Complex post-traumatic stress disorder (CPTSD) of ICD-11 in youths with childhood maltreatment: Associations with age of exposure and clinical outcomes.

BACKGROUND: Exposure to childhood maltreatment (CM) increases the risk of psychiatric morbidity in youths. The new Complex Post-Traumatic Stress Disorder (CPTSD) diagnosis captures the heterogeneity and complexity of clinical outcomes observed in youths exposed to CM. This study explores CPTSD symptomatology and its association with clinical outcomes, considering the impact of CM subtypes and age of exposure. METHODS: Exposure to CM and clinical outcomes were evaluated in 187 youths aged 7-17 (116 with psychiatric disorder; 71 healthy controls) following the Tools for Assessing the Severity of Situations in which Children are Vulnerable (TASSCV) structured interview criteria. CPTSD symptomatology was explored by confirmatory factor analysis, considering four subdomains: post-traumatic stress symptoms, emotion dysregulation, negative self-concept and interpersonal problems. RESULTS: Youths exposed to CM (with or without psychiatric disorders) showed greater internalizing, externalizing and other symptomatology, worse premorbid adjustment and poorer overall functioning. Youth with psychiatric disorder and exposed to CM reported more CPTSD symptomatology, psychiatric comorbidity and polypharmacy and earlier onset of cannabis use. Different subtypes of CM and the developmental stage of exposure differentially impact CPTSD subdomains. LIMITATIONS: Small percentage of resilient youths was studied. It was not possible to explore specific interactions between diagnostic categories and CM. Direct inference cannot be assumed. CONCLUSIONS: Gathering information on type and age of exposure to CM is clinically useful to understand the complexity of psychiatric symptoms observed in youths. Inclusion of the CPTSD diagnosis should increase the implementation of early specific interventions, improving youths' functioning and reducing the severity of clinical outcomes.

Characterization of industrial alkylpolyphosphonates by infusion electrospray ionization-ion trap mass spectrometry with identification of the impurities by tandem capillary zone electrophoresis.

Technical grade diethylene-triaminepentakis(methylenephosphonic acid) (I), dihexamethylene-triaminepentakis(methylenephosphonic acid) (II), ethylene-diaminetetrakis(methylenephosphonic acid) (III), hexamethylene-diaminetetrakis(methylenephosphonic acid) (IV), amino-tris(methylenephosphonic acid) (V), hydroxyethyl-aminobis(methylenephosphonic acid) (VI), 1-hydroxyethylidene-1,1-diphosphonic acid (VII), and 2-phosphonobutane-1,2,4-tricarboxylic acid (VIII) were characterized by ion trap mass spectrometry with electrospray ionization (ESI-ITMS). Using the negative ion mode and acid and alkaline media, peak series corresponding to the nominal compounds and to impurities with a lower number of phosphonate groups were distinguished in I-V. Each series was constituted by [M - nH + (n - 1)Na](-) peaks and peaks produced from them by losses of water, H(3)PO(3)(or water plus HPO(2)), and combined losses. For each [M - nH + (n - 1)Na](-) peak, the number of losses coincided with the number of phosphonate groups not bound to sodium ions minus one (the group bearing the charge). Owing to the hydroxyethyl group, the spectrum of VI was dominated by the formation of intermolecular esters, with both losses and gains of water according to [nM - H +/- mH(2)O](-). A series of [M - nH + (n - 1)Na](-) peaks were observed for VII and VIII, showing in the latter case that the carboxylate groups may also form adducts with sodium ions. Losses of water and H(3)PO(3)were observed in VII, whereas losses of water, CO(2), and HPO(3) were seen in VIII. The reaction pathways leading to the production of the observed ions are described. The nominal compounds and the impurities were also separated and identified by capillary electrophoresis with ESI-ITMS detection.

Capillary electrophoresis enhanced by automatic two-way background correction using cubic smoothing splines and multivariate data analysis applied to the characterisation of mixtures of surfactants.

Mixtures of the surfactant classes coconut diethanolamide, cocamido propyl betaine and alkylbenzene sulfonate were separated by capillary electrophoresis in several media containing organic solvents and anionic solvophobic agents. Good resolution between both the surfactant classes and the homologues within the classes was achieved in a BGE containing 80 mM borate buffer of pH 8.5, 20% n-propanol and 40 mM sodium deoxycholate. Full resolution, assistance in peak assignment to the classes (including the recognition of solutes not belonging to the classes), and improvement of the signal-to-noise ratio was achieved by multivariate data analysis of the time-wavelength electropherograms. Cubic smoothing splines were used to develop an algorithm capable of automatically modelling the two-way background, which increased the sensitivity and reliability of the multivariate analysis of the corrected signal. The exclusion of significant signals from the background model was guaranteed by the conservativeness of the criteria used and the safeguards adopted all along the point selection process, where the CSS algorithm supported the addition of new points to the initially reduced background sample. Efficient background modelling made the application of multivariate deconvolution within extensive time windows possible. This increased the probability of finding quality spectra for each solute class by orthogonal projection approach. The concentration profiles of the classes were improved by subsequent application of alternating least squares. The two-way electropherograms were automatically processed, with minimal supervision by the user, in less than 2 min. The procedure was successfully applied to the identification and quantification of the surfactants in household cleaners.

Resolution of overlapped non-absorbing and absorbing solutes using either an absorption null-balance detection window or multivariate deconvolution applied to capillary electrophoresis of anionic surfactants.

Non-absorbing alkyl ether sulfates (AES) can be separated using anthraquinone-2-carboxylic acid (AQCA) as a probe; however, absorbing alkyl benzene sulfonates (ABS), if present, interfere indirect detection of most AES oligomers. Overcoming of this interference, as well as the simultaneous characterisation and evaluation of AES, fatty acids and ABS, was accomplished by using a diode-array detector and the procedures here discussed. First, it was shown that ABS can be made undetectable by using a 9 nm wide and 227 nm centred charge-absorptivity null-balance detection window (NBDW), where its contribution to the absorbance cancels the dilution effects that its presence induces on the signal of the background chromophore (BGC). Two other procedures, not requiring any prior knowledge on the nature of the absorbing interference, were also addressed. In the first one, the NBDW procedure was emulated by software, by treating the time-wavelength data matrix stored during the experimental run, and in the second one, both the ABS and BGC spectra, and the concentration profiles of ABS and the non-absorbing solutes, were recovered by orthogonal projection approach (OPA) and alternating least squares (ALS). The OPA-ALS processing provided the deconvolved signals and the wavelengths required to implement the experimental and software-emulated NBDW procedures. A composite ABS spectrum and a mixed concentration profile of the non-absorbing solutes, that involves mutual ABS-BGC dilution effects are enclosed in the OPA-ALS straightforward solutions. The pure spectra and concentration profiles were finally retrieved by crossed orthogonalisation. For the NBDW procedures, the limits of detection (S/N = 3) for AES oligomers overlapped by 1500 microg ml(-1) ABS were of ca. 10 microM AES. Using decyl sulfate as internal standard, the relative standard deviation for AES in an ABS containing industrial sample was 4.5%. The procedures here described are useful to remove the interference produced by any absorbing solute when overlapped with indirectly detected solutes in both capillary electrophoresis (CE) and HPLC.

Characterization and quantitation of mixtures of alkyl ether sulfates and carboxylic acids by capillary electrophoresis with indirect photometric detection.

The separation, characterization, and determination of mixtures of alkyl ether sulfates (AES) and fatty acids (C10-C16) in background electrolytes (BGEs) containing acetonitrile (ACN)-water mixtures is addressed. Due to inhibition of the ionization of the carboxylate groups, the migration time and the resolution between the fatty acids decreased when the water content of the BGE was reduced, but efficiency and resolution between the AES oligomers improved. The migration times increased and resolution improved by substituting 5% ACN by an equivalent amount of dioxane. A complete separation of the two surfactant classes, up to the AES oligomers with 8 ethylene oxide units (EOs) with respect to C10, with excellent resolution between the AES oligomers, while preserving a satisfactory resolution between the fatty acids, was achieved with a BGE containing 5 mM trimethoxybenzoic acid, 7 mM dipentylamine, 85% ACN, 5% dioxane, and 10% water. The two surfactant classes were increasingly resolved by further reducing the water content of the BGE. Thus, C2 (acetate) was resolved from the AES oligomers up to 7 EOs using 90% ACN and 5% dioxane, but the resolution between the heavier fatty acids was poor with this BGE. Identification of the AES oligomers was eased by the excellent regularity of the successive migration times; thus, within each AES subclass or series of oligomers with the same number of carbon atoms in the alkyl chain, the migration times decreased following a mild curve as the number of EOs increased. The way how the data obtained by indirect photometry (corrected peak areas that are proportional to the molar concentrations) should be managed to avoid systematic error when the calibration curve is constructed using an AES standard with an oligomer distribution different from that of the samples is discussed and equations are given. Decyl sulfate was successfully used as internal standard. The detection limits (S/N = 3) were of ca. 2 microM for individual AES oligomers.