RESUMO
Individuals with paraphilic interests in sexual violence or children may be more likely to sexually offend if they possess offense-supportive cognitions. These cognitions may develop in response to childhood adversity. However, this idea is largely based on research in men convicted of sexual offenses and may not generalize to non-incarcerated adults with paraphilic interests. In a sample of 178 adults screened for paraphilic interests in violence or children (from the general Czech population), we hypothesized that childhood sexual abuse and emotional neglect would be associated with offense-supportive cognitions about rape and child molestation. Participants came from a nationally representative sample of Czech adults and were selected if they self-reported high levels of sexual interest in violence and/or children. Participants completed an online survey with self-report measures of sexual orientation, offense-supportive cognitions (Bumby RAPE and MOLEST scales), and childhood sexual abuse and emotional neglect (Childhood Trauma Questionnaire). Controlling for gender, age, and sexual orientation, we found that both rape-supportive cognitions and child molestation-supportive cognitions were significantly associated with higher levels of childhood sexual abuse, but not emotional neglect. These findings indicate that childhood sexual abuse may lead to offense-supportive cognitions among men and women with paraphilia.
Assuntos
Cognição , Humanos , Masculino , Feminino , República Tcheca , Adulto , Pessoa de Meia-Idade , Criança , Experiências Adversas da Infância/psicologia , Experiências Adversas da Infância/estatística & dados numéricos , Abuso Sexual na Infância/psicologia , Abuso Sexual na Infância/estatística & dados numéricos , Estupro/psicologia , Transtornos Parafílicos/psicologia , Delitos Sexuais/psicologia , Delitos Sexuais/estatística & dados numéricos , Comportamento Sexual/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Adulto Jovem , Inquéritos e Questionários , AdolescenteRESUMO
BACKGROUND: Childhood victimization has been associated with long-term psychological effects and an increased risk of being victimized in later life. Previous research has primarily focused on sexual abuse during childhood, and a wide range of consequences have been identified. However, a significant gap remains in our understanding of the complex interaction between different forms of childhood abuse and violence in later life, particularly in the context of broader social stressors such as armed conflict and displacement. METHODS: This study examines the association between exposure to different types of childhood maltreatment in the context of family and intimate partner violence (IPV) among displaced women living in refugee camps in northern Iraq. Structured interviews were conducted by trained female psychologists with 332 women aged between 20 and 62 years. RESULTS: Results indicated that over one-third of the participating women reported experiencing at least one occurrence of IPV by their husbands within the past year. In addition, participants reported experiences of different types of maltreatment (physical, emotional, and sexual violence and physical and emotional neglect) perpetrated by family members in their childhood. While all forms of childhood maltreatment showed an association with IPV within the past year, only emotional childhood maltreatment was found to be a significant predictor of IPV in a multivariate analysis. CONCLUSION: The study highlights the ongoing impact of child maltreatment and its contribution to increased vulnerability to IPV victimization in later life. In addition, this study describes the specific cultural and contextual elements that contribute to IPV in refugee camps.
Assuntos
Vítimas de Crime , Violência por Parceiro Íntimo , Refugiados , Humanos , Feminino , Adulto , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Refugiados/psicologia , Refugiados/estatística & dados numéricos , Pessoa de Meia-Idade , Iraque , Vítimas de Crime/psicologia , Vítimas de Crime/estatística & dados numéricos , Adulto Jovem , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Campos de Refugiados , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Conflitos Armados/psicologiaRESUMO
OBJECTIVES: Childhood maltreatment has long-lasting effects on mental health. Existing evidence suggests that trajectories of depressive symptoms vary among individuals; however, little is known about how childhood maltreatment shapes these trajectory patterns. Therefore, this study investigated the impacts of childhood maltreatment on eight-year depressive trajectories among Chinese older adults. METHOD: Five waves of longitudinal data from the China Health and Retirement Longitudinal Study were utilized. Growth Mixture Modelling was performed to identify distinct trajectories of depressive symptoms, and multinomial logistic regression was conducted to explore the associations between these trajectories and childhood maltreatment. RESULTS: Four trajectories of depressive symptoms were identified: the 'no symptoms' class (61.83%), the 'increasing symptoms' class (14.49%), the 'decreasing symptoms' class (16.44%), and the 'chronic symptoms' class (7.24%). Older adults who experienced childhood physical abuse were more likely to be in the 'chronic symptoms' class than in the 'no symptoms' class, whereas emotional neglect did not show a significant association with three problematic trajectories. CONCLUSION: This study provides empirical evidence that childhood physical abuse increases the likelihood of developing chronic depressive symptoms in later life. To mitigate this risk, it is crucial to institute comprehensive treatment plans that incorporate trauma-informed care principles, employ evidence-based therapies specifically designed to address the long-term effects of abuse, and prioritize regular screening and assessment of mental health among older adults.
Assuntos
Depressão , Humanos , Masculino , Estudos Longitudinais , Feminino , Idoso , China/epidemiologia , Depressão/epidemiologia , Depressão/psicologia , Pessoa de Meia-Idade , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Idoso de 80 Anos ou mais , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricosRESUMO
OBJECTIVE: This longitudinal cohort study aims to investigate the relationship between self-reported childhood maltreatment (CM) and the retrospective trajectory of substance use, mental health, and satisfaction with life in individuals with substance use disorders. METHODS: One hundred eleven treatment-seeking individuals with substance use disorder were recruited from clinical settings and monitored prospectively for 6 years. The participants' substance use, mental health, and satisfaction with life were assessed using standardized measures. Cluster analysis divided the cohort into two groups-low CM and high CM-based on their scores on the Childhood Trauma Questionnaire Short Form at year 6. Mixed-effects linear models were fitted to assess the association between longitudinal scores on drug use, mental health, and satisfaction with life and CM group. RESULTS: Most participants (92%) reported at least 1 CM. Out of all participants, 36% were categorized into the high-CM group, while 59% were categorized into the low-CM group. CM group was not associated with the amount of substance or alcohol use. CM group was significantly associated with the longitudinal course of mental health and life satisfaction. CONCLUSIONS: This study underscores the association between self-reported CM and mental health and life satisfaction in patients with substance use disorder. Our results may imply an increased risk of adverse outcomes in patients with high levels of CM, while bearing in mind that both current and retrospective mental health and substance use problems can influence the accuracy of recalling CM.
Assuntos
Saúde Mental , Autorrelato , Transtornos Relacionados ao Uso de Substâncias , Humanos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Feminino , Masculino , Adulto , Estudos Retrospectivos , Estudos Longitudinais , Pessoa de Meia-Idade , Satisfação Pessoal , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Diagnóstico Duplo (Psiquiatria) , Maus-Tratos Infantis/estatística & dados numéricos , Maus-Tratos Infantis/psicologiaRESUMO
Objective: This article intends to reveal the long-term effects of physical maltreatment in childhood on depressive symptoms in later life in China. Methods: Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS). 8676 respondents aged 45 and older were included in the study. In this study, we use ordinary least squares (OLS) regression models to estimate the long-term impact on children of physical punishment from their parents. Results: We found that individuals who recalled being hit by their mother in early life reported more depressive symptoms than those who recalled being punished by their father. Difficult family contexts (e.g., comparative poverty, family violence, and parent's poor mental health) had a weak association with higher risk of reporting physical maltreatment and more depressive symptoms among respondents in later life. Conclusion: This article extended the exploration of the long-term impact of child physical maltreatment beyond adolescence and into until later adult life. Effective policies to protect children from maltreatment in the form of physical punishment require further attention to the challenges posed by tradition and culture.
Assuntos
Depressão , Humanos , Feminino , Masculino , China/epidemiologia , Depressão/psicologia , Depressão/epidemiologia , Pessoa de Meia-Idade , Estudos Longitudinais , Idoso , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Criança , Punição/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricosRESUMO
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.
Assuntos
Ansiedade , Depressão , Ideação Suicida , Humanos , Nigéria/epidemiologia , Estudos Transversais , Adulto , Feminino , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Prevalência , Adolescente , Depressão/epidemiologia , Depressão/psicologia , Ansiedade/epidemiologia , Idoso , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , CriançaRESUMO
Child maltreatment (CM) is associated with multiple adverse health outcomes. Hence, there is a great need to identify factors that promote resilience in CM survivors. Mentorship may promote positive coping in CM survivors, but this may vary by health outcome and mentor/mentee characteristics. Among participants in a United States nationally representative sample, the National Longitudinal Study of Adolescent to Adult Health, who retrospectively reported any CM before age 18 (sexual, emotional or physical, abuse or neglect; N = 3364), we examined associations between mentorship during adolescence and body mass index (BMI), obesity, and depressive symptoms at ages 24-32 (in 2008-2009). We utilized linear regression and predictive margins with complex sample weighting. Models were stratified by sex and race/ethnicity. Thirty-one percent and 40% of participants' most influential mentor was inside and outside the family, respectively, and 29% reported no mentor. Any mentorship was associated with decreased depressive symptoms in females (adjusted beta for any mentor = -0.78, 95% CI:-1.54,-0.02). By contrast, any mentorship was associated with increased adiposity, namely among Latinas (adjusted beta for BMI = 2.23, 95% CI:0.45,4.02, adjusted risk ratio for obesity = 1.42, 95% CI:1.03,1.97). The influence of mentorship in CM survivors is heterogeneous. While mentorship was associated with reduced psychopathology, it was also linked with worse physical health, underscoring that mentoring does not necessarily promote long-term resilience to physical health outcomes, particularly in minorities. A better understanding of how mentors influence specific mentee behaviors may be important in informing how mentors can promote better physical health and lower obesity risk among CM survivors.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis , Depressão , Mentores , Obesidade , Adolescente , Adulto , Feminino , Humanos , Adulto Jovem , Adiposidade , Depressão/epidemiologia , Estudos Longitudinais , Obesidade/epidemiologia , Estudos Retrospectivos , Estados Unidos/epidemiologia , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricosRESUMO
Intrafamilial child sexual abuse (IFCSA) is a social problem with longstanding effects on victims' lives. While scholarly literature has focused on the adverse aftermath of sexual abuse, only a few studies have acknowledged older women's perspectives on their experience of IFCSA and their journey of healing and recovery. The aim of the present study was to explore how older survivors of IFCSA construct and shape their experience of healing in later life and the meaning they assign to this process. Narrative inquiry was selected to explore the narratives of 11 older women survivors of IFCSA. Participants were interviewed using a biographical narrative interviewing method. The narratives were then transcribed and analyzed using thematic, structural, and performance analyses. Four major themes emerged from the participants' narratives: Achieving closure; Spiritual framing of IFCSA as a platform for self-growth; Becoming whole in old age; and Looking to the future after IFCSA. During the aging years, IFCSA survivors may redefine their identity and their place in the world. Using life review processes, older women in this study were striving to heal and reconcile with their past.
Assuntos
Adaptação Psicológica , Sobreviventes Adultos de Maus-Tratos Infantis , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , NarraçãoRESUMO
OBJECTIVE: The aim of the study was to analyse the relationship between adverse childhood experiences (ACEs) and repeat induced abortion, with regard to the potential effects of social deprivation and intimate partner violence. METHODS: An observational cross-sectional survey was conducted across each of the 25 abortion centres in Aquitaine, France, from 15 June to 15 September 2009. The sample comprised 806 women >18 years who had requested an induced abortion. Data were collected through a self-reported anonymous questionnaire on ACEs and experience of previous abortion. The main outcome measure was the percentage of repeat induced abortions. RESULTS: Among the participants, 473 (58.7%) were having their first induced abortion and 333 (41.3%) had already had a previous induced abortion. The abortion rank (first, second, third or more) was inversely related to the proportion of women with no ACE exposure (28%, 20% and 9%, respectively) and positively related to the proportion of women with a high ACE exposure (17%, 27% and 32%, respectively). Compared with women with no ACE exposure who were having a first induced abortion, in those with high ACE exposure, the odds of a third or more request for abortion was high: adjusted odds ratio 7.73 (95% confidence interval 3.56, 16.77). CONCLUSION: We found a strong graded link between the extent of ACE exposure and the occurrence of repeat induced abortion.
Assuntos
Aborto Induzido/estatística & dados numéricos , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Experiências Adversas da Infância/psicologia , Violência por Parceiro Íntimo/psicologia , Administração Sublingual , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Experiências Adversas da Infância/estatística & dados numéricos , Estudos Transversais , Feminino , França , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Acontecimentos que Mudam a Vida , Gravidez , Inquéritos e QuestionáriosRESUMO
BACKGROUND: A growing body of research suggests that childhood adversities are associated with later psychosis, broadly defined. However, there remain several gaps and unanswered questions. Most studies are of low-level psychotic experiences and findings cannot necessarily be extrapolated to psychotic disorders. Further, few studies have examined the effects of more fine-grained dimensions of adversity such as type, timing and severity. AIMS: Using detailed data from the Childhood Adversity and Psychosis (CAPsy) study, we sought to address these gaps and examine in detail associations between a range of childhood adversities and psychotic disorder. METHOD: CAPsy is population-based first-episode psychosis case-control study in the UK. In a sample of 374 cases and 301 controls, we collected extensive data on childhood adversities, in particular household discord, various forms of abuse and bullying, and putative confounders, including family history of psychotic disorder, using validated, semi-structured instruments. RESULTS: We found strong evidence that all forms of childhood adversity were associated with around a two- to fourfold increased odds of psychotic disorder and that exposure to multiple adversities was associated with a linear increase in odds. We further found that severe forms of adversity, i.e. involving threat, hostility and violence, were most strongly associated with increased odds of disorder. More tentatively, we found that some adversities (e.g. bullying, sexual abuse) were more strongly associated with psychotic disorder if first occurrence was in adolescence. CONCLUSIONS: Our findings extend previous research on childhood adversity and suggest a degree of specificity for severe adversities involving threat, hostility and violence.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Experiências Adversas da Infância/estatística & dados numéricos , Maus-Tratos Infantis/estatística & dados numéricos , Hostilidade , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/etiologia , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Feminino , Humanos , MasculinoRESUMO
In the past decade, the links between core types of childhood maltreatment and suicidal acts have become an increasingly important area of investigation. However, no meta-analytic review has examined this relationship in prisoners. We undertook the first systematic meta-analytic review examining the link between childhood maltreatment and suicide attempts in prisoners to redress this important gap. We searched Medline, PsychINFO, Embase, Web of Science and CINAHL from inception until August 2019. Meta-analyses using random effect models were applied, and heterogeneity was quantified using the I2 statistic. Publication bias and risk of bias across studies were assessed. We identified 24 studies comprising 16 586 prisoners. The rates of different types of childhood maltreatment ranged between 29% and 68% [95% confidence interval (CI) 18-81%]. The rate of suicide attempts in prisoners was 23% (95% CI 18-27%). Main results demonstrated that sexual abuse [odds ratio (OR) 2.68, 95% CI 1.86-3.86], physical abuse (OR 2.16, 95% CI 1.60-2.91), emotional abuse (OR 2.70, 95% CI 1.92-3.79), emotional neglect (OR 2.29, 95% CI 1.69-3.10), physical neglect (OR 1.57, 95% CI 1.27-1.94) and combined abuse (OR 3.09, 95% CI 2.14-4.45) were strongly associated with suicide attempts in prisoners. There was an indication of publication bias. Duval and Tweedie's trim-and-fill method was applied, which increased the odds for suicide attempts. Given the high rates of prison suicide deaths and suicide attempts, our findings suggest an urgent need for targeted suicide prevention priorities for prisoners, with a particular focus on ameliorating the effects of childhood traumatic experiences on suicidal prisoners.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Prisioneiros/psicologia , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Masculino , Prisioneiros/estatística & dados numéricos , Adulto JovemRESUMO
BACKGROUND: Childhood abuse is a risk factor for poorer illness course in bipolar disorder, but the reasons why are unclear. Trait-like features such as affective instability and impulsivity could be part of the explanation. We aimed to examine whether childhood abuse was associated with clinical features of bipolar disorder, and whether associations were mediated by affective instability or impulsivity. METHODS: We analysed data from 923 people with bipolar I disorder recruited by the Bipolar Disorder Research Network. Adjusted associations between childhood abuse, affective instability and impulsivity and eight clinical variables were analysed. A path analysis examined the direct and indirect links between childhood abuse and clinical features with affective instability and impulsivity as mediators. RESULTS: Affective instability significantly mediated the association between childhood abuse and earlier age of onset [effect estimate (θ)/standard error (SE): 2.49], number of depressive (θ/SE: 2.08) and manic episodes/illness year (θ/SE: 1.32), anxiety disorders (θ/SE: 1.98) and rapid cycling (θ/SE: 2.25). Impulsivity significantly mediated the association between childhood abuse and manic episodes/illness year (θ/SE: 1.79), anxiety disorders (θ/SE: 1.59), rapid cycling (θ/SE: 1.809), suicidal behaviour (θ/SE: 2.12) and substance misuse (θ/SE: 3.09). Measures of path analysis fit indicated an excellent fit to the data. CONCLUSIONS: Affective instability and impulsivity are likely part of the mechanism of why childhood abuse increases risk of poorer clinical course in bipolar disorder, with each showing some selectivity in pathways. They are potential novel targets for intervention to improve outcome in bipolar disorder.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/etiologia , Transtorno Bipolar/fisiopatologia , Comportamento Impulsivo , Adulto , Sintomas Afetivos/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias , Tentativa de Suicídio/estatística & dados numéricosRESUMO
PURPOSE: Few clinical guidelines focus on how physicians can identify intimate partner violence (IPV) perpetration or victimization among male patients, and little is known of men's experiences and beliefs regarding screening in health care settings. Our objective was to determine prevalence of men's experiences with IPV screening in health care settings and associations with men's beliefs regarding health care clinician identification of IPV. METHODS: Using a cross-sectional online survey of a nationally representative sample of 916 men aged 18-35 years, we conducted survey-weighted descriptive analyses to determine IPV prevalence, screening experiences and beliefs, and multivariate logistic regression to examine associations of demographics, IPV perpetration, and IPV victimization with men's screening experiences and beliefs. RESULTS: Of 916 men surveyed, 19% reported perpetration and 27% reported victimization in relationship with current or previous spouse/partner, 90% believed health care clinicians should ask about perpetration, 92% believed health care clinicians should ask about victimization, but only 11% had been asked about perpetration and 13% about victimization. Beliefs regarding IPV were associated with African American non-Hispanic race, IPV perpetration, and IPV victimization. Experiences being asked about IPV were associated with educational attainment and IPV perpetration. CONCLUSIONS: Among young US men, 9 in 10 support IPV identification by health care clinicians, nearly 1 in 5 report using IPV, but only about 1 in 10 report health care clinicians asking about IPV. These represent missed opportunities for health care IPV identification. Beliefs and experiences regarding health care IPV identification vary by race, education, and men's IPV perpetration and victimization. These disparities can inform tailored health care identification approaches.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Negro ou Afro-Americano/estatística & dados numéricos , Renda/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Escolaridade , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Prevalência , Fatores de Risco , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: To study if childhood emotional, physical and sexual abuse are determinants for having an unplanned pregnancy, if the categories of abuse interact, and if a potential bias due to the selection of the participants (collider stratification bias) could explain the effect of childhood abuse. DESIGN: A cross-sectional study. SETTING: The study is based on the Norwegian Mother and Child Cohort Study (MoBa) and uses data from the Medical Birth Registry of Norway. SAMPLE: Women participating in the MoBa for the first time, ≥18 years of age who responded to questions regarding childhood abuse and pregnancy planning (n = 76 197). METHODS: Data were collected using questionnaires. We conducted analyses using modified Poisson regressions and the relative excess risks due to interaction (RERI). Sensitivity analyses were performed. MAIN OUTCOME MEASURE: An unplanned pregnancy (yes/no). RESULTS: Exposure to childhood emotional (adjusted relative risk [RR] 1.14, 95% CI 1.10-1.19), physical (adjusted RR 1.11, 95% CI 1.04-1.18) and sexual (adjusted RR 1.20, 95% CI 1.14-1.27) abuse increased the risk of having an unplanned pregnancy. The effects could not be explained by the collider stratification bias. The different combinations of categories of abuse did not show any interaction effects. CONCLUSIONS: Childhood emotional, physical and sexual abuses separately increase the risk of having an unplanned pregnancy. The results indicate that victims of childhood abuse are in greater need of support to achieve their reproductive goals. TWEETABLE ABSTRACT: Childhood abuse increases the risk of having an unplanned pregnancy. #reproductivehealth #epitwitter.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Maus-Tratos Infantis/estatística & dados numéricos , Gravidez não Planejada , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Estudos Transversais , Feminino , Humanos , Noruega/epidemiologia , Gravidez , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Functional limb weakness is a common symptom of functional neurological disorder. Few controlled studies have examined possible predisposing factors to determine their specificity for this symptom. METHODS: In this prospective case-control study, patients with functional limb weakness (<2 years duration, N=107) were compared with a control group (comprising patients with weakness attributable to neurological disease, N=46, and healthy individuals, N=39). A structured clinical interview and questionnaires assessed potential predisposing factors, including family structure and childhood abuse and neglect (Childhood Trauma Questionnaire [CTQ]), personality traits (NEO Five-Factor Inventory), medical and surgical comorbidity, and exposure to a symptom model. RESULTS: The patients with functional limb weakness and the control subjects were similar in gender and age. Self-reported childhood sexual abuse (15% versus 5%, p<0.01), and physical abuse (18% versus 7%, p<0.01; CTQ "moderate or above") were more common in the functional limb weakness group, although the absolute frequency was lower than anticipated. In the functional limb weakness group, there were modest differences in two personality traits, compared with the control group: higher neuroticism (p=0.02) and lower openness (p=0.01). Medical comorbidity, including appendectomy (33% versus 5%), irritable bowel syndrome (36% versus 18%), and chronic back pain (40% versus 16%), was more frequent in the functional limb weakness group. There were no differences in birth order or exposure to a symptom model. CONCLUSIONS: Medical and surgical comorbidity and adverse childhood experience are risk factors, but not essential, for the development of functional limb weakness. However, evidence for personality traits or exposure to a symptom model is less robust.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis , Experiências Adversas da Infância , Transtorno Conversivo , Extremidades , Doenças do Sistema Nervoso , Personalidade , Adolescente , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Experiências Adversas da Infância/estatística & dados numéricos , Idoso , Estudos de Casos e Controles , Comorbidade , Transtorno Conversivo/epidemiologia , Transtorno Conversivo/fisiopatologia , Extremidades/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/fisiopatologia , Personalidade/fisiologia , Estudos Prospectivos , Fatores de Risco , Adulto JovemRESUMO
Childhood maltreatment (CM) is a strong risk factor for alcohol dependence (AD) and is associated with a more severe course of the disease. Alterations of the hypothalamic-pituitary-adrenal (HPA) axis may play an important role in this relationship. The aim of the present study was to systematically investigate potential alterations in HPA functioning associated with AD diagnosis and CM. Four study groups were recruited: AD patients with (n = 29; 10â) and without (n = 33; 8â) CM and healthy controls with (n = 30; 20â) and without (n = 38; 15â) CM. Cumulative cortisol secretion was measured by hair cortisol concentration (HCC). To measure HPA axis response to the Trier social stress test (TSST), saliva and blood samples were analysed for adrenocorticotropic hormone (ACTH) and cortisol. In the AD groups, the period of hair growth covered acute alcohol consumption and withdrawal. The TSST was scheduled after completion of withdrawal. Irrespective of CM, higher HCCs and reduced ACTH and cortisol levels before and after TSST were observed in AD patients. The analyses did not reveal any differences between AD patients with and without CM. Healthy controls with CM had lower plasma cortisol levels compared with those without CM. The results suggest that AD is strongly related to HPA axis functioning, which may superimpose possible differences between AD patients with and without CM. Future studies should investigate whether biologically different subtypes of AD with and without CM can be identified in earlier stages or before the development of AD.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Alcoolismo/metabolismo , Hidrocortisona/metabolismo , Sistema Hipotálamo-Hipofisário/metabolismo , Sistema Hipófise-Suprarrenal/metabolismo , Estresse Psicológico/metabolismo , Adulto , Alcoólicos/estatística & dados numéricos , Feminino , Cabelo/metabolismo , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Methamphetamine (MA)-related psychiatric symptoms (MAP) are serious comorbidities of MA use and result in many social problems such as violence and suicide. We investigated the sociodemographic and genetic risk factors for persistent MAP of MA users (MUs) and constructed an early MAP prediction model. Derivation and replication samples had 1734 and 905 MUs, respectively. Symptom Checklist 90, Childhood Trauma Questionnaire, Attention-Deficit Hyperactivity Disorder (ADHD) Rating Scale-IV, and Social Support Rating Scale were used to assess the past-year prevalence of general MAP and life events retrospectively. Genome-wide association study (GWAS) was used to analyze MAP-related genetic factors. The prediction model was constructed by integrating the risk life events and clinical and genetic features using logistic regression. Of the 2639 MUs, 1293 (48.83%) had past-year MAP. The severity of MA addiction (SMA), childhood trauma, childhood ADHD symptoms, and social support were reliable risk factors for persistent MAP. By integrating these risk factors and the polygenic risk score from GWAS from derivation samples, the area under the curve (AUC) of the predictive model for MAP was 0.754 (95% CI 0.717~0.771). The risk factors and prediction model were also verified in replication samples. In addition, SMA, ADHD, and social support were mediators for the effect of the risk genetic factor on persistent MAP. Our study identified several risk factors for persistent MAP and will be helpful for developing scalable tools for the prevention of persistent and general MAP.
Assuntos
Transtornos Relacionados ao Uso de Anfetaminas/epidemiologia , Transtornos Relacionados ao Uso de Anfetaminas/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Inquéritos e Questionários/estatística & dados numéricos , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Transtornos Relacionados ao Uso de Anfetaminas/genética , China , Comorbidade , Feminino , Estudo de Associação Genômica Ampla/métodos , Estudo de Associação Genômica Ampla/estatística & dados numéricos , Humanos , Masculino , Transtornos Mentais/genética , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
In recent times, an increasing interest in the role of childhood adversities in schizophrenia can be seen. In this study, 37 schizophrenic patients were compared with 25 individuals from the general population with regard to the quality of parental care and traumatic experiences in childhood. Two self-report scales for retrospective measurement of these variables were used that differentiate between maternal and paternal rejection, emotional warmth and control on the one hand, and trauma subtypes on the other. The schizophrenic patients scored lower regarding both parents' emotional warmth and higher regarding emotional and physical abuse and neglect. Group membership was correctly predicted with these childhood variables in 83% of cases, with the mother's emotional warmth being the best predictor. The findings underline the relevance of childhood adversities in schizophrenic diseases in adulthood, with special emphasis on the role of emotional acceptance from the primary caregiver.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Experiências Adversas da Infância/estatística & dados numéricos , Relações Pai-Filho , Relações Mãe-Filho/psicologia , Poder Familiar , Esquizofrenia/epidemiologia , Psicologia do Esquizofrênico , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Experiências Adversas da Infância/psicologia , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Masculino , Fatores de Risco , Adulto JovemRESUMO
This study aimed to investigate the association between childhood neglect and psychological distress in pregnant women and to assess whether perceived social support and coping styles mediated this association. Pregnant women (N = 276) recruited from the prenatal clinic of a comprehensive hospital in China participated in this study. Participants reported their experiences of childhood neglect and abuse, depression, anxiety, perceived social support, and coping styles. Childhood neglect was positively associated with psychological distress. Perceived social support mediated the relationship between childhood neglect and psychological distress. Perceived social support and positive coping acted as chain mediators between childhood neglect and psychological distress. Childhood neglect is a risk factor for psychological distress during pregnancy independent of childhood abuse; perceived social support and positive coping can influence this relationship.
Assuntos
Adaptação Psicológica , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Ansiedade/epidemiologia , Depressão/epidemiologia , Complicações na Gravidez/epidemiologia , Angústia Psicológica , Apoio Social , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Ansiedade/psicologia , China , Depressão/psicologia , Feminino , Humanos , Análise de Mediação , Gravidez , Complicações na Gravidez/psicologia , Fatores de RiscoRESUMO
Intimate partner violence (IPV) has a remarkable impact on mental health and is common in people diagnosed with severe mental disorders (SMDs). Data of 102 outpatients were collected from clinical records and the Traumatic Life Events Questionnaire (TLEQ). Global estimation of lifetime IPV exposure was obtained by combining answers to selected TLEQ questions about physical, psychological, and sexual IPV. Overall, 24.5% of the participants reported at least one lifetime episode of IPV victimization. Female gender (odds ratio [OR] = 3.15, p = 0.016) and childhood trauma (OR = 4.7, p = 0.002) significantly increased the likelihood of IPV victimization. Conversely, posttraumatic stress disorder was not significantly increased in IPV victims. These findings are in line with current literature and suggest a remarkable and transdiagnostic prevalence of lifetime IPV victimization in SMD. Gender, childhood trauma, and SMD are relevant factors in IPV analysis and prevention. Diathesis of trauma, psychosocial vulnerability to revictimization and intersectional feminist theory help explain our results.