History Of Childhood Abuse Research Articles

Childhood Maltreatment and Electrodermal Reactivity to Stress Among Pregnant Women.

There are competing theoretical hypotheses regarding the consequences of early adversity, such as childhood maltreatment, for individuals' autonomic nervous system activity. Research examining potential implications of child maltreatment for sympathetic nervous system activity, specifically, is scarce. In this preregistered study, we examined whether childhood maltreatment history is associated with pregnant adults' sympathetic responses to different stressors. This population is particularly relevant, given potential intergenerational consequences of pregnant individuals' physiological responses to stress. Pregnant women's (N=162) electrodermal levels were recorded while completing the Trier Social Stress Test (TSST), which elicits social-evaluative threat, and while watching a video of an unfamiliar infant crying, which was intended to activate the attachment system. Pregnant women's retrospective reports of childhood maltreatment were negatively associated with their electrodermal reactivity to the TSST and to the video of the infant crying. Follow-up analyses indicated that these associations were specific to reported experiences of childhood abuse and not childhood neglect. Altogether, these findings indicate that self-reported childhood maltreatment experiences, and childhood abuse in particular, may result in blunted activity of the sympathetic nervous system in response to multiple types of stressors.

EMDR–Teens–cPTSD: Efficacy of Eye Movement Desensitization and Reprocessing in Adolescents with Complex PTSD Secondary to Childhood Abuse: A Case Series

Background: Mental healthcare for children and adolescents with a history of childhood abuse constitutes a major public health issue. Indeed, abuse exposes children to severe and complex post-traumatic stress disorder (cPTSD) but also to neurodevelopmental and psychological repercussions impacting the developmental trajectory. Trauma-focused care is essential to avoid the chronicization of symptoms and disorders. Objective: The aim of this prospective case series study was to investigate the efficacy of eye movement desensitization and reprocessing (EMDR) on complex post-traumatic symptoms and associated psychiatric disorders in adolescents with a history of abuse. Method: Twenty-two adolescents, aged 12 to 17, who had been abused during childhood were included. All adolescents met ICD-11 criteria for complex PTSD. Subjective measures of PTSD and associated psychiatric disorders were taken before (T0) and after 3 months of EMDR therapy (T1). Results: The average PTSD symptom score on the CPTS-RI significantly decreased from 40.2 to 34.4 after EMDR, indicating improvement in post-traumatic symptoms. A significant decrease in the average depression score (CDI from 18.2 at T0 to 10.6 at T1), anxiety score (R–CMAS from 21.3 at T0 to 13.3 at T1), emotional regulation score (ALS from 29 at T0 to 10.8 at T1), insomnia score (ISI from 18.5 at T0 to T1 of 9.2 at T1), and harmful use of alcohol and drugs score (ADOSPA from 2.3 at T0 to 0.3 at T1) was observed after EMDR therapy, as well as an increase in quality of life (CBCL 4–16 score from 57.9 at T0 to 77.4 at T1). Conclusions: The results of this study are encouraging and suggest that EMDR may be effective in the symptom management reducing post-traumatic symptoms and certain comorbid disorders frequently seen in adolescents who have experienced childhood abuse. Further research is needed on adolescent populations suffering from cPTSD (e.g., randomized controlled trials with control groups and other therapies or evaluating the action of the different phases of the study).

Complex Posttraumatic Stress Disorder (CPTSD) is Uniquely Linked to Suicidality Beyond Posttraumatic Stress Disorder (PTSD) in Adults with Childhood Maltreatment: A Multinational Study Across Four Countries

BackgroundSuicide is a leading cause of death worldwide, with childhood maltreatment identified as a significant risk factor for suicidal behavior in adulthood. The link between childhood maltreatment and suicidality is well-documented; however, the role of complex posttraumatic stress disorder (CPTSD), which includes an additional symptom cluster of disturbances in self-organization (DSO) compared to posttraumatic stress disorder (PTSD), remains underexplored. This study aimed to investigate the association between meeting the criteria for ICD-11 PTSD or CPTSD and suicidality in adults with a history of childhood maltreatment across culturally diverse samples. MethodsData were collected across four sites: the United States, the United Kingdom, China, and Malaysia. The Childhood Trauma Questionnaire (CTQ), Suicidal Behaviors Questionnaire-Revised (SBQ-R), and International Trauma Questionnaire (ITQ) were used to assess childhood maltreatment, suicidality, and PTSD or CPTSD, respectively. Linear regressions were conducted to examine the associations, controlling for demographic variables (age, sex, ethnicity, educational level, and subjective socioeconomic status) as well as the severity of maltreatment (CTQ total scores). ResultsAmong the 1,324 participants who experienced childhood maltreatment, meeting the criteria for CPTSD was significantly associated with higher suicidality compared to not meeting the criteria for either PTSD or CPTSD (B(SE) = 1.68 (0.30), p < .001), or only meeting the criteria for PTSD (B(SE) = 1.38 (0.43), p < .001). In contrast, meeting the criteria for PTSD alone was not significantly associated with suicidality (B(SE) = 0.35 (0.46), p = .45). These associations remained consistent across different cultural settings. ConclusionThe study findings highlight the unique association of CPTSD with suicidality in adults with a history of childhood maltreatment, suggesting that the DSO symptom cluster of CPTSD, which distinguish it from PTSD, play a critical role in the development of suicidality in this population. Targeting these symptoms may be essential for effective intervention strategies. Screening for childhood maltreatment and CPTSD in individuals at risk of suicide is crucial for guiding treatment planning.

Childhood Traumas and Depressive Symptoms: The Moderating Role of Anxiety Sensitivity.

Depression is one of the most common public health problems. Considering the frequency of childhood trauma in people with depressive symptoms, determining mediating factors is important in understanding the relationship between them. Our study aimed to evaluate the mediating effect of anxiety sensitivity, one of the cognitive structures that plays a role in the etiology and maintenance of psychopathologies, on depression symptoms of childhood traumas. The study included 110 participants aged between 18 and 65, diagnosed with depression, and applied to the psychiatry outpatient clinic. Of the participants, 35 were male and 75 were female. The majority of participants were in the 18-25 age group (39.1%), followed by a smaller percentage in the 25-35 age group (32.7%). The Beck Depression Inventory (BDI-I), Childhood Trauma Questionnaire (CTQ), and Anxiety Sensitivity Index (ASI-3) were administered to participants between 15 February and 15 April 2024. When the sample was examined according to the history of depressive symptoms, it was found that the score of the cognitive subscale of ASI-3 and the scores of the physical neglect, emotional neglect, and emotional abuse subscales of the CTQ were significantly higher in the group with depressive symptoms. When the mediating effect of the scores of "Emotional neglect", "Physical neglect", and "Emotional abuse" subscales of CTQ, and the score of "Cognitive" subscale of ASI-3 score was examined with regression models, it was found that the history of emotional neglect and abuse in childhood predicted depressive symptoms through the cognitive sub-group of AS. In our study, it was shown that childhood trauma, which could cause a person to evaluate stressful life events as more depressogenic and the formation of negative cognitions about themselves and the world, predicted the severity and occurrence of depressive symptoms through fear of cognitive dysfunction.

Parental History of Childhood Maltreatment and Offspring Attachment Insecurity and Disorganization: Two Meta-Analyses.

Research findings have shown that parental history of childhood maltreatment (CM) increases the risk of insecure and disorganized attachment in offspring. However, the extent of the detrimental effects of childhood trauma on attachment in the next generation is unclear. The current meta-analyses aimed at synthesizing the available literature on the link between parental history of CM and offspring attachment insecurity and disorganization (with no restriction of offspring age). In total, 25 studies (23 unique samples; N = 2,592) comprising u = 61 effect sizes were included. Offspring age ranged from 12 to 79 months (Mweighted = 18.69; SDweighted = 11.53). Findings from two three-level random effects meta-analyses revealed a weak but significant combined effect of parental history of CM on child attachment insecurity (k = 20, u = 35, r = .06) and a non-significant effect on child attachment disorganization (k = 12, u = 26, r = .03). For the meta-analysis on disorganization, effect sizes were weaker in more recent studies, and trim and fill analyses provided evidence of publication bias. These findings provide a nuanced view of the intergenerational transmission of childhood trauma phenomenon, whereby parents' self-reported history of CM does not appear decisive for child attachment. Conclusions could not be drawn for specific types of CM because of the small number of studies. Research with more objective measures of parental exposure to CM is needed to gain a more comprehensive view of the possible intergenerational effects of CM on child attachment.

Resolving trauma: The unique contribution of trauma-specific mentalization to maternal insightfulness.

Resolving trauma may contribute to mental health and parenting in mother with histories of childhood maltreatment. The concept of trauma-specific reflective functioning (T-RF) was developed to assess the complexity of thought processes regarding trauma. The study aimed to validate the T-RF scale applied to the Trauma Meaning-Making Interview by examining its psychometric properties, associations with measures of trauma-processing strategies, maternal reflective functioning and mental health (depression and post-traumatic stress disorder [PTSD]), as well as evaluating whether T-RF offered a unique contribution to maternal insightfulness. Good construct validity of the T-RF scale was confirmed in a sample of 112 mothers with histories of childhood maltreatment using an independent coding system of trauma-processing. Better mentalization of trauma was prospectively associated with higher parental reflective functioning and mothers with high T-RF were much more likely to be insightful regarding the child's mental states than non-reflective mothers and mothers with limited T-RF. The association between T-RF and insightfulness was observed even when controlling for maternal reflective functioning, trauma-processing strategies, maternal education and sociodemographic risk. T-RF was associated neither with depression, PTSD nor the characteristics of trauma. Findings suggest that mentalizing trauma would be an important protective factor in the intergenerational trajectories of trauma.

Childhood maltreatment, social connectedness, and depression: A prospective analysis of trajectories over time.

Childhood maltreatment is associated with a range of negative social and psychological outcomes at different developmental stages. Using data from a prospective longitudinal study of the consequences of childhood maltreatment, we examine whether childhood maltreatment predicts lower levels of social connectedness and more depression symptoms over a 30-year time period and examine the directionality of the trajectories from childhood into middle adulthood. Children (ages 0-11 years) with documented histories of maltreatment and demographically matched controls were followed into adulthood across four waves: 1989-1995 (n = 1,196; Mage = 29.2 years, SD = 3.9), 2000-2002 (n = 896; Mage = 39.5 years, SD = 3.6), 2003-2005 (n = 808; Mage = 41.2 years, SD = 3.6), and 2009-2010 (n = 649; Mage = 47.0 years, SD = 3.5). Social connectedness and depressive symptoms were measured at all four time points. Random intercept cross-lagged panel models were used to estimate bidirectional relationships between social connectedness and depression symptoms and the extent to which the trajectories differed for the maltreated and control groups. Individuals with documented histories of childhood maltreatment generally had significantly lower levels of social connectedness and higher levels of depression compared to matched controls. Depression was associated with lower levels of social connectedness concurrently at ages 39, 41, and 47. Depression predicted lower social connectedness, and social connectedness predicted lower depression in middle adulthood, but not young adulthood. Better understanding of the long-term impact of childhood maltreatment on social connectedness and depression has implications for designing effective interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Understanding the relationship between childhood abuse and affective symptoms in bipolar disorder: New insights from a network analysis

The impact of childhood abuse on the presentation of bipolar disorder could be further elucidated by comparing the networks of affective symptoms among individuals with and with no history of childhood abuse. Data from 476 participants in the Clinical Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder study were used to fit several regularised Gaussian Graphical Models. Differences in the presentation of depressive and manic symptoms were uncovered: only among participants with a history of childhood abuse, inadequacy and pessimism were central symptoms in the network of depressive symptoms, while racing thoughts was an important symptom in the network of manic symptoms. Following network theory, focusing treatments at the symptom-level and on central symptoms – like inadequacy, pessimism, and racing thoughts – could be an effective approach for managing affective symptoms among the sizeable proportion of people with bipolar disorder who have experienced childhood abuse. This study contributes a thorough investigation of the networks of affective symptoms among participants with and with no history of childhood abuse, albeit limited by the use of a binary, self-report measure of childhood abuse, thereby emphasising the importance of assessing for childhood abuse and taking needed steps towards identifying novel targets for treating bipolar disorder.

Childhood Maltreatment, Revictimization, and Partner Violence Victimization Through Midlife: A Prospective Longitudinal Investigation.

Existing research suggests that prior victimizations during a person's lifetime, particularly childhood traumas and maltreatment, are risk factors for abuse and revictimization in adulthood, although longitudinal evidence is sparse. Using data from a 30-year ongoing longitudinal study of the long-term consequences of childhood maltreatment, this paper describes the extent to which childhood maltreatment predicts subsequent victimization and partner violence victimization at two time points in adulthood. Data were obtained from a prospective cohort design study in which children with court-substantiated cases of maltreatment (ages 0-11 years) and demographically matched controls were followed into adulthood and interviewed over several waves. Childhood maltreatment was assessed through juvenile and adult court records from 1967 to 1971 in a midwestern county area in the United States. Victimization experiences were assessed from 2000 to 2002 (Mage = 39.5 years) and 2009 to 2010 (Mage = 47.5) and included two types based on information from the lifetime trauma and victimization history instrument and questions about past year partner violence victimization. Individuals with histories of childhood maltreatment were more likely to report physical and sexual assaults and kidnapping and stalking victimization than controls through age 39.5. In contrast, the two groups did not differ at the later assessment at age 47.5, except maltreated individuals reported greater risk for sexual assault/abuse than controls. For intimate partner violence victimization at age 39.5, maltreated and control groups differed only in terms of victimization involving injury. Later in adulthood, more individuals with histories of childhood maltreatment reported partner physical violence victimization compared to controls. Although these longitudinal findings showed a general decline in victimization experiences over the two time points, these results demonstrate that childhood maltreatment increases risk for subsequent revictimization in middle adulthood, specifically for sexual assault/abuse and intimate partner physical violence victimization. These findings have implications for prevention and intervention efforts targeting maltreated children.

Responding to suicidal behaviour in children and young people with a child maltreatment history: A scoping review

Child maltreatment affects millions of children internationally every year. Development is negatively impacted by maltreatment increasing the likelihood of maladaptive behaviours. Associations between child maltreatment and suicidal behaviour and suicide in young people has been established. However, there is a research gap in understanding effective ways to respond to and intervene with suicidal behaviour in young people who have experienced child maltreatment. A scoping review was conducted in accordance with the Joanna Briggs Institute methodology to investigate interventions that may be effective in preventing and reducing suicidal behaviours in young people who have experienced child maltreatment. Inclusion criteria were studies: (a) of children and young people who engage in suicidal behaviour and have experienced child maltreatment; (b) published in English during the time period 2000–2020; and (c) focused on responses and interventions to prevent or address suicidal behaviour. Across 37 studies, several intervention targets were identified through reflexive thematic analysis including cultivation of self-compassion, gratitude and future orientation, alleviation of depression, anxiety and post-traumatic stress disorder (PTSD) symptoms and psychological distress and addressing cognitive errors and negative views of the self. Screening and clear assessment of suicidal risk by health professionals and child welfare professionals was endorsed across studies. Several evidence-based treatments were proposed to support intervening with this client group, although only Emotional Intelligence Therapy (EIT) was empirically tested with this population. Utilisation of safe systems that the child or young person is in may be beneficial in addressing and reducing suicidal behaviour, such as inclusion of families, peers and the implementation of school-based interventions strategies. Future research is needed to empirically test and assess the effectiveness of interventions.

The Connections Between Alexithymia, Childhood Maltreatment, Impulsivity and Extreme Sensory Processing Patterns in Relation to Bipolar Symptoms in Inpatients With Bipolar Disorder.

Childhood maltreatment, alexithymia and impulsivity are related to bipolar disorder (BD), but the role of potential underlying mechanisms of this link, such as extreme sensory processing, in BD are unclear. This study compared sensory processing patterns between individuals with BD-I or BD-II and between those with and without alexithymia and childhood maltreatment. Additionally, the study aimed to examine the role of extreme sensory processing in the relationship between childhood trauma, alexithymia and impulsivity with both depression and mania in a sample of hospitalized individuals with BD (n = 300). Participants completed self-report and clinician-rated scales. Patients with BD-II exceeded those with BD-I in low registration, sensory sensitivity and sensation avoidance, whereas patients with BD-I exhibited a more heightened sensation-seeking pattern. Patients with BD who had alexithymia and a history of childhood maltreatment exhibited more heightened sensory processing patterns, apart from sensory seeking, compared to those without alexithymia and childhood maltreatment. Additionally, the same pattern was more pronounced in individuals with BD who had both alexithymia and childhood maltreatment compared to those with either condition or neither of these conditions. The pathways from childhood maltreatment and alexithymia to depressive symptoms were mediated by low registration and sensation avoidance. Sensory seeking indirectly affected the link between alexithymia and manic symptoms. Childhood maltreatment and challenges in effectively processing emotional information, along with their related hypo- and hypersensitivity, may characterize BD individuals and its manifestation of depressive and manic symptoms.

Relationships between serotonin 1A receptor DNA methylation, self-reported history of childhood abuse and gray matter volume in major depression

BackgroundEarly life adversity is a risk factor for psychopathology and is associated with epigenetic alterations in the 5-HT1A receptor gene promoter. The 5-HT1A receptor mediates neurotrophic effects, which could affect brain structure and function. We examined relationships between self-reported early childhood abuse, 5-HT1A receptor promoter DNA methylation, and gray matter volume (GMV) in Major Depressive Disorder (MDD). MethodsPeripheral DNA methylation of 5-HT1A receptor promoter CpG sites −681 and −1007 was assayed in 50 individuals with MDD, including 18 with a history of childhood abuse. T1-weighted structural magnetic resonance imaging (MRI) was performed. Voxel-based morphometry (VBM) was quantified in amygdala, hippocampus, insula, occipital lobe, orbitofrontal cortex, temporal lobe, parietal lobe, and at the voxel level. ResultsNo relationship was observed between DNA methylation and history of childhood abuse. We observed regional heterogeneity comparing −681 CpG site methylation and GMV (p = 0.014), with a positive relationship to GMV in orbitofrontal cortex (p = 0.035). Childhood abuse history was associated with higher GMV considering all ROIs simultaneously (p < 0.01). In whole-brain analyses, childhood abuse history was positively correlated with GMV in multiple clusters, including insula and orbitofrontal cortex (pFWE = 0.005), and negatively in intracalcarine cortex (pFWE = 0.001). LimitationsSmall sample size, childhood trauma assessment instrument used, and assay of peripheral, rather than CNS, methylation. ConclusionsThese cross-sectional findings support hypotheses of 5-HT1A receptor-related neurotrophic effects, and of increased regional GMV as a potential regulatory mechanism in the setting of childhood abuse. Orbitofrontal cortex was uniquely associated with both childhood abuse history and 5-HT1A receptor methylation.

From Early Trauma to Cardiovascular Risk Among a Nationally Representative Sample of Young Adults.

This study aimed to investigate the connection between childhood abuse history and cardiovascular health indicators among a nationally representative sample of young adults aged 24-32. Using data from waves three and four of the National Longitudinal Study of Adolescent to Adult Health (n = 4, 164) multivariate logistic regression was employed to investigate childhood trauma (i.e., childhood physical abuse, sexual abuse, and neglect) as predictors for cardiovascular disease, hypertension, high cholesterol, diabetes, and obesity. Results showed that adults who reported history of sexual abuse were 4.3 times more likely to report diagnosis of cardiovascular disease and those who reported childhood physical abuse at wave three had 1.4 times the odds of reporting high cholesterol diagnosis. Although trauma history is often calculated as a composite, some forms of childhood abuse may have greater impacts on cardiovascular risk than others.

Interaction Effect of Childhood Abuse History and Suicidality on 12-Month Antidepressant Response in Patients With Depressive Disorder.

We aimed to identify the individual and interactive effects of childhood abuse and suicidal ideation on antidepressant treatment response in 12 months. In this prospective research, 1,262 depressive patients were asked about their childhood abuse history, suicidal ideation, and other clinical characteristics and socio-demographic features at baseline, and 1,015 of them were followed during 1 year of stepwise pharmacotherapy. The individual and interactive relationships of the childhood abuse history and suicidal ideation on 12-month antidepressant non-remission were explored by logistic regression with relevant covariates. Having a childhood abuse history and higher suicidal ideation significantly predicted a non-remission state in 12 months respectively. The interaction term of childhood abuse and suicidal ideation was also significantly related to a non-remission state at 12 months. To be specific, in the low suicidal ideation group, depressive patients with a childhood abuse history were more likely to be in a non-remission state after 12 months of medication. In the high suicidal ideation group, however, childhood abuse history was not significantly associated with the non-remission state at 12 months. The childhood abuse history and the level of suicidal ideation are informative factors predicting the long-term results of antidepressant treatment, especially when they are combined. Clinicians may consider antidepressants with a higher affinity for patients with childhood abuse history even if they don't have suicidal ideation. The cognitive intervention for suicidal ideation might be helpful in addition to pharmacological treatment.

Maternal history of childhood maltreatment and pregnancy weight outcomes.

Childhood maltreatment is associated with elevated adult weight. It is unclear whether this association extends to pregnancy, a critical window for the development of obesity. We examined associations of childhood maltreatment histories with pre-pregnancy BMI and gestational weight gain among women who had participated for >20 years in a longitudinal cohort.At age 26-35 participants reported childhood maltreatment (physical, sexual, and emotional abuse; emotional neglect) and, 5 years later, about pre-pregnancy weight and gestational weight gain for previous pregnancies (n=656). Modified Poisson regression models were used to estimate associations of maltreatment history with pre-pregnancy BMI and gestational weight gain z-scores, adjusting for sociodemographics. We used Multivariate Imputation by Chained Equations to adjust outcome measures for misclassification using data from an internal validation study. Before misclassification adjustment, results indicated a higher risk of pre-pregnancy BMI ≥30 kg/m2 in women with certain types of maltreatment (e.g., emotional abuse RR=2.4; 95% CI: 1.5, 3.7) compared with women without that maltreatment type. After misclassification adjustment, estimates were attenuated but still modestly elevated (e.g., emotional abuse RR=1.7; 95% CI: 1.1, 2.7). Misclassification-adjusted estimates for maltreatment associations with gestational weight gain z-scores were close to the null and imprecise. Findings suggest an association of maltreatment with pre-pregnancy BMI ≥30 kg/m2 but not with high gestational weight gain. Results suggest a potential need for equitable interventions that can support all women, including those with maltreatment histories, as they enter pregnancy.

The impact of childhood abuse on patients with obsessive–compulsive disorder: an Egyptian study

BackgroundThe presence of childhood abuse is expected to have a great impact on several psychological domains on obsessive–compulsive disorder (OCD) patients. This study was designed to assess the psychological impact of history childhood abuse (emotional abuse, physical abuse, sexual abuse, and emotional and physical neglect) on five psychological domains among OCD patients (self-esteem, depression, suicidal risk, cognitive functions, and anxiety).MethodsThis cross-sectional study included 101 OCD patients who were seen in the psychiatric department’s outpatient clinic at Zagazig University Hospital. They were diagnosed according to DSM-IV (SCID-I interview). All the patients were assessed using Childhood Trauma Questionnaire (CTQ-28), the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM-A), Beck’s Suicide Scale, Rosenberg Self-Esteem Scale, and the MoCA scale (Montreal Cognitive Assessment Test).ResultsThe prevalence of childhood abuse in the studied group was 74.3%. 24.8% with emotional abuse, 20.8% with physical abuse, 16.8% with sexual abuse, and 11.9% of patients with emotional and physical neglect. The different types of childhood abuse (emotional, physical, and sexual abuse) were significantly associated with decreased self-esteem and increased depressive symptoms, while emotional and physical neglect were associated with decreased self-esteem only among OCD patients. The most powerful and significant predictor of lower self-esteem and depression was sexual abuse, and it was also the only significant predictor of increased suicidal risk among OCD patients.ConclusionsHistory of childhood abuse was significantly associated with decreased self-esteem and increased depressive symptoms among OCD patients. Only history of sexual abuse was significantly associated with increased suicidal risk. So, evaluation of the childhood abuse history is highly important among OCD patients to be incorporated in the management plan to reduce the suffering of OCD patients and for better improvement.

History of childhood maltreatment associated with hospitalization or death due to COVID-19: a cohort study

BackgroundChildhood maltreatment (CM) has been indicated in adverse health outcomes across the lifespan, including severe infection-related outcomes. Yet, data are scarce on the potential role of CM in severe COVID-19-related outcomes as well as on mechanisms underlying this association.MethodsWe included 151,427 individuals in the UK Biobank who responded to questions on the history of CM in 2016 and 2017 and were alive on January 31, 2020. Binomial logistic regression models were performed to estimate the association between a history of CM and severe COVID-19 outcomes (i.e. hospitalization or death due to COVID-19), as well as COVID-19 diagnosis and vaccination as secondary outcomes. We then explored the potential mediating roles of socio-economic status, lifestyle and pre-pandemic comorbidities, and the effect modification by polygenic risk score for severe COVID-19 outcomes.ResultsThe mean age of the study population at the start of the pandemic was 67.7 (SD = 7.72) years, and 56.5% were female. We found the number of CM types was associated with the risk of severe COVID-19 outcomes in a graded manner (pfor trend < 0.01). Compared to individuals with no history of CM, individuals exposed to any CM were more likely to be hospitalized or die due to COVID-19 (odds ratio [OR] = 1.54 [95%CI 1.31–1.81]), particularly after physical neglect (2.04 [1.57–2.62]). Largely comparable risk patterns were observed across groups of high vs. low genetic risks for severe COVID-19 outcomes (pfor difference > 0.05). Mediation analysis revealed that 50.9% of the association between CM and severe COVID-19 outcomes was explained by suboptimal socio-economic status, lifestyle, and pre-pandemic diagnosis of psychiatric disorders or other chronic medical conditions. In contrast, any CM exposure was only weakly associated with COVID-19 diagnosis (1.06 [1.01–1.12]) while significantly associated with not being vaccinated for COVID-19 (1.21 [1.13–1.29]).ConclusionsOur results add to the growing knowledge base indicating the role of childhood maltreatment in negative health outcomes across the lifespan, including severe COVID-19-related outcomes. The identified factors underlying this association represent potential intervention targets for mitigating the harmful effects of childhood maltreatment in COVID-19 and similar future pandemics.

Childhood Trauma and Panic Disorder: The Impact of History of Child Abuse on Illness Severity and Treatment Response.

Patients who have experienced child abuse often have complex clinical presentations; whether a history of child abuse (HCA) affects psychotherapy outcomes is unclear. The authors examined relationships between HCA, clinical baseline variables, and change in these variables after three different psychotherapies for panic disorder (PD). Two hundred adults with PD (with or without agoraphobia) were randomly assigned to one of three treatments across two sites: panic-focused psychodynamic psychotherapy (PFPP), cognitive-behavioral therapy (CBT), or applied relaxation training (ART). Differences in demographic and clinical variables between those with and without HCA were compared. The primary analysis addressed odds of meeting clinical response criteria on the Panic Disorder Severity Scale (PDSS) between treatments, as moderated by HCA. This effect was examined via continuous outcomes on the PDSS and psychosocial functioning (Sheehan Disability Scale). Compared with patients without HCA (N=154), patients with HCA (N=46) experienced significantly more severe symptoms of PD (d=0.60), agoraphobia (d=0.47), and comorbid depression (d=0.46); significantly worse psychosocial impairment (d=0.63) and anxiety sensitivity (d=0.75); greater personality disorder burden (d=0.45)-particularly with cluster C disorders (d=0.47)-and more severe interpersonal problems (d=0.54). HCA significantly moderated the likelihood of clinical response, predicting nonresponse to ART (B=-2.05, 95% CI=-4.17 to -0.30, OR=0.13, z=-2.14, p=0.032) but not CBT or PFPP. HCA did not interact with treatment condition to predict slopes of PDSS change. The results of this study highlight the importance of HCA in formulating treatment recommendations. Increased awareness of HCA's effects on severity of PD and treatment responsiveness among patients with PD may improve outcomes.

Sex differences in the roles of nicotine use and puberty on youth C-reactive protein levels: Effects above and beyond adversity

Inflammation likely mediates associations between nicotine use and negative health outcomes. Sex differences have been observed in nicotine use–inflammation links, and physiological processes during puberty might allow for these differences to arise. In this cross-sectional study of 498 youth (ages 8–13, 52% girls, 77% with history of child maltreatment (CM) investigation), sex-differentiated associations between self-reported nicotine use and high-sensitivity C-reactive protein (hs-CRP) were explored. Additionally, self-reported pubertal stage was investigated as a moderator of such nicotine use–hs-CRP links. Hierarchical generalized estimating equation models were adjusted for a wide range of adversity effects: CM investigation history derived from state records, self- and caregiver-report of traumatic life events, adversity-related demographic risk factors (i.e., identification with historically marginalized racial and ethnic groups, household income), and other characteristics that may influence the variables of interest (e.g., medication use, age, body mass index). Nicotine use had a negative main effect on hs-CRP among boys (β = −0.50, p = 0.02), and pubertal stage did not moderate this association (β = 0.06, p = 0.71). In contrast, pubertal stage moderated the association between nicotine use and hs-CRP among girls (β = 0.48, p = 0.02) such that a positive association between nicotine use and hs-CRP levels was stronger at more advanced pubertal stages (β = 0.45, SE = 0.21, 95% CI [0.03, 0.87]). Findings suggest that puberty may influence the effect of nicotine on inflammation in sex-differentiated ways and have implications for timing of prevention and treatment efforts geared toward reducing nicotine use and subsequent inflammation-related health risk among youth.

Pet Attachment and Anxiety and Depression in Middle-Aged and Older Women

Understanding how attachment to pets can alleviate depression and anxiety offers valuable insights for developing preventive and therapeutic strategies, particularly for those with insecure attachment styles from childhood trauma. To determine if a close bond with a pet is associated with reduced depression and anxiety, especially among women who experienced childhood abuse. This cross-sectional study involved women who voluntarily enrolled in the Mind Body Study (MBS), a substudy of the Nurses' Health Study II (NHS2) focusing on psychosocial factors. Women reporting childhood abuse were oversampled to capture their psychosocial distress in adulthood. MBS participants were invited to complete comprehensive online questionnaires, which were administered twice (March 2013 and February 2014). Pet attachment measured by Lexington Attachment to Pets Scale (LAPS). Levels of depression and anxiety (10-item Centre for Epidemiologic Studies Depression Scale [CESD-10]; Kessler Psychological Distress Scale [K6]; 7-item Generalized Anxiety Disorder scale [GAD-7]; Crown Crisp Experiential Index phobic anxiety subscale [CCI]), considered individually and combined into an overall z-score measure of anxiety and depression symptoms. A total of 214 women (mean [SD] age, 60.8 [3.9] years) were included; 156 women (72.6%) reported a history of childhood abuse. Of 688 invited MBS participants in 2013, 293 (42.6%) expressed interest; there were 228 completed questionnaires (response rate, 77.8%) in 2013 and 208 questionnaires (response rate, 71.0%) in 2014. LAPS scores were provided by 140 participants (65.4%), 78 (55.7%) for dogs and 46 (32.9%) for cats. Overall higher pet attachment on the LAPS score was significantly associated with lower GAD-7 scores (β = -0.17; 95% CI, -0.29 to -0.06), but there was no association for phobic anxiety or depression. There were no statistically significant associations between cat attachment and depression or anxiety. Higher dog attachment was associated with significantly lower scores in depression (CESD-10: β, -0.47; 95% CI, -0.68 to -0.26; K6: β = -0.42; 95% CI, -0.54 to -0.31), generalized anxiety (GAD-7: β = -0.47; 95% CI, -0.65 to -0.3), and the overall measure of anxiety and depression (z score: β = -0.12; 95% CI, -0.17 to -0.08), but there was no association between dog attachment and phobic anxiety (CCI: β = -0.08; 95% CI, -0.24 to 0.09). All effect sizes for associations were higher when analyses were restricted to women with a history of childhood abuse. In this explorative cross-sectional study, strong attachment to pets, especially dogs, was associated with lower anxiety and depression symptoms. The favorable association was particularly apparent in women with a history of childhood abuse.