ABSTRACT
INTRODUCTION: Suicide is a severe public health problem. Impacts of childhood traumas, unsecure adult attachment styles and personality traits have been suggested as possible risk factors for suicide attempts. The aim of this cross-sectional, case-controlled study is to investigate the impact of childhood traumas, adult attachment styles and personality traits on suicide attempt. METHODS: The sample consisted of psychiatric patients who attempted suicide (n=101) on the one hand and those who did not attempt suicide (n=114) on the other. The questionnaires used were the Hungarian validated versions of Adult Attachment Scale (AAS), Childhood Trauma Questionnaire (CTQ), Temperament and Character Inventory (TCI) and a demographic questionnaire. RESULTS: Results indicated that Novelty Seeking (NS) temperament trait [EH=1.043; 95% C.I.=(0.950-1.145)] p=0.376; emotional abuse [EH=1.034; 95% C.I.=(0.966-1.107)] p=0.336; emotional neglect [EH=1.022; 95% C.I.=(0.936-1.116)] p=0.626; and sexual abuse [EH=1.047; 95% C.I.=(0.959-1.142)] p=0.305 were associated with nonsignificant increases in the odds of suicide attempts. Whereas secure attachment style [EH=0.908; 95% C.I.=(0.842-0.980)] p=0.013 appeared to be a significantly protective factor (c2(1)=6.515 p=0.011). Furthermore, when examining the connection between childhood traumas and adult attachment styles it was found that the anxious attachment style had a positive significant correlation with emotional abuse (rs(197)=0.293) p<0.001, avoidant attachment style with emotional neglect (rs(197)= 0.273) p<0.001. CONCLUSION: Our findings suggest that individuals with avoidant attachment style and childhood traumas are likely to present a higher suicide risk. However secure attachment style likely to present a lower risk for suicide.
Subject(s)
Character , Object Attachment , Suicide, Attempted , Temperament , Humans , Suicide, Attempted/psychology , Suicide, Attempted/statistics & numerical data , Adult , Risk Factors , Male , Female , Hungary/epidemiology , Case-Control Studies , Cross-Sectional Studies , Middle Aged , Surveys and Questionnaires , Child , Emotional Abuse/psychology , Personality Inventory , Adult Survivors of Child Abuse/psychology , Exploratory BehaviorABSTRACT
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.
Subject(s)
Cognitive Behavioral Therapy , Depressive Disorder, Major , Psychological Tests , Self Report , Adult , Female , Humans , Male , Middle Aged , Adult Survivors of Child Abuse/psychology , Child Abuse/psychology , Child Abuse/therapy , Cluster Analysis , Cognitive Behavioral Therapy/methods , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/psychology , Depressive Disorder, Major/therapy , Psychotherapy/methods , Surveys and Questionnaires , Treatment OutcomeABSTRACT
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.
Subject(s)
Cognitive Dysfunction , Humans , Female , Male , Adult , Cohort Studies , Cognitive Dysfunction/psychology , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/etiology , Child Abuse/psychology , Child Abuse/statistics & numerical data , Child , Adult Survivors of Child Abuse/psychology , Adult Survivors of Child Abuse/statistics & numerical data , United States/epidemiology , Neuropsychological Tests/statistics & numerical data , Self Report , Executive Function , Midwestern United States/epidemiologyABSTRACT
Objective: People living with HIV (PLWH) experience high rates of childhood trauma exposure, which is a significant risk factor for the development of posttraumatic stress disorder (PTSD). Because Black Americans living in urban environments are exposed to high levels of trauma, suffer from chronic PTSD, and are at increased risk for HIV infection, it is important to understand how HIV status interacts with childhood maltreatment to influence PTSD symptom severity and underlying psychophysiology. Methods: The current cross-sectional study assessed whether HIV status interacts with childhood maltreatment to influence PTSD symptom severity and heart rate variability during a dark-enhanced startle (DES) task in 88 Black women with (n=30) and without HIV (n=58). Results: HIV was associated with greater PTSD symptom severity only in women with low levels of childhood maltreatment (p=.024). Startle potentiation during DES was highest in women living without HIV and with high childhood maltreatment (p=.018). In women who had experienced low levels of childhood maltreatment, respiratory sinus arrhythmia (RSA) was lower during the dark phase of DES in women living without HIV than women living with HIV (WLWH), (p=.046). RSA during the light phase of DES was lower in WLWH than in women living without HIV (p=.042). Conclusion: In the current sample of Black women, HIV status was associated with PTSD symptom severity in a manner dependent on level of childhood maltreatment, suggesting that HIV status may be an important factor to consider for behavioral and pharmacological treatment strategies for PTSD. Additionally, HIV status is associated with lower percent potentiation to darkness and lower RSA during the light phase of DES, suggesting physiological mechanisms by which HIV may contribute to PTSD symptoms in individuals exposed to low levels of childhood maltreatment.
Subject(s)
Adult Survivors of Child Abuse , Black or African American , HIV Infections , Heart Rate , Reflex, Startle , Stress Disorders, Post-Traumatic , Humans , Female , Stress Disorders, Post-Traumatic/physiopathology , Stress Disorders, Post-Traumatic/psychology , Heart Rate/physiology , Adult , Cross-Sectional Studies , Reflex, Startle/physiology , HIV Infections/physiopathology , HIV Infections/psychology , Adult Survivors of Child Abuse/psychology , Middle Aged , Severity of Illness Index , Psychophysiology , Respiratory Sinus Arrhythmia/physiologyABSTRACT
BACKGROUND: Childhood exposure to maltreatment is an endemic health issue with tragic personal and socioeconomic repercussions. There is a dearth of information on the psychological outcomes of childhood trauma, specifically anxiety and depression, in adulthood in Nigeria. This study was conducted to determine the prevalence of childhood trauma and its relationship with anxiety, depression, and suicidal ideation among adults in a Nigerian community. METHODS: The study is a product of a secondary analysis of the relevant aspects of the data collected for the Ilisan-Remo Functional Bowel Disorder Project. It was a cross-sectional community-based study of adult aged 18-70 years in Nigeria. The relevant aspects of the research instrument included the demographic information; the Beck Anxiety and Depression Inventories for assessing anxiety and depression respectively, and the Early Trauma Inventory-Self Report Short-Form for accessing childhood trauma. Data were summarized and analyzed with appropriate instruments. Variables with p-values < 0.05 were considered significant. RESULTS: Adequate data for statistical analysis was available for 501 respondents. The mean age of the respondents was 32.69 ±12.8 years. Four hundred and forty (87.8%) respondents had at least one childhood trauma exposure. Physical punishment had the highest prevalence (77.2%), followed by general trauma (68.9%), emotional abuse (51.1%) and sexual abuse (34.9%). All the childhood traumas were either moderately or weakly correlated with the psychopathologies except physical trauma which was not correlated with suicidal ideation. Childhood trauma had a significant association with anxiety [AOR = 1.23 (95% CI, 1.13 - 1.35), p<0.001], depression [AOR = 1.19 (95% CI, 1.13 - 1.25), p <0.001] and suicidal ideation [AOR = 1.09 (95% CI, 1.02 - 1.16), p = 0.007]. CONCLUSION: The prevalence of childhood trauma was high in our study population and was associated with sychopathologies in adulthood. Stakeholders such as parents, government, teachers, and civil society organizations should make a concerted effort to deter it.
CONTEXTE: L'exposition des enfants aux mauvais traitements est un problème de santé endémique avec des répercussions personnelles et socio-économiques tragiques. Il existe une pénurie d'informations sur les conséquences psychologiques des traumatismes infantiles, notamment l'anxiété et la dépression à l'âge adulte au Nigeria. Cette étude a été menée pour déterminer la prévalence des traumatismes infantiles et leur relation avec l'anxiété, la dépression et les idées suicidaires chez les adultes d'une communauté nigériane. MÉTHODES: L'étude est issue d'une analyse secondaire des aspects pertinents des données collectées pour le projet Ilisan-Remo sur les troubles fonctionnels de l'intestin. Il s'agissait d'une étude transversale communautaire auprès d'adultes âgés de 18 à 70 ans au Nigeria. Les aspects pertinents de l'instrument de recherche comprenaient des informations démographiques ; les inventaires d'anxiété et de dépression de Beck pour évaluer respectivement l'anxiété et la dépression, et l'inventaire des traumatismes précoces - auto-rapport version courte pour évaluer les traumatismes infantiles. Les données ont été résumées et analysées avec des instruments appropriés. Les variables avec des valeurs de p < 0,05 ont été considérées comme significatives. RÉSULTATS: Des données adéquates pour l'analyse statistique étaient disponibles pour 501 répondants. L'âge moyen des répondants était de 32,69 ±12,8 ans. Quatre cent quarante (87,8 %) répondants avaient été exposés à au moins un traumatisme infantile. La punition physique avait la plus haute prévalence (77,2 %), suivie des traumatismes généraux (68,9 %), des abus émotionnels (51,1 %) et des abus sexuels (34,9 %). Tous les traumatismes infantiles étaient modérément ou faiblement corrélés avec les psychopathologies, sauf le traumatisme physique qui n'était pas corrélé avec les idées suicidaires. Les traumatismes infantiles avaient une association significative avec l'anxiété [OR ajusté = 1,23 (IC à 95 %, 1,13 1,35), p < 0,001], la dépression [OR ajusté = 1,19 (IC à 95 %, 1,13 1,25), p < 0,001] et les idées suicidaires [OR ajusté = 1,09 (IC à 95 %, 1,02 1,16), p = 0,007]. CONCLUSION: La prévalence des traumatismes infantiles était élevée dans notre population d'étude et était associée à des psychopathologies à l'âge adulte. Les parties prenantes telles que les parents, le gouvernement, les enseignants et les organisations de la société civile devraient faire des efforts concertés pour les prévenir. MOTS CLÉS: Traumatismes infantiles, Maltraitance des enfants, Anxiété, dépression, Nigeria.
Subject(s)
Anxiety , Depression , Suicidal Ideation , Humans , Nigeria/epidemiology , Cross-Sectional Studies , Adult , Female , Male , Middle Aged , Young Adult , Prevalence , Adolescent , Depression/epidemiology , Depression/psychology , Anxiety/epidemiology , Aged , Adult Survivors of Child Abuse/psychology , Adult Survivors of Child Abuse/statistics & numerical data , ChildABSTRACT
This case report describes 19 years of psychiatric care of a young female survivor of childhood sexual and physical abuse and neglect who also had the misfortune of having a life-compromising and life-limiting physical disease, cystic fibrosis. It summarizes ~ 100 therapeutic contacts from age 21 to age 40 and spans her journey through lung transplantation to the end of her life. The nature of cystic fibrosis and its treatment is reviewed and there is a discussion of the therapeutic process. The case is enriched by emails from the young woman describing her struggles to maintain personal integrity as her lung function declined. The case is presented with the young woman's consent.
Subject(s)
Cystic Fibrosis , Humans , Cystic Fibrosis/therapy , Female , Adult , Young Adult , Adult Survivors of Child Abuse/psychology , Lung TransplantationABSTRACT
Background: There is a vast amount of evidence supporting the effectiveness of trauma-focused cognitive-behavioral therapy in treating posttraumatic stress disorder (PTSD). However, it remains unclear which specific treatment is most effective for patients with PTSD following childhood sexual and physical abuse (CSPA). Although Imaginal Exposure (IE) has proven highly effective in treating PTSD and is widely acknowledged as a standard method, Imagery Rescripting (IR) may be more suitable for CSPA-related PTSD. IR not only addresses fear but also targets other emotions and cognitions associated with childhood maladaptive schemas. Preliminary findings suggest lower drop-out rates for IR compared to IE, but no Randomized Controlled Trial (RCT) currently assesses the effectiveness of IR for CSPA-related PTSD.Objective: This article presents a study protocol designed to investigate the optimal treatment (IE or IR) for individuals with CSPA-related PTSD and explore predictors of treatment success.Method: In our study protocol, we suggest the inclusion of 173 patients (N = 64 in IR, N = 64 in IE, and N = 45 in the waitlist condition). The therapy procedures for both IE and IR will consist of 16 sessions lasting 90 min each, with treatment durations of 11 weeks. Measurements take place at baseline, at start of treatment, 11 weeks after the start of treatment (after 16 sessions) and at follow-up at 26 weeks after the last session. A mixed regression will be used to compare the three active conditions before and after measurement.Results: This article serves as a study protocol. The results are not yet available but they will be presented in a subsequent article.Conclusion: This study protocol outlines a RCT which will be the first to provide information on the effectiveness of IR versus IE versus a control group in CSPA-related PTSD.Trial registration: Netherlands Trial Register NTR 4817. Registered 26 September 2014.
This study protocol is designed to enhance the clinical treatment for individuals (aged 18 and above) experiencing posttraumatic stress disorder (PTSD) resulting from childhood sexual and physical abuse (CSPA) occurring before the age of 16.Within this protocol, the efficacy of two PTSD interventions Imagery Rescripting (IR) and Imaginal Exposure (IE) will be systematically compared, both against each other and a control group.The secondary objective of this study protocol is to investigate potential predictors of treatment success, including factors such as tonic immobility, dissociation, heart rate variability, measures of autonomic arousal, personality disorders, and the quality of therapeutic alliance.
Subject(s)
Imagery, Psychotherapy , Implosive Therapy , Stress Disorders, Post-Traumatic , Humans , Stress Disorders, Post-Traumatic/therapy , Male , Female , Child , Cognitive Behavioral Therapy , Treatment Outcome , Adult , Netherlands , Adult Survivors of Child Abuse/psychology , Physical Abuse/psychology , Child Abuse, Sexual/psychologyABSTRACT
INTRODUCTION: Childhood maltreatment, particularly emotional abuse (EA), has been identified as a significant risk factor for the development of eating disorders (EDs). This study investigated the association between EA and ED symptoms while considering multiple potential mediators. METHODS: Participants included 151 individuals with Anorexia Nervosa (AN), 115 with Bulimia Nervosa (BN), and 108 healthy controls. The Childhood trauma questionnaire, the Toronto Alexithymia scale, the Behavioral inhibition System, and the Eating Disorder Inventory 2 scale were completed before treatment. A mediator path model was conducted in each group: EA was set as independent variable, eating symptoms as dependent variables and ineffectiveness, sensitivity to punishment, alexithymia, and impulsivity as mediators. RESULTS: In individuals with AN, impulsivity emerged as a significant mediator between EA and desire for thinness and bulimic behaviors. Conversely, in individuals with BN, sensitivity to punishment was found to mediate the association between EA and dissatisfaction with one's body. Ineffectiveness and difficulty identifying emotions were identified as transdiagnostic mediators in both clinical groups. No mediation effect was found in healthy individuals. DISCUSSION: The simultaneous assessment of multiple mediators in a unique model outlines the complex interplay between childhood EA and ED psychopathology. Improving ineffectiveness, emotion identification, sensitivity to punishment and impulsivity and exploring their relations with early emotional abuse may represent treatment targets in individuals with EDs and childhood trauma.
Subject(s)
Affective Symptoms , Anorexia Nervosa , Bulimia Nervosa , Emotional Abuse , Impulsive Behavior , Mediation Analysis , Humans , Female , Adult , Anorexia Nervosa/psychology , Bulimia Nervosa/psychology , Affective Symptoms/psychology , Young Adult , Emotional Abuse/psychology , Male , Adolescent , Surveys and Questionnaires , Adult Survivors of Child Abuse/psychologyABSTRACT
BACKGROUND: Previously, we demonstrated that childhood maltreatment could worsen depressive symptoms through neuroticism. On the one hand, some studies report that sleep disturbances are related to childhood maltreatment and neuroticism and worsens depressive symptoms. But, to our knowledge, no reports to date have shown the interrelatedness between childhood maltreatment, neuroticism, and depressive symptoms, and sleep disturbance in the one model. We hypothesized that sleep disturbance enhances the influence of maltreatment victimization in childhood or neuroticism on adulthood depressive symptoms and the mediation influence of neuroticism between maltreatment victimization in childhood and adulthood depressive symptoms. SUBJECTS AND METHODS: Total 584 Japanese volunteer adults recruited through convenience sampling from 4/2017 to 4/2018 were assessed regarding their characteristics of demographics, history of childhood maltreatment, sleep disturbance, neuroticism, and depressive symptoms with questionnaires self-administered. Survey data were analyzed using simple moderation models and a moderating mediation model. RESULTS: The interaction of sleep disturbance with childhood maltreatment or neuroticism on depressive symptoms was significantly positive. Furthermore, the moderating effect of sleep disturbance on the indirect effect of childhood maltreatment to depressive symptoms through neuroticism was significantly positive. LIMITATIONS: Because this was a cross-sectional study, a causal relationship could not be confirmed. CONCLUSIONS: Our findings indicate that individuals with milder sleep disturbance experience fewer depressive symptoms attributable to neuroticism and childhood maltreatment. Additionally, people with less sleep disturbance have fewer depressive symptoms arising from neuroticism owing to childhood maltreatment. Therefore, improvement of sleep disturbance will buffer the aggravating effect of childhood maltreatment, neuroticism caused by various factors, and neuroticism resulting from childhood maltreatment on depressive symptoms.
Subject(s)
Depression , Neuroticism , Humans , Male , Female , Adult , Depression/psychology , Middle Aged , Sleep Wake Disorders/psychology , Sleep Wake Disorders/etiology , Cross-Sectional Studies , Surveys and Questionnaires , Child Abuse/psychology , Sleep/physiology , Child , Young Adult , Adult Survivors of Child Abuse/psychology , AgedABSTRACT
Background: Childhood maltreatment is a risk factor for developing multiple forms of psychopathology, including depression, posttraumatic stress disorder (PTSD), and anxiety. Yet, the mechanisms linking childhood maltreatment and these psychopathologies remain less clear.Objective: Here we examined whether self-stigma, the internalization of negative stereotypes about one's experiences, mediates the relationship between childhood maltreatment and symptom severity of depression, PTSD, and anxiety.Methods: Childhood trauma survivors (N = 685, Mage = 36.8) were assessed for childhood maltreatment, self-stigma, and symptoms of depression, PTSD, and anxiety. We used mediation analyses with childhood maltreatment as the independent variable. We then repeated these mediation models separately for childhood abuse and neglect, as well as the different subtypes of childhood maltreatment.Results: Self-stigma significantly mediated the relationship between childhood maltreatment and depression, PTSD, and anxiety symptoms. For sexual abuse - but not physical or emotional abuse - a significant mediation effect of self-stigma emerged on all symptom types. For childhood neglect, self-stigma significantly mediated the relationship between both emotional and physical neglect and all symptom types.Conclusion: Our cross-sectional study suggests that different types of childhood maltreatment experiences may relate to distinct mental health problems, potentially linked to increased self-stigma. Self-stigma may serve as an important treatment target for survivors of childhood abuse and neglect.
Childhood maltreatment is linked to depression, PTSD, and anxiety symptoms.Self-stigma, or internalizing negative stereotypes, plays a significant role in mediating this relationship.Different types of maltreatment are linked to varying levels of self-stigma and symptom severity.
Subject(s)
Adult Survivors of Child Abuse , Anxiety , Depression , Social Stigma , Stress Disorders, Post-Traumatic , Humans , Female , Male , Stress Disorders, Post-Traumatic/psychology , Adult , Depression/psychology , Anxiety/psychology , Adult Survivors of Child Abuse/psychology , Child Abuse/psychology , Self Concept , Middle Aged , Risk FactorsABSTRACT
BACKGROUND: Although there is a wealth of evidence indicating the enduring consequences of childhood emotional maltreatment (CEM) on social and relational functioning across life stages, little known about how CEM affects marital attitudes in emerging adulthood, particularly among rural first-generation college students (rural FGCS) at the critical stage of developing romantic relationships. OBJECTIVE: To explore whether differential patterns of CEM existed among rural FGCS in China during emerging adulthood. Furthermore, the study aims to examine the potential differences in the chain mediating role of CEM on the pathway to adulthood marital attitudes across different CEM profiles. PARTICIPANTS AND SETTING: Using a cluster sampling approach, a total of 3848 rural first-generation college freshmen (males = 39.2 %, mean age = 18.42 years) were recruited from three universities in China. METHODS: Latent profile analysis was utilized to identify potential patterns of CEM using Mplus version 7.4. Structural equation modeling and multigroup comparisons were then performed to investigate the association between CEM and attitudes towards marriage in emerging adulthood, utilizing AMOS 24.0. RESULTS: Three profiles of CEM was identified among rural FGCS: a low-CEM group (51.87 %), a moderate-CEM group (36.69 %), and a severe-CEM group (11.44 %). The association between CEM and adulthood marital attitudes was mediated by core self-evaluation and meaning in life. However, the mediation effects varied across the three CEM profiles. In the low-CEM group, core self-evaluation and meaning in life were observed to partially mediate the negative association between CEM and adulthood marital attitudes. On the other hand, in the moderate-CEM and severe-CEM groups, the relationship between CEM and adulthood marital attitudes was fully mediated by core self-evaluation. CONCLUSIONS: The study's findings suggest that CEM is a significant predictor of marital attitudes among rural FGCS during emerging adulthood, with the severity of emotional neglect and abuse being the primary distinguishing factor between different CEM profiles. Core self-evaluation plays an important role in this relationship. Future clinical interventions could benefit from focusing on enhancing core self-evaluation and meaning in life, particularly for those with CEM experiences.
Subject(s)
Attitude , Marriage , Rural Population , Students , Humans , Male , Female , China , Adolescent , Rural Population/statistics & numerical data , Young Adult , Students/psychology , Marriage/psychology , Emotional Abuse/psychology , Universities , Adult , Latent Class Analysis , Adult Survivors of Child Abuse/psychologyABSTRACT
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.
Subject(s)
Community Mental Health Services , Hospitalization , Mental Disorders , Self Report , Humans , Male , Female , Mental Disorders/epidemiology , Adult , Child , Adolescent , Community Mental Health Services/statistics & numerical data , Hospitalization/statistics & numerical data , Young Adult , Adult Survivors of Child Abuse/statistics & numerical data , Adult Survivors of Child Abuse/psychology , Child Abuse/statistics & numerical data , Child Abuse/psychology , Child, Preschool , Cohort StudiesABSTRACT
BACKGROUND: Childhood sexual abuse (CSA) is a global problem that is preventable. Sexual grooming behaviors have been deemed an integral part of CSA for the purpose of avoiding detection and preventing disclosure. Many of these behaviors are reported more often by adults who experienced CSA as compared to those that did not (Jeglic et al., 2023). Such behaviors form important targets for prevention efforts, as well as the investigation and prosecution of CSA. Consequently, it is important to identify the prevalence rates of sexual grooming behaviors. OBJECTIVE: The aim of the present study was to identify the prevalence of sexual grooming as reported by adult survivors of CSA. PARTICIPANTS AND SETTING: A large sample of adults who reported a history of CSA (n = 1045) completed the study online via Prolific. METHODS: Participants completed an anonymous self-report survey which included the Sexual Grooming Scale - Victim Version (Winters & Jeglic, 2022). RESULTS: Overall, 99% of participants endorsed experiencing at least one sexual grooming behavior, with an average of 14.25 sexual grooming behaviors out of a possible 42 (range = 0-36) reported per survivor. Participants endorsed behaviors across all five stages of the sexual grooming process: victim selection, gaining access and isolation, trust development, desensitization, and post-abuse maintenance. The most frequently reported sexual grooming behaviors included the perpetrator selecting a child who was compliant/trusting (68%) or had low self-esteem (61%); arranging activities alone with the child (57%); presenting themselves as nice/charming/likeable (70%); showing the child large amounts of attention (56%) or affection (54%); and using seemingly innocent touch (51%). CONCLUSIONS: Sexual grooming is prevalent based on reports from adult survivors of CSA. These findings will be discussed as they pertain to the prevention, detection, and prosecution of CSA.
Subject(s)
Adult Survivors of Child Abuse , Child Abuse, Sexual , Humans , Female , Adult , Male , Adult Survivors of Child Abuse/psychology , Adult Survivors of Child Abuse/statistics & numerical data , Child Abuse, Sexual/psychology , Child Abuse, Sexual/statistics & numerical data , Prevalence , Young Adult , Adolescent , Middle Aged , Child , Sexual Behavior/psychology , Sexual Behavior/statistics & numerical data , Self Report , Aged , Surveys and QuestionnairesABSTRACT
BACKGROUND: A relatively understudied but growing body of research indicates that individuals with a history of childhood trauma exhibit altered reward processing in adulthood. Research to date has focused on adversity broadly, with studies typically finding evidence of blunted response to rewards in adults with a history of childhood trauma. OBJECTIVE: Given the role of reward processing in risk for psychopathology and the particularly pathogenic nature of sexual abuse (SA), the present study sought to assess whether adults with a history of severe childhood SA exhibit altered neurophysiological response to rewards. PARTICIPANTS AND SETTING: Female adults (N = 105) were included from two study sites that used the same measures of childhood trauma (Childhood Trauma Questionnaire, CTQ), reward processing (Doors Task), and psychopathology (SCID). METHODS: Based on participants' CTQ and SCID responses, three groups were created: Severe SA (n = 36), Clinical Match (with comparable lifetime psychopathology but no-to-minimal SA history; n = 35), and Healthy Controls (n = 34). Group differences in RewP amplitude were assessed. RESULTS: The Severe SA group exhibited larger reward positivity (RewP) amplitude to monetary rewards than the Clinical Match and Healthy Control groups (partial Æ2 = 0.06, p = .047). This effect remained after covarying for severity of other forms of childhood trauma. CONCLUSIONS: Our study found that severe SA in childhood was related to a heightened response to reward in adulthood. Furthermore, this was not attributable to the severity of other forms of early trauma or comorbid psychopathology. Future studies are needed to identify how heightened reward processing following severe childhood SA may be implicated in the onset and course of psychopathology.
Subject(s)
Adult Survivors of Child Abuse , Child Abuse, Sexual , Reward , Humans , Female , Adult , Child Abuse, Sexual/psychology , Adult Survivors of Child Abuse/psychology , Young Adult , Child , Electroencephalography , Case-Control Studies , Adolescent , Evoked Potentials/physiologyABSTRACT
BACKGROUND/AIMS: The link between child maltreatment (CM) and substance use (SU) in young adulthood is established. The sympathetic nervous system (SNS) division of the autonomic nervous system may mediate this link. However, less is known on the indirect link between CM and SU via SNS functioning. Due to individual variability in the link between SNS functioning and SU risk, we aimed to examine the moderating role of distress tolerance (DT). METHODS: A longitudinal sample of 118 young adults (YAs) from a low socioeconomic status background were assessed twice (between 9 and 12 months apart). CM, DT, and galvanic skin response (GSR) stress reactivity were measured during the initial study visit, while SU was assessed at both timepoints. Stress reactivity was assessed by measuring the GSR reactivity during a stress task. We tested the indirect associations between CM and changes in SU problems via GSR stress reactivity, and the moderation effects of DT on these indirect associations. A mediation model in the structural equation modeling (SEM) framework was then followed by a moderated mediation model to analyze these data. RESULTS: YA's stress reactivity mediated the association between CM and alcohol use problems, and this indirect effect was weaker among YAs who had higher levels of DT. This pattern did not emerge with drug use problems. CONCLUSIONS: Findings suggest that intervention and prevention efforts for SU outcomes should consider incorporating strategies that increase at-risk individuals' levels of DT. Providing strategies to help individuals stem their stress reactivity may reduce their risk for alcohol use.
Subject(s)
Autonomic Nervous System , Substance-Related Disorders , Humans , Male , Female , Substance-Related Disorders/psychology , Substance-Related Disorders/physiopathology , Young Adult , Longitudinal Studies , Autonomic Nervous System/physiopathology , Galvanic Skin Response/physiology , Adult , Mediation Analysis , Adolescent , Adult Survivors of Child Abuse/psychology , Stress, Psychological/psychology , Stress, Psychological/physiopathology , Child , Child Abuse/psychology , Psychological Distress , Adverse Childhood Experiences/statistics & numerical data , Risk FactorsABSTRACT
BACKGROUND: Childhood sexual abuse can increase both body weight and inflammation later in life. Higher weight or faster changes in weight, as measured by changes in body mass index (BMI), may mediate the relationship between childhood sexual abuse and inflammation, however, most studies to date have used a cross-sectional design limiting causal inferences. OBJECTIVE: The current study aimed to investigate the interrelationships between childhood sexual abuse, BMI, and C-reactive protein (CRP) and interleukin-6 (IL6). PARTICIPANTS AND SETTING: Data from 461 adults who participated in the Midlife in the United States (MIDUS) study were utilized. METHODS: Growth curve modeling was used to test initial levels of BMI and changes of BMI over an 18-year period as mediators linking childhood sexual abuse to CRP and IL6. RESULTS: Sexual abuse was not significantly associated with the initial level of BMI; however, sexual abuse was associated with the slope of BMI (b = 0.072, p = .006). BMI intercept (b = 0.080, p = .001) and slope (b = 0.240, p = .002) predicted IL6 values whereas the slope of BMI (b = 0.398, p = .033) but not intercept predicted CRP values. The indirect effect from sexual abuse to IL6 through BMI slope was significant (b = 0.017, 95 % [CI.001, 0.033]) while the indirect effect from sexual abuse to CRP through BMI slope was not significant (b = 0.028, 95 % [CI -0.004, 0.061]). CONCLUSION: Childhood sexual abuse was indirectly associated with IL6 through rates of change in BMI over time.
Subject(s)
Body Mass Index , C-Reactive Protein , Child Abuse, Sexual , Interleukin-6 , Humans , Female , Interleukin-6/blood , Male , Middle Aged , C-Reactive Protein/metabolism , Adult , United States/epidemiology , Adult Survivors of Child Abuse/psychology , Child , Aged , Longitudinal Studies , Cross-Sectional StudiesABSTRACT
BACKGROUND: This longitudinal study assessed the prospective link between childhood maltreatment and sleep quality in adulthood, with a specific focus on examining whether different coping style tendencies influence these associations. METHODS: The baseline sample included 1600 adult participants, with 1140 participants successfully followed up 5 years later. The key variables were measured using the Childhood Trauma Questionnaire (CTQ), Simplified Coping Style Questionnaire (SCSQ), and Pittsburgh Sleep Quality Index (PSQI). Generalized linear mixed models were employed to estimate unstandardized ß estimates and 95 % confidence intervals (95%CIs). Structural equation modeling was used to test the mediation model. RESULTS: Individuals reported childhood maltreatment at baseline were at an increased risk for sleep disturbances at follow-up. Childhood maltreatment negatively predicted the baseline coping style tendency (ß = -0.29, P < 0.001), the baseline coping style tendencies negatively predicted the follow-up sleep quality (ß = -0.10, P < 0.001), and childhood maltreatment positively predicted the follow-up sleep quality (ß = 0.42, P < 0.01). The mediating effect of baseline coping style tendencies between childhood maltreatment and the follow-up sleep quality was significant, with an effect value of 0.03. LIMITATIONS: First, the sample was from a single province (Shandong), which limits the generalizability of the findings. Second, recall bias was unavoidable in this adult sample study. CONCLUSIONS: Developing positive coping strategies is an important way to reduce the risk of sleep problems in adults with a history of childhood maltreatment.
Subject(s)
Adaptation, Psychological , Adult Survivors of Child Abuse , Humans , Male , Female , Adult , China , Adult Survivors of Child Abuse/psychology , Adult Survivors of Child Abuse/statistics & numerical data , Longitudinal Studies , Surveys and Questionnaires , Sleep Quality , Middle Aged , Prospective Studies , Sleep Wake Disorders/psychology , Sleep Wake Disorders/epidemiology , Young Adult , Child Abuse/psychology , Child Abuse/statistics & numerical data , East Asian PeopleABSTRACT
BACKGROUND: Childhood trauma, including emotional neglect, emotional abuse, physical abuse, and sexual abuse, may contribute to borderline personality features like affective instability, identity problems, negative relationships, and self-harm. This study aims to explore how different types of childhood trauma affect these features in bipolar versus unipolar depressive disorders. METHODS: We included 839 participants of the Netherlands Study of Depression and Anxiety (NESDA) with a lifetime diagnosis of major depressive disorder single episode (MDDS; N = 443), recurrent major depressive disorder (MDD-R; N = 331), or bipolar disorder (BD; N = 65). Multivariate regression was used to analyze data from the Childhood Trauma Interview and borderline features (from the self-report Personality Assessment Inventory). RESULTS: On average, participants were 48.6 years old (SD: 12.6), with 69.2 % being women, and 50.3 % of participants assessed positive for childhood trauma. Adjusted analyses revealed that participants diagnosed with BD, followed by MDD-R, exhibited the highest number of borderline personality features. Additionally, within the entire group, a strong association was found between childhood trauma, especially emotional neglect, and the presence of borderline personality features. CONCLUSION: Given the high prevalence of childhood trauma and borderline personality features, screening for these factors in individuals with mood disorders is crucial. Identifying these elements can inform and enhance the management of the often fluctuating and complex nature of these comorbid conditions, leading to more effective and tailored treatment strategies.
Subject(s)
Bipolar Disorder , Borderline Personality Disorder , Depressive Disorder, Major , Humans , Female , Male , Borderline Personality Disorder/epidemiology , Borderline Personality Disorder/psychology , Bipolar Disorder/psychology , Bipolar Disorder/epidemiology , Middle Aged , Depressive Disorder, Major/psychology , Depressive Disorder, Major/epidemiology , Adult , Netherlands/epidemiology , Adverse Childhood Experiences/statistics & numerical data , Adverse Childhood Experiences/psychology , Adult Survivors of Child Abuse/psychology , Adult Survivors of Child Abuse/statistics & numerical data , Child Abuse/psychology , Child Abuse/statistics & numerical dataABSTRACT
OBJECTIVE: Utilizing national longitudinal data, this study examines how polygenic depression risk and childhood abuse interactively influence the life-course development of depressive conditions from middle to late adulthood. METHOD: Data from 7512 participants (4323 females and 3189 males) of European ancestry aged 51-90, retrieved from the U.S. Health and Retirement Study (1992-2020), were analyzed. Childhood physical abuse and polygenic depression score were the primary predictors. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression (CESD) scale, and clinical depression risk was a binary indicator. Growth-curve linear mixed and logit mixed-effects models were conducted for analysis. RESULTS: Increasing polygenic depression scores were associated with elevated CES-D levels and potential risks of clinical depression. Males experienced more detrimental effects of childhood abuse on depression development from ages 51 to 90 years. In contract, non-maltreated females generally exhibited higher depressive symptoms and clinical depression risk than males. A significant interactive effect was found between polygenic depression risk and childhood abuse among males. Higher depression levels and clinical risk were observed with increasing polygenic depression score among maltreated males, surpassing those of females with standardized polygenic score ≥0 from age 51 to 90 years. CONCLUSIONS: The interaction between childhood abuse and genetic factors significantly shaped lifelong depression trajectories in males, while the negative impact of abusive parenting remained constant regardless of polygenic depression risk among females. Individualized prevention and intervention strategies could be crucial in mitigating lifelong depression development, especially for high-genetic-risk males with a history of childhood physical abuse.
Subject(s)
Depression , Gene-Environment Interaction , Humans , Male , Female , Aged , Middle Aged , Longitudinal Studies , Depression/epidemiology , Depression/genetics , United States/epidemiology , Aged, 80 and over , Multifactorial Inheritance , Risk Factors , Child Abuse/psychology , Child Abuse/statistics & numerical data , Adult Survivors of Child Abuse/psychologyABSTRACT
BACKGROUND: Mothers with a history of childhood maltreatment (CM) are particularly vulnerable to postpartum mental health changes. Variability in mental health trajectories is present over the first 18-months postpartum. Little is known about the potentially unique impacts of post-traumatic change or resilience on later postpartum mental health. METHODS: Participants (N = 97) completed questionnaires over the first 18-months postpartum measuring demographic risk, mental health symptoms, traumatic experiences, and resilience. Mothers also completed an interview measure coded for post-traumatic changes at 6-months postpartum. Multinomial logistic regression models examined post-traumatic change and resilience factors as predictors of mothers' longitudinal latent mental health trajectory. RESULTS: Three classes of latent postpartum mental health emerged: low-symptom, vulnerable, and chronic high-risk. Mothers reporting stronger positive post-traumatic changes were more likely to be in the low-symptom class than the chronic high-risk class (B = -1.082, p = .01). Mothers reporting stronger negative post-traumatic changes were more likely to be in the vulnerable class (B = 0.778, p = .006) or chronic high-risk class (B = 0.906, p = .046) than the low-symptom class. Resilience was not predictive of mental health class. LIMITATIONS: Findings are correlational, and causal effects between post-traumatic growth and mental health symptoms cannot be assumed. Mothers who consented to the interview may not be fully representative of all women who have experienced CM, limiting generalizability of findings. CONCLUSIONS: Positive post-traumatic change is associated with reduced psychopathology. These findings may assist in identification of mothers at greater risk of adverse postpartum outcomes and futher inform interventions focused on enhancing positive changes in post-traumatic cognitions.