years old, to test whether trait mindfulness and dissociative experiences mediated the relationship between CEA and PIU, and whether the proposed mediation was invariant across genders. Furthermore, the main analyses were controlled for background variables. The findings highlighted significant associations between all direct and indirect paths and invariance of the mediation model across boys and girls. The results of this study highlight that emotionally abused boys and girls with high levels of dissociation and inadequate mindful skills may be more exposed to dysfunctional online activities. Hence, developing dissociation-focused and mindfulness-based interventions for emotionally abused adolescents may be clinically effective when building tailored approaches for the prevention and management of PIU. Further implications are discussed.

Comentários nas mídias sociais e a banalização da violência psicológica contra as mulheres / Comments on social media and the trivialization of psychological violence against women / Comentarios en las redes sociales y la banalización de la violencia psicológica contra las mujeres

A violência psicológica é frequente, porém, de difícil detecção, muitas vezes presente em relacionamentos abusivos e confundida com ciúmes e cuidado. Nas mídias sociais isso pode ser incentivado através de postagens, assim como pode servir de espaço de suporte e compartilhamento de experiências. Objetivou-se analisar comentários publicados em mídias sociais relacionados à violência contra a mulher e sua associação à violência psicológica. Utilizou--se o método da netnografia, através de análise textual dos comentários de um vídeo publicado na rede social Facebook chamado: "Não confunda amor com abuso". Foram transcritos 571 comentários da publicação, sendo o corpus analisado pelo software Iramuteq. Os comentários analisados mostram que questões culturais contribuem para a banalização da violência contra a mulher, principalmente da violência psicológica, pois geralmente só é considerado como violência quando há agressão física. Percebe-se a importância de um trabalho de psicoeducação, como por exemplo através de vídeos orientativos, visando a conscientização da população e possível redução da violência. (AU)

Psychological violence is frequently encountered but often difficult to detect, as it is commonly present in abusive relationships and can be mistaken for jealousy and care. In the realm of social media, it can either be encouraged through posts or serve as a space for support and the sharing of experiences. The objective of this study was to analyze comments posted on social media platforms related to violence against women and its association with psychological violence. The netnography method was employed, involving textual analysis of comments on a video posted on the social media platform Facebook, titled "Não confunda amor com abuso" (Do Not Confuse Love with Abuse). A total of 571 comments from the post were transcribed and analyzed using the Iramuteq software. The analyzed comments reveal that cultural factors contribute to the trivialization of violence against women, particularly psychological violence, since the term violence is often only recognized when it escalates to physical aggression. The significance of psychoeducational efforts, such as informative videos, becomes apparent in raising awareness among the population and potentially reducing instances of violence. (AU)

La violencia psicológica es frecuente, sin embargo, difícil de detectar, a menudo presente en relaciones abusivas y confundida con celos y cuidados. En las redes sociales, esto se puede fomentar a través de publicaciones, así como un espacio de apoyo e intercambio de experiencias. El objetivo fue analizar los comen-tarios publicados en las redes sociales relacionados con la violencia contra las mujeres y su asociación con la violencia psicológica. Se utilizó el método de la netnografía, mediante el análisis textual de los comentarios de un video publicado en la red social Facebook denominado: "Não confunda amor com abuso". Se transcribieron 571 comentarios de la publicación, siendo analizado el corpus por el software Iramuteq. Los comentarios analizados muestran que las cuestiones culturales contribuyen a la banalización de la violencia contra a mujer, especialmente la psicológica, ya que generalmente solo se considera violencia cuando hay agresión física. Uno se da cuenta de la importancia del trabajo psicoeducativo, por ejemplo, a través de videos de orientación, desti-nados a sensibilizar a la población y posible reducción de la violencia. (AU)

Women's perspectives on disrespect and abuse during facility-based childbirth in Ethiopia: a qualitative study.

BACKGROUND: Disrespect and abuse violates women's basic human rights and autonomy and can traumatize women who are already in a vulnerable position during childbirth and deter them from utilizing skilled care for future childbirth. This study explored women's perspectives on the acceptability of disrespect and abuse during facility-based childbirth in Ethiopia. METHODS: A qualitative descriptive design using five focus group discussions and fifteen in-depth, semi-structured, interviews was conducted with women between October 2019 to January 2020 in north Showa zone of Oromia region, central Ethiopia. Using purposive sampling, women who had given birth at public health facilities of North Showa zone during the twelve months preceding data collection were recruited, regardless of birth outcome. Inductive thematic analysis using Open Code software was used to explore the perspectives of participants. RESULTS: While women reject disrespectful and abusive acts during childbirth generally, they may consider some disrespectful acts as acceptable and or necessary under certain circumstances. Four emerging themes were identified. (1) Disrespect and abuse is not acceptable, (2) Disrespectful and abusive actions are acceptable only if intended to save lives, (3) Disrespectful and abusive actions are an accepted part of everyday practice to prevent complications and adverse outcomes, (4) Disrespectful and abusive actions are necessary to discipline disobedient women. CONCLUSION: Women's perceptions of disrespectful and abusive acts of care providers is deeply rooted within the context of violence in Ethiopia and the societal hierarchies that have systematically disempowered women. Given the pervasiveness of disrespect and abusive actions during childbirth, policymakers, clinical managers and care providers must take these essential contextual and societal norms into account and devise comprehensive clinical interventions that addresses the root causes.

Perceived abusive supervision and graduate students' suicidal ideation: from the perspective of interpersonal psychological theory of suicide.

BACKGROUND: In recent years, the issue of suicide caused by the stress of a contradictory relationship between graduate students and academic supervisors has aroused heated discussion in society. Based on the interpersonal psychological theory of suicide, this study aims to examine the influence of the perceived abusive supervision on graduate students' suicidal ideation and the parallel mediating roles of thwarted belongingness and perceived burdensomeness. METHODS: We conducted a cross-sectional online survey measuring perceived abusive supervision, interpersonal psychological needs and suicidal ideation among 232 Chinese graduate students. A structural equation model was constructed to test the hypothesis. RESULTS: The results showed that abusive supervision directly exacerbated suicidal ideation (ß = 0.160, 95% CI = [0.038, 0.281], p = 0.009) and indirectly influenced suicidal ideation through thwarted belongingness (ß = 0.059, 95% CI = [0.008, 0.110], p = 0.019) and perceived burdensomeness (ß = 0.102, 95% CI = [0.013, 0.191], p = 0.018). The indirect effect accounted for 50.15% of the overall effect. CONCLUSIONS: These findings enrich our understanding of the influence of supervisor-student relationship by integrating the literatures on educational and organizational behaviour, and provide practical insights for psychosocial interventions from the perspective of the interpersonal psychological theory of suicide.

Association between intimate partner violence and male alcohol use and the receipt of perinatal care: Evidence from Nepal demographic and health survey 2011-2016.

The utilization of perinatal care services among women experiencing intimate partner violence (IPV) and male alcohol use is a major problem. Adequate and regular perinatal care is essential through the continuum of pregnancy to mitigate pregnancy and birth complications. The aim of this study is to determine the association between IPV and male alcohol use and the receipt of perinatal care in Nepal. This study used pooled data from 2011 and 2016 Nepal Demographic and Health Surveys (NDHS). A total of 3067 women who interviewed for domestic violence module and had most recent live birth 5 years prior surveys were included in the analysis. Multivariable logistic regression analysis was performed to determine the association between IPV and male alcohol use and the receipt of perinatal care. Of the total women interviewed, 22% reported physical violence, 14% emotional violence, and 11% sexual violence. Women who were exposed to physical violence were significantly more likely to report non-usage of institutional delivery [adjusted Odds Ratio (aOR) = 1.30 (95% Cl: 1.01, 1.68)] and skilled delivery assistants [aOR = 1.43 (95% Cl: 1.10, 1.88)]. Non-attendance of 4 or more skilled antenatal care visits was associated with a combination of alcohol use by male partner and exposure to emotional [aOR = 1.42 (95% Cl: 1.01, 2.00)] and physical violence [aOR = 1.39 (95% Cl: 1.03, 1.88)]. The negative association between IPV and perinatal care suggests it is essential to develop comprehensive community-based interventions which integrates IPV support services with other health services to increase the uptake of perinatal care through the continuum of pregnancy.

The impact of group psychological abuse on distress: the mediating role of social functioning and resilience.

Background: Previous studies indicate that social functioning and resilience can mitigate the adverse psychological effects of interpersonal violence. Unfortunately, the role of these variables has not been studied in survivors of groups, organizations, and communities in which psychological abusive strategies are inflicted to recruit and dominate their members. Objective: To examine the mediating role of social functioning and resilience in the relationship between psychological abuse experienced in the past while in a group and current psychosocial distress and psychopathological symptoms. Method: In this cross-sectional study, an online questionnaire was administered to 794 English-speaking former members of different kinds of groups, such as religious, pseudo therapeutic, pyramid scheme groups, and others. Among them, 499 were victims of group psychological abuse and 295 were non-victims. Results: Victims of group psychological abuse reported lower levels of social functioning and resilience than non-victims, and higher levels of psychosocial difficulties and psychopathological symptoms. Serial mediation analyses revealed that social functioning and resilience mediated part of the impact of group psychological abuse on psychosocial difficulties and psychopathological symptoms. Sex and age joining the group were included as covariates. Participants who had experienced higher levels of group psychological abuse tend to have poorer social functioning, which is related to lower resilience. In turn, lower levels of social functioning and resilience are related with higher distress. Conclusions: This research sheds light on the underlying mechanisms involved in the relationship between group psychological abuse and distress suffered following this kind of traumatic experiences. Findings highlight the protective role of social adjustment, which can help promote and enhance resilience and mitigate psychosocial difficulties and psychopathological symptoms in survivors of group psychological abuse.

Antecedentes: Estudios previos indican que la adaptación social y la resiliencia pueden mitigar los efectos psicológicos adversos de situaciones de violencia interpersonal. Desafortunadamente, no se ha estudiado aún el rol de estas variables en supervivientes de grupos, organizaciones y comunidades en las cuales se aplican estrategias de abuso psicológico para reclutar y dominar a sus miembros.Objetivo: Examinar el rol mediador de la adaptación social y la resiliencia en la relación entre el abuso psicológico experimentado en un grupo en el pasado y el malestar psicosocial y síntomas psicopatológicos sufridos en la actualidad.Método: Se diseñó un estudio transversal y se administró un cuestionario online a 794 personas de habla inglesa exmiembros de grupos de distinta naturaleza, como religiosos, pseudo terapéuticos, de estructura piramidal, u otros. De ellas, 499 fueron víctimas de abuso psicológico en grupo y 295 personas no fueron víctimas.Resultados: Las víctimas de abuso psicológico en grupos reportaron menores niveles de adaptación social y resiliencia que las personas que no fueron víctimas, y mayores niveles de dificultades psicosociales y síntomas psicopatológicos. Los análisis de mediación en serie revelaron que la adaptación social y la resiliencia mediaron parte del impacto del abuso psicológico en las dificultades psicosociales y los síntomas psicopatológicos. El sexo y la edad de entrada al grupo fueron introducidos como covariantes. Los participantes que han experimentado mayores niveles de abuso psicológico en grupos tienden a tener menor funcionamiento social, lo que está relacionado con menor resiliencia. En consecuencia, menores niveles de funcionamiento social y resiliencia se relacionan con mayor malestar.Conclusiones: Este estudio ayuda a comprender los mecanismos subyacentes implicados en la relación del abuso psicológico en grupos y el malestar sufrido después de este tipo de experiencias traumáticas. Los hallazgos resaltan la importancia del rol protector de la adaptación social, el cual puede ayudar a promover y mejorar la resiliencia y a mitigar las dificultades psicosociales y síntomas psicopatológicos en supervivientes de abuso psicológico en grupos.

Trauma-focused cognitive-behavioral therapy (TF-CBT) for interpersonal trauma in transitional-aged youth.

OBJECTIVE: Posttraumatic stress disorder (PTSD) following interpersonal trauma in transitional-aged youth (TAY), aged 15 to 25, is highly prevalent; however, evidence-based interventions have rarely been studied. METHOD: A single-group pre-/posttest study was conducted at headspace Sunshine, Melbourne, Australia, evaluating the feasibility, acceptability, safety, tolerability, and potential clinical effectiveness of trauma-focused cognitive-behavioral therapy (TF-CBT). RESULTS: An intent-to-treat analysis was conducted for N = 20 participants (65% female, n = 13) who attended a mean of 15 TF-CBT sessions over 25 weeks. At the end of treatment, only 1 of the 16 participants with a baseline PTSD diagnosis still met diagnostic criteria. Significant improvements were also noted for self-report measures of PTSD (d = -.83), anxiety (d = -.74), and depression (d = -.76). A minority of participants reported a brief exacerbation in symptoms of PTSD (n = 8) and anxiety and depression (n = 5) during stabilization and directly before and/or after the trauma-narration phase. However, all symptoms resolved at the end of treatment. The majority of participants (85%, n = 17) rated the intervention as helpful. CONCLUSION: Regardless of the expected temporary symptom exacerbation, the results indicated that TF-CBT was safe, tolerable, and acceptable. Transitional-aged youth is an emerging area of research. With limited research available on this age group to inform evidence-based practice, it is recommended that a randomized controlled trial is conducted to determine if TF-CBT (Cohen et al., 2017) can be effectively translated to this underresearched age group. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Impact of abuse on migraine-related sensory hypersensitivity symptoms: Results from the American Registry for Migraine Research.

BACKGROUND AND OBJECTIVES: Prior studies have established an association between a history of abuse and the development of migraine. This cross-sectional observational study explored the relationship between self-reported abuse history with migraine-related sensory hypersensitivity symptoms. METHODS: In total, 588 adult patients with migraine from the American Registry for Migraine Research completed questionnaires: Generalized Anxiety Disorder-7, Patient Health Questionnaire-2 for depression, Photosensitivity Assessment Questionnaire, Hyperacusis Questionnaire, and Allodynia Symptom Checklist. Using four binary screening questions, patients were asked to self-report if they believed they had suffered emotional, physical, or sexual abuse in their lifetime. Differences in questionnaire scores between groups with and without a history of abuse were determined. Regression models adjusted for age, sex, and basic headache features analyzed the relationship between abuse history and sensory hypersensitivity symptoms. Moderation analysis explored the role of headache frequency in this relationship. Mediation analysis assessed the indirect (Mediated) effect (IE) of abuse on sensory hypersensitivity through depression or anxiety. Additional models analyzed relationships between sensory hypersensitivity symptoms and abuse subtypes or the number of abuse subtypes. RESULTS: Of 588 participants, 222 (38%) reported a history of abuse. Patients with a history of abuse reported statistically significantly greater average headache frequency (7.6 vs. 4.7 days, p = 0.030). Patients with a history of abuse also reported higher average or median questionnaire scores: anxiety (7.6 vs. 4.7, p < 0.001, d = 0.56), depression (1.7 vs. 1.3, p = 0.009, d = 0.24), photophobia (0.54 vs. 0.44, p < 0.001, d = 0.32), hyperacusis (19.6 vs. 14.9, p < 0.001, d = 0.49), ictal allodynia (6.0 vs. 3.0, p < 0.001, d = 0.46), and interictal allodynia (1.0 vs. 0.0, p < 0.001, d = 0.30). After controlling for patient age, sex and years lived with headache, abuse maintained a significant association with every sensory hypersensitivity measure. Headache frequency significantly moderated the relationship between a history of abuse with increased ictal allodynia (p = 0.036). Anxiety significantly mediated the relationships between abuse with photophobia (IE = 0.03, 95% CI = 0.01-0.04), hyperacusis (IE = 1.51, 95% CI = 0.91-2.24), ictal allodynia (IE = 0.02, 95% CI = 0.01-0.04), and interictal allodynia (IE = 0.02, 95% CI = 0.01-0.06). Depression significantly mediated the relationship between abuse with photophobia (IE = 0.02, 95% CI = 0.01-0.03) and with hyperacusis (IE = 0.45, 95% CI = 0.11-0.88). The association between the individual subtypes of abuse and the number of subtypes of abuse with sensory hypersensitivity symptoms varied. CONCLUSION: A history of abuse is associated with greater migraine-related sensory hypersensitivity symptoms. To reduce the impact of abuse on migraine symptoms, future studies should explore mechanistic connections between abuse and migraine-associated symptoms.

Mistreatment, discrimination and burn-out in Neurosurgery.

OBJECTIVE: Issues concerning harassment, bullying and discrimination are not unknown to medical specialties and are likely to be present in neurosurgery as well. The aim of this study was to estimate the extent to which neurosurgeons are faced with issues pertaining to this mistreatment. METHODS: A survey consisting of fourteen questions was distributed among members of the Congress of Neurological Surgeons (CNS). The survey consisted of three parts: 1) demographics; 2) exposure to mistreatment; 3) experienced burnout symptoms. RESULTS: In total 503 out of the 5665 approached CNS members filled in a survey (response rate 8.9 %). Respondents consisted for 85.9 % out of neurosurgeons and for 13.9 % out of residents. Overall, 61.4 % of the respondents was a victim of form of abusive behavior, while 47.9 % was a victim of at least one form of discrimination. Most reported sources of these mistreatments were other neurosurgeons or (family of) patients. Overall, 49.9 % of the respondents experienced burnout symptoms. Multivariable logistic regression analysis showed that female respondents had higher odds of being a victim of abuse (OR 2.5, 95 % CI 1.4-4.6). Female respondents (OR 19.8, 95 % CI 8.9-43.9) and ethnic minorities (OR 3.8, 95 % CI 2.3-6.2) had higher odds of being a victim of discrimination. Furthermore, victims of abuse were at higher odds (OR 1.7, 95 % CI 1.1-2.6) of having burnout symptoms. CONCLUSIONS: Mistreatment and experiencing burnout symptoms frequently occurs among neurosurgeons and residents.