Childhood trauma exposure while growing up during war and PTSD symptoms in adulthood

Trauma exposure is strongly linked to maternal posttraumatic stress disorder (PTSD) and depressive symptoms during the perinatal period; however, childhood trauma exposure is often assessed without accounting for adult exposure. This study tested the unique impacts of childhood and adulthood trauma exposure on PTSD and depressive symptoms among pregnant women (N = 107, 82.9% Latina) enrolled in a nonrandomized intervention study. Regression analyses at baseline showed positive associations between trauma exposure and PTSD symptoms irrespective of trauma timing, childhood: B = 1.62, t(91) = 2.11, p = .038; adulthood: B = 2.92, t(91) = 3.04, p = .003. However only adulthood trauma exposure, B = 1.28, t(94) = 2.94, p = .004, was positively associated with depressive symptoms. Mixed-effects analyses of variance revealed interaction effects of time and adulthood trauma exposure, indicating that women with high degrees of adulthood trauma exposure had higher baseline levels of PTSD, F(1, 76.4) = 6.45, p = .013, and depressive symptoms, F(1, 87.2) = 4.88, p = .030, but showed a more precipitous decrease posttreatment than women with lower levels of adulthood trauma exposure. These findings support the clinical relevance of assessing both childhood and adulthood trauma exposure during the perinatal period given their impacts on baseline symptoms and psychotherapy response.

The mediating role of emotion dysregulation and depression on the relationship between childhood trauma exposure and emotional eating

This replication study examined protective effects of positive childhood memories with caregivers ("angels in the nursery") against lifespan and intergenerational transmission of trauma. More positive, elaborated angel memories were hypothesized to buffer associations between mothers' childhood maltreatment and their adulthood posttraumatic stress disorder (PTSD) and depression symptoms, comorbid psychopathology, and children's trauma exposure. Participants were 185 mothers (M age = 30.67 years, SD = 6.44, range = 17-46 years, 54.6% Latina, 17.8% White, 10.3% African American, 17.3% other; 24% Spanish speaking) and children (M age = 42.51 months; SD = 15.95, range = 3-72 months; 51.4% male). Mothers completed the Angels in the Nursery Interview (Van Horn, Lieberman, & Harris, 2008), and assessments of childhood maltreatment, adulthood psychopathology, children's trauma exposure, and demographics. Angel memories significantly moderated associations between maltreatment and PTSD (but not depression) symptoms, comorbid psychopathology, and children's trauma exposure. For mothers with less positive, elaborated angel memories, higher levels of maltreatment predicted higher levels of psychopathology and children's trauma exposure. For mothers with more positive, elaborated memories, however, predictive associations were not significant, reflecting protective effects. Furthermore, protective effects against children's trauma exposure were significant only for female children, suggesting that angel memories may specifically buffer against intergenerational trauma from mothers to daughters.

The dissociative subtype of posttraumatic stress disorder (PTSD) is estimated to characterize about 12-30% of those with PTSD. Some research links this subtype with increased severity of PTSD symptoms compared to samples with “classic” PTSD. However, prevalence and severity rates reported in the literature have varied. One possible explanation for these discrepancies could be related to where the populations were sampled. Therefore, we investigated whether these differences are still observed when holding level of care constant. We collected data from 104 women at a partial and residential psychiatric hospital program focused on trauma-related disorders. Participants completed self-report questionnaires assessing trauma exposure, symptoms and provisional diagnosis of PTSD, trauma-related thoughts and beliefs, and feelings of shame. All participants reported a history of childhood and/or adulthood trauma exposure. Eighty-eight (85%) met criteria for PTSD, and of those, seventy-three (83%) met criteria for the dissociative subtype as assessed by the Dissociative Subtype of PTSD Scale. A series of independent t-tests revealed no significant differences between the “classic” and dissociative PTSD groups with respect to lifetime or childhood trauma exposure, posttraumatic cognitions, shame, or overall PTSD severity. Our results suggest that samples with classic PTSD and the dissociative subtype may not differ in some types of symptom severity when holding level of care constant. Importantly, however, we found at partial/residential level of care the majority of patients with PTSD were dissociative. Given the elevated prevalence rate in this sample, these findings support the need to assess dissociative symptoms, particularly in more acute psychiatric settings.

Background: Dissociation is commonly reported by individuals who meet criteria for posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD). However, the association between the age of trauma exposure, dissociation, and CPTSD is not well understood. This study aimed to test whether dissociation mediated the relationship between the developmental stage of trauma exposure and CPTSD symptoms. Method: A nationally representative sample from Ireland (N = 1020) completed self-report measures on trauma exposure in childhood, adolescence, adulthood, current trauma symptomatology, and dissociation symptoms. A mediation analysis was conducted. Results: Childhood, adolescent, and adulthood trauma exposure were all related to dissociation and ICD-11 CPTSD symptom clusters. Dissociation mediated the effect of developmental stage of trauma exposure on PTSD and disturbances in self-organization(DSO). The direct and indirect effect models provided the best fit of the data. Childhood trauma exposure was the only developmental stage that was directly associated with both PTSD and DSO symptoms in our sample. Conclusion: Dissociation mediates the relationship between reported trauma exposure and the presence of ICD-11 CPTSD symptom clusters, and this relationship appears at its strongest when trauma occurs in childhood. CPTSD interventions should also promote dissociation management to aid recovery from this debilitating condition.

Sexual IPV and non-partner rape of female sex workers: Findings of a cross-sectional community-centric national study in South Africa

The role of cognitive functioning in the relationship between childhood trauma and a mixed phenotype of affective-anxious-psychotic symptoms in psychotic disorders

Demographic Characteristics of Individuals Who Received Project Liberty Crisis Counseling Services

Decision-making for concurrent reward and threat is differentially modulated by trauma exposure and PTSD symptom severity

Background: It is essential to address psychological health, particularly post-traumatic stress disorder (PTSD), among patients who have recovered from COVID-19. The negative impacts on the psychological health of an individual have negative impacts on health-related quality of life. The authors aimed to assess PTSD in patients recovered from COVID-19, and COVID-19-related comorbidities. Methodology: The present study was conducted as an observational cross-sectional study on patients diagnosed with COVID-19 who were discharged from Gandhi Medical College and Hamidia Hospital, both in Bhopal, India, and returning to follow-up at the medicine/psychiatry outpatient department within 6 months after discharge, during the study period of 20 months. Detailed history regarding sociodemographic variables, previous medical history, comorbidities associated with COVID-19 (e.g., mucormycosis, etc.) were noted. PTSD was assessed using the PTSD Symptom Scale (PSS). Results: A total of 120 cases, who recovered from COVID-19 infection and sought care at the authors’ centre, were included in this study, with mean age of 37.520±12.756 years. Mean PTSD score was 3.350±1.528, and PTSD was noted in 85% cases. Of these, 83.3% cases had mild, and 1.7% cases had moderate PTSD. The authors observed no significant association of sociodemographic variables with PTSD on univariate as well as multivariate analysis (p>0.05). Conclusions: Though the wave of COVID-19 pandemic has subsided, the long-term morbidities, particularly due to the impact on psychological health, are still persistent. PTSD is a common consequence following recovery from COVID-19 infection. Thus, mental health services must be provided to patients recovered from COVID-19 infection, mainly targeted at prevention of PTSD.

Background. War and its consequences not only dominate the collective and national consciousness of every citizen but also, as a stressor, lead to emotional tension and exhaustion. They are a major factor in stress-associated disorders, particularly post-traumatic stress disorder (PTSD). The diagnosis of PTSD is based on the presence of at least one symptom: intrusion, avoidance, negative mood and cognitive impairments, hyperreactivity. The purpose was to investigate the prevalence and severity of probable PTSD among patients visiting primary health care (PHC) facilities, military personnel, and forcibly displaced people (FDP) using various questionnaires. Materials and methods. A total of 90 individuals (46 men and 44 women, average age 39.65 ± 13.93 years) were examined. Participants were divided into three groups (30 individuals each): group I — military personnel of the Armed Forces of Ukraine receiving treatment at the Municipal Non-Profit Enterprise “Vinnytsia City Clinical Emergency Hospital”; group II — internally displaced persons who are forced to live in Vinnytsia (FDP); group III — controls (civilian residents of Vinnytsia visiting PHC facilities). All respondents were surveyed using the Spielberg-Hanin Anxiety Scale, assessed for the likelihood of PTSD using a PTSD screening questionnaire approved by the Ministry of Health of Ukraine (Order No. 1265 dated February 23, 2024), and with the PTSD Checklist for DSM-5 (PCL-5). Results. Probable PTSD was more frequently detected among FDP (83.33 % on the PTSD screening scale and 56.67 % on the PCL-5) compared to military personnel (53.33 and 40.0 %, respectively) and civilians (10.0 and 3.33 %, respectively). Among FDP, symptoms of avoidance (76.67 %), negative cognition (76.67 %), and hyperarousal (88.33 %) were predominant, emphasizing the significant role of emotional responses and their potential impact on other PTSD symptoms. Correlations (p < 0.05) were found between age, gender, and the score on the PCL-5. Conclusions. Probable PTSD can be successfully detected using any of the available tools (PTSD screening, PCL-5) with almost equal frequency, allowing for the identification of individuals who should undergo additional examination for PTSD confirmation and subsequent treatment of this condition.

Shifts in migration and border control policies may increase the likelihood of trauma exposure related to child–parent separation and result in costs to the health system and society. In the present study, we estimated direct and indirect costs per child as well as overall cohort costs of border control policies on migrant children and adolescents who were separated from their parents, detained, and placed in the custody of the United States following the implementation of the 2018 Zero Tolerance Policy. Economic modeling techniques, including a Markov process and Monte Carlo simulation, based on data from the National Child Traumatic Stress Network's Core Data Set (N = 458 migrant youth) and published studies were used to estimate economic costs associated with three immigration policies: No Detention, Family Detention, and Zero Tolerance. Clinical evaluation data on mental health symptoms and disorders were used to estimate the initial health state and risks associated with additional trauma exposure for each scenario. The total direct and indirect costs per child were conservatively estimated at $33,008, $33,790, and $34,544 after 5 years for No Detention, Family Detention, and Zero Tolerance, respectively. From a health system perspective, annual estimated spending increases ranged from $1.5 million to $14.9 million for Family Detention and $2.8 million to $29.3 million for Zero Tolerance compared to baseline spending under the No Detention scenario. Border control policies that increase the likelihood of child and adolescent trauma exposure are not only morally troubling but may also create additional economic concerns in the form of direct health care costs and indirect societal costs.

Background: Potentially traumatic events (PTEs) are unfortunately common experiences among children and adolescents. Approximately one quarter of US children are exposed to a PTE before the age of four, with rates increasing to 60% by 16 years of age (Briggs-Gowan, Ford, Fraleigh, McCarthy, & Carter, 2010; Copeland, Keeler, Angold, & Costello, 2007). Exposure to PTEs during childhood is associated with a wide range of negative emotional, behavioral, and physical health consequences over the life course (Anda et al., 2006; Felitti et al., 1998; Gilbert et al., 2009; Shonkoff et al., 2012). Emerging research suggests that childhood trauma may also increase susceptibility to the development of chronic pain in adolescence and adulthood (Boey & Goh, 2001; Davis, Luecken, & Zautra, 2005; Larsson & Sund, 2007; Liakopoulou-Kairis et al., 2002; Mulvaney, Lambert, Garber, & Walker, 2006). However, most investigations of the link between childhood trauma and chronic pain have focused on adults with history of maltreatment. As a result, the contribution of other PTEs to the development of chronic pain among children and adolescents is poorly understood. Additionally, prior research has largely emphasized the prevalence of comorbid chronic pain and posttraumatic stress disorder (PTSD) diagnoses, rather than closely examining the associations between specific posttraumatic stress symptoms (PTSS), pain severity, and functional impairment. As such, much remains unknown regarding the interplay between exposure to PTEs, PTSS, and chronic pain in youth. Aims: The current study aimed to investigate the relationships between quantity and timing of PTEs, pain severity, and pain-related functional impairment among children with amplified musculoskeletal pain syndromes (AMPS). Additionally, this investigation examined the relationships between indices of PTSD symptomatology (i.e., overall symptom severity and symptom clusters) and pain. Finally, this study explored whether potential associations between childhood trauma and pain outcomes were moderated by anxiety, depression, PTSS, and family functioning. Methods: This study employed a cross-sectional design. Participants included 76 children ages 8-17 years (M = 14.08, SD = 2.14) diagnosed with AMPS and their caregivers presenting to the CHOP Center for Amplified Musculoskeletal Pain Syndromes. Participants completed assessments of childhood trauma history, family functioning, and child anxiety, depression, and PTSS online within two weeks before or after their initial consultation appointment. Medical records were reviewed to obtain information about demographic characteristics, pain severity, and pain-related functional disability from measures administered as part of routine clinical care. Results: While total quantity of PTEs was not associated with pain, PTEs reported during the first five years of life significantly predicted pain-related disability. This relationship varied as a function of both child depression and perceptions of family functioning, such that children who endorsed higher current depression and family functioning exhibited the strongest relationship between early trauma and disability. Total PTSS severity and specific symptom clusters were not associated with pain outcomes and did not moderate the relationship between early childhood PTEs and pain-related disability. Conclusions: Early childhood may be a sensitive period for the effects of PTEs on risk for functional disability in youth with AMPS. Additional research utilizing prospective and longitudinal designs is needed to better understand the biopsychosocial mechanisms underlying the relationship between early childhood trauma and pediatric chronic pain.

Trauma From the Eye of the Beholder: Reporter Discordance in Children's Trauma, Psychopathology, and Neurobiology.

Within the last ten years, there has been a growing number of epidemiological studies, examining the effect of trauma exposure in children and adolescents. Although studies concerning Post-traumatic Stress Disorder (PTSD) have been conducted in a wide array of different cultural contexts [1], the knowledge on traumatization and development of PTSD is still limited [2]. Most studies conducted are clinical studies, which deal with subjects that have already been traumatized or affected by specific single events such as war [3], natural disasters [1], serious accidents [4] or physical/sexual abuse [5-7]. Though research indicates that adolescents are very vulnerable to the exposure of Potentially Traumatic Events (PTEs) [8], studies targeting non-clinical youth populations and the impact of their life experiences are very few. With the increasing ethnic diversity of populations worldwide, it is of particular interest to compare the prevalence of exposure and PTSD in children and adolescents of different ethnic backgrounds. When designing preventive interventions and treatment programs for youth suffering from PTSD it is crucial to understand the complex interaction of variables behind the disorder. Differences in prevalence of exposure, PTSD and demographic variables between ethnicities may reveal some important clues to the etiology of the disease.The present study replicated six previous non-clinical studies which were designed to provide epidemiological information about exposure to PTEs, and the prevalence of PTSD among adolescents (see Table 1). The six studies were conducted in different countries and were very similar in their research methods and samples. The studies have been conducted in four European countries: Denmark [9], Iceland, [10], Lithuania [11], and the Faroe Islands [2], as well as in two Asian countries: Israel [12], and India [13] of which the four first samples were nationally representative.