Association Of Childhood Trauma Research Articles

Association of childhood trauma with choice of bilateral mastectomy for the treatment of unilateral breast cancer.

e24096 Background: Patients are increasingly choosing bilateral mastectomy (BMX) for the treatment of primary breast cancer (BC) despite minimal survival benefits and potential for adverse medical and psychosocial consequences. Exposure to childhood trauma is associated with dysregulation of stress response systems, threat perception alterations, increased risk-taking behaviors, and body dissatisfaction. We examined childhood trauma in relation to treatment decision-making in adulthood within a sample of breast cancer patients undergoing either BMX or more conservative BC treatment. Methods: Secondary analyses of a case-control study of the neurobiological and affective determinants of BMX choice were conducted. Cross-sectional data from the baseline survey were analyzed. Participants were recruited via institutional clinic practices, social media, and patient advocacy groups. Patients completed a medical status questionnaire and the Childhood Trauma Questionnaire (CTQ). Chi-square and Mann-Whitney U tests examined differences in treatment decision-making by childhood trauma exposure and type. Results: The sample included 137 patients with unilateral stages 0-III BC (mean age 49.2; SD = 11.2; 76.6% White; 10.9% Hispanic/Latina; 68.6% married). Seven tested positive for a BRCA gene mutation. Patients were divided between BMX (n = 66) and non-BMX (n = 71) treatment groups. On average, patients in the non-BMX group reported higher levels of childhood trauma severity (Median = 7; IQR = 0-12.5) compared to patients in the BMX group (Median = 4; IQR = 0-11.75; Mann Whitney U = 4728; small effect size; SRD = -0.11; p = .26). Patients who reported a major parental upheaval (e.g., divorce, separation) were significantly more likely to pursue non-BMX compared to BMX (small effect size; SRD = -.16; p = .047). Patients who reported any uncategorized major upheaval were more likely to choose non-BMX than BMX (small effect size; SRD = -.14), but group differences did not reach significance (p = .093) . No other statistically significant relationships were observed. Conclusions: Contrary to hypotheses, preliminary results suggest BC patients who were exposed to traumatic events in childhood may be more likely to elect conservative BC surgical treatments. Trauma-related hypervigilance to threats may cause patients to exercise more caution regarding treatment choice. More research exploring the effects of adverse childhood experiences in the BC population is warranted. [Table: see text]

The association of childhood trauma with suicidality in adult psychiatric patients: The mediating role of NSSI and the moderating role of self-esteem.

The contribution of specific childhood trauma subtypes to suicidal thoughts and the associated mechanisms remains unclear, particularly in psychiatric patients. Face-to-face interviews were conducted with 449 psychiatric patients aged 18-73. Childhood trauma, self-esteem, nonsuicidal self-injury (NSSI), and suicidality were assessed retrospectively. Regression and moderated mediation model were employed to examine these relationships. Emotional and sexual abuse were independently associated with suicidality. Female patients reported higher levels of emotional and sexual abuse, lower self-esteem, and a heightened risk of suicide. Self-esteem moderated the links between childhood trauma and NSSI, as well as between NSSI and suicidality. NSSI served as a mediator between childhood trauma and suicidality. Suicide prevention in mentally ill patients should involve targeted programs addressing specific childhood trauma. Additionally, psychological interventions to enhance self-esteem and assist individuals engaging in NSSI behavior are crucial.

Religious Attendance, Childhood Trauma, and Later Life Depressive Symptoms

AbstractBackgroundOlder adults who experienced childhood trauma are at higher risk of developing depression. Depression is linked with structural changes in the brain and alterations in neurotransmitters and inflammation, placing individuals with depression at 2 times as likely to develop dementia than individuals without depression. A growing body of literature supports religion and spirituality as protective factors for mental health, yet few studies have examined the mediating role of religious attendance on the association between childhood trauma and depressive symptoms in later life. Identifying modifiable protective factors to decrease depression and, potentially, dementia is needed to decrease the growing dementia burden.MethodWe analyzed data from the Health and Retirement Study in 2006‐2012 to examine the mediating role of religious attendance (in 2010) on the association of childhood trauma (in 2008) with later‐life depressive symptoms (in 2012) among older adults in the U.S. (N = 3,240) aged 60 years and older. A mediation analysis was conducted while controlling for covariates: sex, race, education, age, marital status, body mass index (BMI), and cognition.ResultAged 60‐104 years, participants had a mean age of 72.7 (8.45) years, were 57.9% female, and were 82.9% White. A significant association was found for childhood trauma using 4 self‐report items and self‐reported depressive symptoms using the Center for Epidemiological Studies‐Depression scale (CES‐D) (β = 0.2124, 95% CI [0.31, 0.1201], p<.001). There was a partial mediating effect of self‐reported religious attendance (high vs. low) between childhood trauma and depressive symptoms (β = 0.017, 95% CI [0.03, 0.003], p<.05) adjusting for sex, race, education, age, marital status, BMI, and cognition.ConclusionReligious attendance plays a partial mediating role in the relationship between childhood trauma and later‐life depressive symptoms in older adults. Clinical trials are needed to further examine the effect of religious attendance on depressive symptoms in older adults with a history of childhood trauma, with the potential to decrease the risk of dementia.

The association of childhood trauma with depressive and negative symptoms in recent onset psychosis: a sex-specific analysis.

Childhood trauma may impact the course of schizophrenia spectrum disorders (SSD), specifically in relation to the increased severity of depressive or negative symptoms. The type and impact of trauma may differ between sexes. In a large sample of recent-onset patients, we investigated the associations of depressive and negative symptoms with childhood trauma and whether these are sex-specific. A total of 187 first-episode psychosis patients in remission (Handling Antipsychotic Medication: Long-term Evaluation of Targeted Treatment study) and 115 recent-onset SSD patients (Simvastatin study) were included in this cross-sectional study (men: n = 218; women: n = 84). Total trauma score and trauma subtypes were assessed using the Childhood Trauma Questionnaire Short Form; depressive and negative symptoms were rated using the Positive And Negative Symptoms Scale. Sex-specific regression analyses were performed. Women reported higher rates of sexual abuse than men (23.5% v. 7.8%). Depressive symptoms were associated with total trauma scores and emotional abuse ratings in men (β: 0.219-0.295; p ≤ 0.001). In women, depressive symptoms were associated with sexual abuse ratings (β: 0.271; p = 0.011). Negative symptoms were associated with total trauma score and emotional neglect ratings in men (β: 0.166-0.232; p ≤ 0.001). Negative symptoms in women were not linked to childhood trauma, potentially due to lack of statistical power. Depressive symptom severity was associated with different types of trauma in men and women with recent-onset SSD. Specifically, in women, depressive symptom severity was associated with childhood sexual abuse, which was reported three times as often as in men. Our results emphasize the importance of sex-specific analyses in SSD research.

Association of childhood trauma with cognitive domains in adult patients with mental disorders and in non-clinical populations: a systematic review.

Although the association between cognitive performances and the onset of psychiatric disorders has been widely investigated, limited research on the role of childhood trauma or early life stress (CT/ELS), and whether this role differs between clinical and non-clinical cohorts is available. This systematic review aims at filling this gap, testing whether the occurrence of CT/ELS and its subtypes are associated with cognitive domains (general cognitive ability, executive functions, working memory, attention, processing speed, verbal/visual memory) in patients with psychiatric disorders and in non-clinical populations. This study followed the PRISMA 2020 guidelines and the Newcastle-Ottawa scale for quality assessment. The search was performed until May 2022. Seventy-four studies were classified as eligible. The graphical representations of the results reported an association between exposure to CT/ELS and worse general cognitive ability, verbal/visual memory, processing speed and attention in patients affected by anxiety, mood and psychotic disorders, and that specific CT/ELS subtypes (physical neglect, physical/sexual abuse) can differentially influence specific cognitive abilities (executive functions, attention, working memory, verbal/visual memory). In non-clinical cohorts we found associations between CT/ELS exposure and impairments in executive functions, processing speed and working memory, while physical neglect was related to general cognitive ability and working memory. Concerning the emotional abuse/neglect subtypes in both populations, the results indicated their involvement in cognitive functioning; however, the few studies conducted are not enough to reach definitive conclusions. These findings suggest an association of CT/ELS with specific cognitive deficits and psychopathology.

Association of childhood trauma with cognitive impairment and structural brain alterations in remitted patients with bipolar disorder

BackgroundCognitive impairment affects many patients with bipolar disorder (BD). No pro-cognitive treatment with robust efficacy exists partly due to limited insight into underlying neurobiological abnormalities. MethodsThis magnetic resonance imaging (MRI) study investigates structural neuronal correlates of cognitive impairment in BD by comparing brain measures in a large sample of cognitively impaired versus cognitively intact patients with BD or cognitively impaired patients with major depressive disorder (MDD) and healthy controls (HC). Participants underwent neuropsychological assessments and MRI scans. The cognitively impaired and – intact BD and MDD patient groups were compared with each other and HC regarding prefrontal cortex measures, hippocampus shape/volume, and total cerebral white (WM) and grey matter (GM). ResultsCognitively impaired BD patients showed lower total cerebral WM volume than HC, which scaled with poorer global cognitive performance and more childhood trauma. Cognitively impaired BD patients also showed lower adjusted GM volume and thickness in the frontopolar cortex than HC but greater adjusted GM volume in the temporal cortex than cognitively normal BD patients. Cognitively impaired BD patients showed decreased cingulate volume than cognitively impaired MDD patients. Hippocampal measures were similar across all groups. LimitationsThe cross-sectional study design prevented insights into causal relationships. ConclusionsLower total cerebral WM and regional frontopolar and temporal GM abnormalities may constitute structural neuronal correlates of cognitive impairment in BD, of which the WM deficits scale with the degree of childhood trauma. The results deepen the understanding of cognitive impairment in BD and provide a neuronal target for pro-cognitive treatment development.

Unraveling the complexity of associations between a history of childhood trauma, psychotic-like experiences, depression and non-suicidal self-injury: A network analysis

BackgroundSeveral studies have reported the association of psychotic-like experiences (PLEs) with non-suicidal self-injury (NSSI). It has been hypothesized that both constructs might share overlapping backgrounds. This study aimed to investigate the relationships between childhood trauma, depression, PLEs and lifetime characteristics of NSSI. MethodsParticipants included individuals aged 18–35 years who had a negative history of psychiatric treatment. They were surveyed through the computer-assisted web interview. A network analysis was performed. ResultsA total of 4203 non-clinical adults (63.8 % females) were enrolled. The characteristics of NSSI and a history of childhood sexual abuse were the most central nodes in the network. A history of childhood sexual abuse was the only category of childhood trauma that was directly connected to the characteristics of NSSI (i.e., longer lifetime duration of NSSI). The shortest pathways from other categories of childhood trauma (emotional abuse, emotional neglect and bullying) were connected to the lifetime characteristics through the effects of sexual abuse. However, other pathways were also possible and converged on nodes representing persecutory thoughts, déjàvu experiences, psychomotor retardation/agitation and suicidal ideation. These psychopathological symptoms were the only nodes directly connected to the characteristics of NSSI (i.e., lifetime duration and a history of severe NSSI). LimitationsThe main limitations include the use of a non-clinical sample and cross-sectional design. ConclusionsOur findings do not support the hypothesis that PLEs and NSSI might be associated due to shared correlates. In other words, the associations of childhood trauma and PLEs with NSSI might be independent.

The association of childhood trauma with cognitive domains and emotional regulation in non-clinical populations: role of stress and inflammation

The association of childhood trauma with cognitive domains and emotional regulation in non-clinical populations: role of stress and inflammation

Association of childhood trauma, and resilience, with quality of life in patients seeking treatment at a psychiatry outpatient: A cross-sectional study from Nepal  

Association of childhood trauma, and resilience, with quality of life in patients seeking treatment at a psychiatry outpatient: A cross-sectional study from Nepal  

Association between childhood trauma and medication adherence among patients with major depressive disorder: the moderating role of resilience

BackgroundSuboptimal medication adherence is a major reason for failure in the management of major depressive disorder (MDD), childhood trauma might be an essential risk factor of suboptimal medication adherence. This study aimed to comprehensively explore the associations between different types of childhood trauma and medication adherence among patients with MDD, and to test whether resilience has moderating effects on the foregoing associations.MethodsParticipants were from the Depression Cohort in China (ChiCTR registry number 1900022145), 282 MDD patients with completed both baseline and 12-weeks follow-up investigations were included in this study. The diagnosis of MDD was assessed by trained psychiatrists using the Mini-International Neuropsychiatric Interview (M.I.N.I.). Childhood trauma was evaluated using the Childhood Trauma Questionnaire-28 item Short Form (CTQ-SF), and resilience was evaluated using the Connor-Davidson Resilience Scale (CD-RISC). Demographic characteristics, depression symptoms, anxiety symptoms, suicidal ideation, suicidal attempt, insomnia symptoms, and painful somatic symptoms were also investigated. Participants were divided into groups of optimal and suboptimal adherence based on their Medication Adherence Rating Scale scores. Logistic regression and stratified analyses were performed.ResultsA total of 234 participants (83%) reported suboptimal medication adherence. After adjusting for covariates, CTQ total scores (AOR = 1.03, 95%CI = 1.01–1.06), CTQ measures of sexual abuse (AOR = 1.17, 95%CI = 1.01–1.37), and CTQ measures of physical neglect (AOR = 1.12, 95%CI = 1.02–1.23) were all associated with an increased likelihood of suboptimal adherence. There were significant moderating effects of resilience on the associations of childhood trauma (P = 0.039) and physical neglect (P = 0.034) with medication adherence. The stratification analyses showed that CTQ total scores and CTQ measures of physical neglect were independently associated with an increased risk of suboptimal adherence among patients with MDD with low-resilience or moderate-resilience, while not significantly associated with suboptimal adherence in those with high-resilience.ConclusionChildhood trauma was a significant risk factor of suboptimal adherence among patients with MDD, and resilience moderated the foregoing association. Obtaining a history of childhood trauma and assessing resilience may help identify patients with suboptimal adherence when providing MDD pharmacotherapy. Psychiatrists may consider enhancing resilience to cope with the adverse effects of childhood trauma on medication adherence.

Association of childhood trauma, and resilience, with quality of life in patients seeking treatment at a psychiatry outpatient: A cross-sectional study from Nepal.

Quality of life is defined by the World Health Organization as "Individuals' perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns". It is a comprehensive measure of health outcome after trauma. Childhood maltreatment is a determinant of poor mental health and quality of life. Resilience, however, is supposed to be protective. Our aim is to examine childhood trauma and resilience in patients visiting psychiatry outpatient and investigate their relations with quality of life. A descriptive cross-sectional study was conducted with a hundred patients with trauma and visiting psychiatry outpatient. Standardized tools were applied to explore childhood trauma, resilience, quality of life and clinical diagnoses and trauma categorization. Sociodemographic and relevant clinical information were obtained with a structured proforma. Bivariate followed by multivariate logistic regressions were conducted to explore the relation between childhood trauma, resilience, and quality of life. Poor quality of life was reported in almost one third of the patients. Upper socioeconomic status, emotional neglect during childhood, current depression and low resilience were the determinants of poor quality of life in bivariate analysis. Final models revealed that emotional neglect during childhood and low resilience had independent associations with poor quality of life. Efforts should be made to minimize childhood maltreatment in general; and explore strategies to build resilience suited to the cultural context to improve quality of life.

Association of Childhood Trauma with Migraines in Men

Advancements in knowledge are needed to identify the link between childhood trauma and migraines in men. Though migraines are more prevalent in women, research about migraines in men with past traumatic exposure has received little attention. There are9% of men of all ages with migraines in the United States, 12% of adult males in Europe between the ages of 18 and 65 with migraines, and 5 to 29% of males who experienced childhood sexual abuse, in other words, 1 in 6 males; whereby 50% of children who are sex trafficked in the United States are males, while 4% of male victims of significant trauma develop post-traumatic stress disorder. There may be a strong correlation that suggests that male migraine sufferers are more likely to have experienced some form of childhood trauma, in particular sexual abuse. Men’s migraines underrepresentation in research limits understanding of the adverse effects of childhood sexual abuse that often results in post-traumatic stress disorder and other psychiatric and medical conditions. As migraines become more understood, advances in our understanding of the neurobiological effects of trauma on brain structure and function may suggest a possible impact of early-life stress on the onset of migraines. Early-life stress-induced conditions in males may manifest because of sexual abuse often being undetected, fear of speaking out, or fear of being embarrassed. Unlike physical abuse where bruises are visible or neglect where malnourishment is noticeable, sexual abuse may inflict hidden bruises that may contribute to males suffering in silence. An increase in our knowledge may identify sexual abuse as the link between childhood trauma and migraines in men to suggest new treatment strategies.

Association of Childhood Trauma with Migraines in Men

Advancements in knowledge are needed to identify the link between childhood trauma and migraines in men. Though migraines are more prevalent in women, research about migraines in men with past traumatic exposure has received little attention. There are9% of men of all ages with migraines in the United States, 12% of adult males in Europe between the ages of 18 and 65 with migraines, and 5 to 29% of males who experienced childhood sexual abuse, in other words, 1 in 6 males; whereby 50% of children who are sex trafficked in the United States are males, while 4% of male victims of significant trauma develop post-traumatic stress disorder. There may be a strong correlation that suggests that male migraine sufferers are more likely to have experienced some form of childhood trauma, in particular sexual abuse. Men’s migraines underrepresentation in research limits understanding of the adverse effects of childhood sexual abuse that often results in post-traumatic stress disorder and other psychiatric and medical conditions. As migraines become more understood, advances in our understanding of the neurobiological effects of trauma on brain structure and function may suggest a possible impact of early-life stress on the onset of migraines. Early-life stress-induced conditions in males may manifest because of sexual abuse often being undetected, fear of speaking out, or fear of being embarrassed. Unlike physical abuse where bruises are visible or neglect where malnourishment is noticeable, sexual abuse may inflict hidden bruises that may contribute to males suffering in silence. An increase in our knowledge may identify sexual abuse as the link between childhood trauma and migraines in men to suggest new treatment strategies.

Associations of childhood trauma with long-term diseases and alcohol and nicotine use disorders in Czech and Slovak representative samples

ObjectiveThe abuse and neglect of a child is a major public health problem with serious psychosocial, health and economic consequences. The aim of this study was to assess the relationship between various types of childhood trauma, selected long-term diseases and alcohol and nicotine use disorder in Czech and Slovak representative samples.MethodsData on retrospective reporting about selected long-term diseases, alcohol and nicotine use disorder (CAGE Questionnaire) and childhood maltreatment (Childhood Trauma Questionnaire; CTQ) in two representative samples (Czech sample: n = 1800, 48.7% men, mean age 46.61 ± 17.4; Slovak sample: n = 1018, 48.7% men, mean age: 46.2 ± 16.6) was collected. Multinomial logistic regression models were used to assess the relationships between childhood maltreatment and long-term diseases.ResultsThere is a higher occurrence of some long-term diseases (such as diabetes, obesity, allergy, asthma) and alcohol and nicotine use disorder in the Czech sample; however, in the Slovak sample the associations between child maltreatment and long-term diseases are stronger overall. Emotional abuse predicts the occurrence of all the studied long-term diseases, and the concurrent occurrence of emotional abuse and neglect significantly predicts the reporting of most diseases. All types of childhood trauma were strong predictors of reporting the occurrence of three or more long-term diseases.ConclusionThe extent of reporting childhood trauma and associations with long-term diseases in the Czech and Slovak population is a challenge for the strengthening of preventive and therapeutic programmes in psychosocial and psychiatric care for children and adolescents to prevent later negative consequences on health.

The mediating effect of attachment insecurity on circadian consequences of childhood trauma

ABSTRACT Circadian preferences have been associated with mental health as well as social and physical health in recent years. However, factors associated with circadian preferences have not been fully elucidated. The main aim of this study is to investigate the associations of childhood trauma and attachment styles with circadian preferences. A total of 673 participants were evaluated using the Morningness–Eveningness Questionnaire (MEQ), the Childhood Trauma Questionnaire 28 (CTQ-28), and the Experiences in Close Relationships-Revised (ECR-R) questionnaire. The results indicated that 14.9% (n = 100) of the participants were morning type, 20.6% (n = 139) were evening type, and 64.5% (n = 434) were intermediate type. Both childhood trauma and attachment-related anxiety/avoidance scores were associated with being evening type (p < .01). Moreover, attachment-related anxiety and avoidance fully mediated the association between childhood trauma and circadian preferences. The present study showed that attachment styles might be associated with circadian preferences. Further studies are needed to replicate these results and to infer explanatory mechanisms for these cross-sectional associations.

Associations of childhood trauma and executive functioning in everyday life of those with subjective cognitive complaints

Subjective cognitive complaints are a frequent patient-reported problem. Some adults with cognitive complaints present to the neuropsychology clinic without a diagnosable cognitive disorder but experience subjective daily executive dysfunction. It is well-established that trauma may impact executive function; however, the nuances of this relationship remain of interest. The present study descriptively reports associations between executive function and childhood trauma as well as lifetime trauma and current posttraumatic stress disorder (PTSD) symptoms. Participants were 48 adults referred to a neuropsychology clinic for evaluation without an identified neurocognitive disorder. Correlations between self-reported executive dysfunction, as assessed by the Behavior Rating Inventory of Executive Function-Adult (BRIEF-A), childhood trauma as measured by the Childhood Trauma Questionnaire and lifetime and current symptoms using the PTSD Diagnostic Scale for Diagnostic and Statistical Manual of Mental Disorders-5 were conducted. Correlations indicated that emotional neglect was associated with BRIEF-A indices and specific subscales including self-monitoring, shifting attention, task initiation, and planning/organization. Childhood emotional and sexual abuse and physical neglect and abuse, lifetime trauma and current PTSD symptoms were not associated with BRIEF-A indices. Though preliminary, these results highlight that in this population, history of childhood emotional neglect is particularly important when considering etiology of daily executive function complaints. Clinical implications and limitations are discussed.

The association of childhood trauma, lifetime stressful events and general psychopathological symptoms in euthymic bipolar patients and healthy subjects

BackgroundPsychopathological symptoms during euthymia in Bipolar Disorder (BD) affect quality of life and predispose to the occurrence of new acute episodes, however only few studies investigated potential risk-factors. This study aims to explore the association between childhood trauma (CT), lifetime stressful events (SLEs) and psychopathological symptoms in BD patients during euthymia and controls (HC). MethodsA total of 261 participants (93 euthymic patients with BD, 168 HC) were enrolled. Generalized linear models and multiple logistic models were used to assess the association among the Symptom Check List-90-R (SCL-90-R), the Infancy Trauma Interview, the Paykel Life Events Scale. ResultsThe rate of participants reporting CT was higher in BD (n=47; 53%) than HC (n=43; 30%) (p=0.001). The experience of neglect was strongly related to BD (OR 6.5; p=0.003). CT was associated to higher scores on the SCL-90-R subscales (all the subscales except Phobia). No effects of the interaction between CT and diagnosis were found on SCL-90-R. Finally, there was a main effect of CT on lifetime SLEs (p<.001), that was not associated with diagnosis (p=0.833), nor with the interaction between CT and diagnosis (p=0.624). LimitationsThe cross-sectional design does not allow causal inferences; the exclusion of subjects reporting medical or psychiatric comorbidity limits generalizability. ConclusionsCT was associated both to psychopathological symptoms during euthymia and the lifetime SLEs, thus it may represent a vulnerability factor influencing the course of BD. Overall, these data contribute to overcome the limited evidences documenting the influence of environmental factors on euthymic phase in BD.

A Review on Relationship of Childhood Trauma with Offending Behaviour

Researches indicate interlink between traumatic experiences in childhood and offending behaviour in later stages of life. Further findings revealed that there was high significance of a specific type of trauma leading to criminality in convicted adults. Childhood trauma can be one of the major contributing factors in offending behaviour among prison population. This review report is conducted to analyze and understand the impact of childhood trauma on an individual. Systematic review of the different researches conducted on the association of childhood trauma with offending behaviour revealed that those who were victims of childhood trauma were convicted for different crimes in adulthood. Possible explanations for the obtained results will be discussed in the light of available supportive literature.

The association of childhood trauma with sleep disturbances and risk of suicide in US veterans

BackgroundSleep dysregulation is prevalent among veterans and is associated with increased risk of suicidal ideation and behaviors. A confluence of risk factors have been identified to date that contribute to increase risk for suicidal behavior. How these risk factors including childhood trauma, comorbid psychopathology, impulsivity, and hostility together with sleep disturbance contribute to suicide risk remains an open question. These factors have never been examined simultaneously in a unified mediation model, as investigated in the present study, to determine their relative contribution to suicide risk. MethodsVeterans (N = 105) were recruited across 3-groups, including Major Depressive Disorder (MDD) with/without a history of a suicide attempt (n = 35 and n = 37, respectively), and non-psychiatric controls, who had no history of mental illness or suicidal behavior (n = 33). The participants were assessed using validated self-report assessments with in-depth phenotyping for relevant risk factors associated with suicidal behavior including childhood adversity, depression severity, impulsivity, hostility, and sleep quality. These factors were included in mediation models using path analysis. ResultsAcross all subjects including those with MDD and non-psychiatric controls, mediation analysis showed that higher levels of childhood trauma had an indirect effect on poor sleep quality (p = 0.001). This effect was orthogonal, being independently mediated by both MDD psychopathology (p = 0.003), and higher traits of impulsivity (p = 0.001) and hostility (p = 0.015). Amongst MDD veterans, childhood trauma was directly associated with increased suicide risk (p = 0.034), irrespective of their severity of depression, or their degree of hostility and impulsivity. Limitationsinclude use of self-report data, and the inability to establish causal inferences with cross-sectional design. ConclusionChildhood adversity as a significant pre-deployment risk factor for disturbed sleep and elevated suicide risk, potentially important for incorporation in clinical practice for suicide.

Stress reactivity as a putative mechanism linking childhood trauma with clinical outcomes in individuals at ultra-high-risk for psychosis: Findings from the EU-GEI High Risk Study.

Childhood trauma is associated with an elevated risk for psychosis, but the psychological mechanisms involved remain largely unclear. This study aimed to investigate emotional and psychotic stress reactivity in daily life as a putative mechanism linking childhood trauma and clinical outcomes in individuals at ultra-high-risk (UHR) for psychosis. Experience sampling methodology was used to measure momentary stress, affect and psychotic experiences in the daily life of N = 79 UHR individuals in the EU-GEI High Risk Study. The Childhood Trauma Questionnaire was used to assess self-reported childhood trauma. Clinical outcomes were assessed at baseline, 1- and 2-year follow-up. The association of stress with positive (β = -0.14, p = 0.010) and negative affect (β = 0.11, p = 0.020) was modified by transition status such that stress reactivity was greater in individuals who transitioned to psychosis. Moreover, the association of stress with negative affect (β = 0.06, p = 0.019) and psychotic experiences (β = 0.05, p = 0.037) was greater in individuals exposed to high v. low levels of childhood trauma. We also found evidence that decreased positive affect in response to stress was associated with reduced functioning at 1-year follow-up (B = 6.29, p = 0.034). In addition, there was evidence that the association of childhood trauma with poor functional outcomes was mediated by stress reactivity (e.g. indirect effect: B = -2.13, p = 0.026), but no evidence that stress reactivity mediated the association between childhood trauma and transition (e.g. indirect effect: B = 0.14, p = 0.506). Emotional and psychotic stress reactivity may be potential mechanisms linking childhood trauma with clinical outcomes in UHR individuals.