Childhood Trauma Questionnaire-Short Form Research Articles

Differential association between childhood trauma subtypes and neurocognitive performance in adults with major depression

BackgroundNeurocognitive impairment is one of the prominent manifestations of major depressive disorder (MDD). Childhood trauma enhances vulnerability to developing MDD and contributes to neurocognitive dysfunctions. However, the distinct impacts of different types of childhood trauma on neurocognitive processes in MDD remain unclear.MethodsThis study comprised 186 individuals diagnosed with MDD and 268 healthy controls. Childhood trauma was evaluated using the 28-item Childhood Trauma Questionnaire-Short Form. Neurocognitive abilities, encompassing sustained attention, vigilance, visual memory, and executive functioning, were measured by the Cambridge Neuropsychological Testing Automated Battery.ResultsMultivariable linear regressions revealed that childhood trauma and MDD diagnosis were independently associated with neurocognitive impairment. Physical neglect was associated with impaired visual memory and working memory. MDD diagnosis is associated with working memory and planning. Interactive analysis revealed that physical/sexual abuse was associated with a high level of vigilance and that emotional neglect was linked with better performance on cognitive flexibility in MDD patients. Furthermore, childhood emotional abuse, physical abuse, and emotional neglect were revealed to be risk factors for developing early-onset, chronic depressive episodes.ConclusionThus, specific associations between various childhood traumas and cognitive development in depression are complex phenomena that need further study.

Network analysis of childhood maltreatment and internet addiction in adolescents with major depressive disorder.

Childhood maltreatment (CM) is closely linked to internet addiction (IA), especially in adolescents with Major Depressive Disorder (MDD). Previous studies have shown that adolescents who experience CM are more likely to develop IA and other psychological problems. This study aims to explore the complex relationship between CM and IA through network analysis, particularly identifying the core symptoms and bridge symptoms to better understand the development of IA in these adolescents. A cross-sectional study was conducted in seven hospitals in Anhui Province, China, involving 332 adolescents diagnosed with MDD using DSM-5 criteria. The Childhood Trauma Questionnaire - Short Form (CTQ-SF) and the Internet Addiction Test (IAT) were used to assess CM and IA symptoms, respectively. Gender-based network analysis was also performed. Network analysis constructed a CM-IA network and identified core and bridge symptoms. "Depress/moody/nervous being offline", "Request an extension for longer time", "Sleep loss due to late-night logins", and "emotional abuse" emerged as central symptoms within the CM-IA network. Additionally, "emotional abuse", "sexual abuse", and "complaints about online time" were identified as key bridge symptoms linking CM and IA. These symptoms demonstrated significant connectivity, underscoring their critical role in linking CM and IA. The findings highlight the complex relationship between CM and IA in adolescents with MDD. Specific symptoms, such as emotional abuse and online-related symptoms, play important roles in understanding and intervening in adolescent IA. Future interventions should target these core and bridge symptoms for more effective prevention and treatment.

Relationship between early traumatic experiences and emotional regulation skills in major depressive and bipolar disorders.

Childhood trauma can cause deficits in emotional regulation. However, few studies have investigated childhood trauma and emotional regulation skills in patients with mood disorders. We aimed to investigate how childhood trauma and Emotion Regulation Skills Questionnaire (ERSQ) scores are associated with mood disorders.This study included 779 patients with mood disorders (major depressive disorder [MDD, n = 240], bipolar I disorder [BDI, n = 121], and bipolar II disorder [BDII, n = 418]). We used their Childhood Trauma Questionnaire-Short Form (CTQ) and ERSQ scores for the evaluation.The between-group differences in CTQ and ERSQ scores were examined. The CTQ and ERSQ total scores were negatively correlated. Among the CTQ subscales, emotional neglect showed a significant correlation with the ERSQ total score, whereas acceptance and tolerance showed higher negative correlations with the CTQ than with the other ERSQ subscales. The negative relationship between emotional regulation and childhood trauma varied significantly depending on the group, with the BDI group showing a more prominent association than the other groups.Based on various mood disorders, we observed associations between childhood trauma and emotional regulation skills. Consequently, our study offers notable insights for future research on the impact of childhood trauma on ERSQ.

Association between childhood trauma and social anxiety in adolescents: The mediating role of self-compassion and loneliness

BackgroundPrevious studies have shown a correlation between childhood trauma and social anxiety. However, the underlying mechanism of this association is not well understood. ObjectiveThe aim of this study was to examine the relationship between childhood trauma and social anxiety in adolescents, and to explore the mediating role of self-compassion and loneliness. Participants and settingIn total 1309 adolescents (531 of whom were female) were recruited, and their mean age was 15.4 ± 2.30 years. MethodsParticipants completed the Adolescent Social Anxiety Scale, Childhood Trauma Questionnaire Short Form, Self-Compassion Scale, and University of California, Los Angeles Loneliness Scale. Pearson correlation analysis was conducted to investigate the relationships among childhood trauma, self-compassion, loneliness, and social anxiety. The PROCESS Macro Model 80 was used for regression analysis to explore the mediating effects of self-compassion and loneliness on the relationship between childhood trauma and social anxiety. ResultsAfter controlling for the influence of gender and parental marital status, self-compassion mediated the association between childhood trauma and social anxiety, in which positive self-compassion alleviated the relationship between childhood trauma and social anxiety, while negative self-compassion aggravated the relationship between childhood trauma and social anxiety. Furthermore, self-compassion and loneliness chain-mediated the relationship between childhood trauma and social anxiety. ConclusionThese results offer theoretical support for the research and intervention of adolescents' social anxiety, and are crucial for developing adolescents' mental health education and promoting interpersonal communication.

The mediation role of gray matter volume in the relationship between childhood maltreatment and psychological resilience in adolescents with first-episode major depressive disorder

Previous studies have revealed morphologic alterations in patients with major depressive disorder (MDD) with experiences of childhood trauma. However, the underlying neural mechanisms remain largely unknown. This study aims to explore the brain structural changes and their possible mediation role in the relationship between childhood maltreatment and psychological resilience in drug-naïve adolescents with first-episode MDD. A total of 57 adolescents with first-episode MDD and 36 healthy controls (HCs) completed the T1-weighted magnetic resonance imaging scan. The adverse childhood experiences and current psychological resilience were assessed using the Childhood Trauma Questionnaire-Short Form and the Connor Davidson Resilience Scale, respectively. The voxel-based morphometry approach was applied to examine changes in the gray matter volume (GMV). Compared with the HCs, adolescents with MDD had significantly reduced GMV volumes in the left fusiform gyrus, right orbitofrontal gyrus, right superior temporal gyrus, right calcarine cortex, right middle frontal gyrus, left angular gyrus, right precuneus, right posterior cingulate gyrus, and right posterior central gyrus, as well as significantly increased GMV volumes in the left lenticular putamen and right lenticular pallidum. The GMV of the right calcarine cortex was found to be negatively correlated with the severity of emotional abuse and positively correlated with the level of psychological resilience. Moreover, the GMV of the right calcarine cortex might partially mediate the relationship between childhood maltreatment and psychological resilience. The present study provided further evidence for structural impairments in adolescents with MDD. Our findings also confirmed the important role of depression-related GMV changes in childhood growth experiences and psychological resilience characteristics during adolescent brain maturation.

Childhood maltreatment, cognitive performance, and cognitive decline in middle-aged and older adults with chronic disease: A prospective study

ObjectivesChildhood maltreatment (CM) may increase the risk for cognitive deficits and dementia later in life. However, most research has been cross-sectional in nature, has typically focused on specific types of CM, and rarely examined individual differences. The objectives are to evaluate 1) if CM predicts poorer cognitive performance and greater cognitive decline over a 5-year follow-up in older men and women with coronary artery disease (CAD) or other non-cardiovascular (non-CVD) chronic disease, and whether 2) sex and CAD status influence these relations. MethodsMen and women (N = 1254; 39.6 % women; 65.6 ± 7.0 years old) with CAD or other non-CVD chronic diseases completed the Childhood Trauma Questionnaire Short Form (CTQ-SF). The Montreal Cognitive Assessment (MoCA) was administered twice at 5-year intervals. Main analyses included bivariate correlations, hierarchical analyses and moderation analyses controlling for sociodemographic and health parameters. ResultsCM was experienced by 32 % of the sample, while scores suggestive of cognitive deficits were obtained by 32.7 % and 40.2 % at study onset and follow-up, respectively. CM was associated with significantly lower MoCA scores at study onset (b = −0.013, p = 0.020), but not with change in MoCA over time (b = −0.002, p = 0.796). While MoCA scores did differ as a function of sex and CAD status, the latter did not influence the relations between maltreatment and MoCA. ConclusionsCM predicted poorer cognitive functioning among older individuals with chronic diseases but did not play a role in any further cognitive decline over the follow-up period. Further research is needed to help understand the mechanisms implicated.

Latent profile analysis identifies four different clinical schizophrenia profiles through aberrant salience

Understanding the role of aberrant salience (AS) in psychosis is crucial for comprehending schizophrenia spectrum disorders (SSDs). Researchers emphasize the importance of salience attribution in schizophrenia, acknowledging its interaction with environmental stressors and multiple neurotransmitter systems. Childhood trauma and adversities (CTA) play a significant role in SSDs, potentially contributing to prodromal symptoms characterized by AS. While empirical evidence supports the relationship between AS and SSD, the interplay between different AS patterns, CTA, and psychotic symptoms remains unclear. Clinical diagnosis followed DSM-5 criteria, and participants completed assessments including the Aberrant Salience Inventory (ASI), Childhood Trauma Questionnaire – Short form (CTQ-SF), and Positive and Negative Symptom Scale (PANSS). Latent profile analysis (LPA) was employed to identify distinct AS profiles within the sample, with subsequent analyses examining differences in psychopathological variables among these profiles. Among 262 participants, four distinct AS profiles emerged from LPA: low AS, high AS with severe symptoms and CTA, intermediate AS with sexual abuse correlation, and chronic AS with specific childhood trauma associations. Profile distinctions included differences in age, hospitalizations, psychotic symptoms, and CTA. Logistic regression analyses showed significant associations between the four profiles and emotional and sexual abuse, physical neglect and clinical variables. Subtyping individuals with SSD based on AS revealed four distinct profiles, each with unique clinical characteristics and associations with CTA. Future studies should investigate whether these profiles correspond to diverse treatment outcomes. These findings highlight the complexity of schizophrenia presentation and underscore the importance of considering individualized diagnostic and therapeutic approaches.

Childhood maltreatment and aggressive behavior among college students: a serial mediation model of authenticity and alexithymia.

Aggressive behavior among college students is a concerning issue that not only affects the mental health and personal development of those involved but also poses a threat to societal stability. Existing literature has consistently demonstrated a positive correlation between childhood maltreatment and aggressive behavior. However, the specific mechanisms through which childhood maltreatment leads to aggressive behavior remain unclear. This study aims to explore the impact of childhood maltreatment on aggressive behavior among college students and to examine the mediating roles of authenticity and alexithymia in this relationship. To investigate these relationships, we conducted an online survey among 1,148 Chinese college students. Participants completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), Authenticity Scale, Toronto Alexithymia Scale (TAS-20), and 12-item Aggression Questionnaire (12-AQ). These instruments allowed us to measure the variables of interest and to analyze the potential mediating effects of authenticity and alexithymia. The findings of our study indicate that both authenticity and alexithymia mediate the positive relationship between childhood maltreatment and aggressive behavior. Specifically, the mediating effect of authenticity was 0.04 (95% CI [0.01, 0.06]), while that of alexithymia was 0.10 (95% CI [0.07, 0.13]). Moreover, we observed a chain-mediating effect involving both authenticity and alexithymia, with a chain-mediating effect of 0.03 (95% CI [0.02, 0.05]). This study demonstrates that childhood maltreatment can positively predict aggressive behavior in college students, and this relationship is mediated individually and sequentially by authenticity and alexithymia. Our findings contribute valuable insights to the existing research on aggressive behavior and provide a theoretical framework for developing interventions aimed at reducing aggressive behaviors among college students.

The moderating effect of maternal childhood maltreatment on the association between social support and parenting outcomes

Although social support is generally expected to improve parenting issues, previous findings on its efficacy among parents who have experienced childhood maltreatment are inconsistent. However, the reasons for this inconsistency have not yet been clarified. To address this, the present study examined the possibility that experiencing specific subtypes of childhood maltreatment (i.e., emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) impairs the subsequent function of social support in parenting. A cross-sectional online survey was conducted with Japanese mothers of children aged one to three years. In the survey, participants completed four scales: the Parenting Stress Index-Short Form, Parenting Skills Scales for Mothers of Toddlers, Childhood Trauma Questionnaire-Short Form, and the Brief Inventory of the Social Support Exchange Network. A total of 360 datasets were analyzed (mean age = 33.73, SD = 4.73). The results indicated that physical abuse diminished the effect of social support on the prevention of negative parenting. However, social support alleviated parenting stress regardless of childhood maltreatment subtype. The effects of social support on increased positive parenting and decreased negative parenting were unclear compared to its effect on parenting stress. These findings have important implications for supporting parenting among parents who have experienced childhood maltreatment and preventing. intergenerational transmission.

Methylome-wide association study of adolescent depressive episode with psychotic symptoms and childhood trauma

BackgroundEmerging evidence suggests that DNA methylation is crucial in the mental disorder pathophysiology. The current study attempted to identify the dysregulation of DNA methylation patterns in adolescent patients suffering from depressive episodes (DE) while considering the impact of various subtypes, including psychotic symptoms and a history of childhood trauma. MethodsThe study included 67 patients with DE and 30 healthy controls (HCs) subjects. Severe depressive episode (SDE) patients were grouped according to psychotic symptoms, such as SDE with vs. SDE without psychotic symptoms (cases 29 vs. 21). The Childhood Trauma Questionnaire-Short Form helped assess childhood trauma among all patients. Thus, all the patients were divided into adolescent DE experiencing ≥ two trauma types vs. experiencing ≤ one trauma type (cases, 50 vs. 17). Methylome-wide analysis was conducted on peripheral blood to identify methylation differences in CpG sites for three comparisons: DE vs. HCs, SDE patients with vs. without psychotic symptoms, and DE patients having 0–1 type of childhood trauma vs. those having ≥two types of childhood trauma. ResultsAdolescent DE patients demonstrated a predominant trend of lower methylation levels than HCs, with 259 hypermethylated and 3956 hypomethylated sites. Differentially hypomethylated sites involve related genes such as FKBP5, BDNF, NR3C1, GABRB3, SHANK1, SLC38A1, SLC6A18, CHRNB1, CTNNA2, CTTNBP2, etc. All these genes could be involved in DE pathogenesis. Significant DNA methylation changes could be observed in SDE subgroups with and without psychotic symptoms (e.g., genes like DTNB, CNTN1, CTNNA2), along with those DE patients having 0–1 type of childhood trauma compared to those with ≥2 types (e.g., VWA3B, SYT10, SDK2, CAMSAP3). Many significant methylated sites were associated with genes involved in brain development, highlighting the potential pathophysiological mechanisms linked with DE and its subtypes, such as psychotic symptoms and childhood trauma. ConclusionOur findings suggest that differential DNA methylation is associated with the pathophysiology of DE, as well as the presence of psychotic symptoms and a history of childhood trauma. These blood-based methylation patterns may serve as biomarkers for DE and shed light on underlying mechanisms across these subtypes.

The effect of childhood trauma on moral cognition in patients with schizophrenia.

The aim of this study was to investigate whether a potential moral cognitive impairment (failure in understanding moral rules) exists in patients with schizophrenia (SCZ) and to explore the effect of childhood trauma (CT) on moral cognition in a group of patients with SCZ. A total of 99 patients with SCZ and 102 healthy controls (HCs) were included in this study. The Childhood Trauma Questionnaire-Short Form (CTQ) was administered to assess childhood trauma experiences in both groups, while the Moral Identity Measure (MIM) and the Moral Foundations Questionnaire (MFQ) were applied for a comparative evaluation of moral cognition across the two groups. The Positive and Negative Syndrome Scale (PANSS) was administered to assess the psychopathology. Patients with schizophrenia had significantly greater CTQ scores than HCs (42.77 ± 13.50 vs. 29.11 ± 4.25, t=9.697, p<0.001). The prevalence of childhood trauma (χ 2 = 58.452, p<0.001) and history of aggressive behaviors (χ 2 = 23.565, p=0.001) among patients with SCZ were greater than that among HCs. In addition, the scores of moral cognition (MIM: 61.82 ± 15.12 vs. 70.88 ± 8.87, p=0.001; MFQ: 87.24 ± 22.30 vs. 112.62 ± 23.42, p=0.045) in the SCZ group was lower than that in the HC group after controlling for the influence of CT covariates. The MFQ score was negatively correlated with the CTQ score, the emotional abuse (EA) score, the physical abuse (PA) score and the physical neglect (PN) score in SCZ patients. Among HCs, the MFQ score was positively correlated with the CTQ score, as well as with the dimensions of physical abuse (PA) and emotional Neglect (EN). Multiple linear regression analyses revealed that impaired moral cognition performance was significantly predicted by the CTQ score (beta=-0.235, p=0.034, 95% CI -0.743 to -0.031) in patients with SCZ but was significantly predicted by years of education (beta=-0.392, p<0.001, 95% CI -4.783 to -1.876), alcohol use (beta=0.210, p=0.023, 95% CI 2.191 to 29.399) and the CTQ score (beta=0.184, p=0.046, 95% CI 0.019 to 1.928) in HCs. CTQ moderated the effect of SCZ on MFQ (B = 0.516); Simple tests revealed that the group effect on the MFQ was B=12.306 at the lower level(-1SD) and B = 54.089 at the higher level(+1SD) of the CTQ scores. SCZ patients exhibit impaired moral cognition. The contribution of CT to the presence of moral cognitive impairments seems to be independent of psychopathology.

Childhood Maltreatment Associated with Anxiety and Depression and Complex PTSD Symptoms.

Childhood maltreatment has great impact on physical and mental health. This study was designed to investigate the relationship between childhood maltreatment experience, social support, Anxiety and Depression, and traumatic stress symptoms in adults. There were 113 subjects aged 20-35 recruited. They filled out self-reported questionnaires, including the Childhood Trauma Questionnaire Short Form (CTQ-SF), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), International Trauma Questionnaire (ITQ), Chinese version of the PTSD Checklist for DSM-5 (PCL-5), and Multidimensional Scale of Perceived Social Support (MSPSS), to measure symptom severity regarding childhood maltreatment, Anxiety and Depression, post-traumatic stress/complex post-traumatic stress symptoms (PTSD/CPTSD), and social support. The symptom severity was compared between maltreatment and non-maltreatment groups. Regression and mediator analyzes were done to investigate the relationship between maltreatment experience, mental impact severity, and the role of social support. There were 74.3% of participants who had been maltreated as children. Those who experienced maltreatment had more PTSD/CPTSD symptom severity than those who did not. Family support, but not friend support, mediated the relationship between maltreatment and PTSD/CPTSD symptom severity. Childhood maltreatment was associated with Anxiety and Depression and CPTSD symptom severity in young adults. Future prospective studies are warranted to investigate the role of family support in preventing consequences after maltreatment.

The perspective and preferences of adolescents in addressing sensitive health topics with their family doctor – The influence of childhood adversities

ObjectiveTo investigate whether adverse childhood experiences (ACEs) influence adolescents’ perspectives and preferences in addressing sensitive health topics and their general perception of family doctor's care, and also to study the impact of addressing sensitive topics regarding adolescents’ health-related quality of life (HRQoL). MethodsTwo hundred and forty-five tenth to twelfth grade students completed a questionnaire, comprising the Childhood Trauma Questionnaire-Short Form (CTQ-SF), and scales to assess experiences, preferences, perspectives, the general perception of family doctor visits, and HRQoL. ResultsThe total CTQ-SF score negatively predicted the preferences in addressing sensitive topics and the general perception of family doctor's care. Being asked about sensitive topics positively predicted the perception of family doctor's care and was positively associated with three dimensions of HRQoL. ConclusionThe greater the frequency of ACEs reported by the adolescents, the less willing they were to be asked about sensitive topics and the worse was the general perception of family doctor’s care. However, when asked about sensitive topics, the adolescents had a more positive general perception and a better HRQoL. Practice ImplicationsThis study helps family doctors understand the need to adapt communication skills and to build a trustful relationship with adolescents who reported ACEs.

Regional brain activity and connectivity associated with childhood trauma in drug-naive patients with obsessive–compulsive disorder

Obsessive–compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive, compulsive behaviors, with childhood trauma recognized as a contributing factor to its pathophysiology. This study aimed to delineate brain functional aberrations in OCD patients and explore the association between these abnormalities and childhood trauma, to gain insights into the neural underpinnings of OCD. Forty-eight drug-naive OCD patients and forty-two healthy controls (HC) underwent resting-state functional magnetic resonance imaging and clinical assessments, including the Yale–Brown Obsessive Compulsive Scale (Y–BOCS) and Childhood Trauma Questionnaire-Short Form (CTQ-SF). Compared to HCs, OCD patients exhibited significantly decreased amplitude of low-frequency fluctuations (ALFF) in the right cerebellum, decreased regional homogeneity (ReHo) in the right cerebellum and right superior occipital lobes (FWE-corrected p < 0.05), which negatively correlated with Y–BOCS scores (p < 0.05). Furthermore, cerebellar ALFF negatively correlated with the CTQ emotional abuse subscale (r = − 0.514, p < 0.01). Mediation analysis revealed that cerebellar ALFF mediated the relationship between CTQ-emotional abuse and Y–BOCS (good model fit: R2 = 0.231, MSE = 14.311, F = 5.721, p < 0.01; direct effect, c′ = 0.153, indirect effect, a*b = 0.191). Findings indicated abnormal spontaneous and regional cerebellar activity in OCD, suggesting childhood trauma impacts OCD symptoms through cerebellar neural remodeling, highlighting its importance for clinical treatment selection.

Adverse childhood experiences and psychological maladjustment in adolescence: The protective role of epistemic trust, mentalized affectivity, and reflective functioning.

Adverse childhood experiences (ACEs) are psychosocial factors acknowledged as significant contributors to health consequences later in adolescence, including psychological maladjustment. The research suggests that, at a transdiagnostic and transtheoretical level, working on restoring epistemic trust (ET), mentalized affectivity (MA), and reflective functioning (RF) in adolescents with ACEs assumes a central role in the therapeutic process. However, there are still few studies that attempted to investigate the specific role of these sociocognitive factors in the detrimental positive association between levels of experienced ACEs during childhood and psychological maladjustment in nonclinical adolescents. A community sample of 306 Italian cisgender adolescents (61.4% assigned females at birth; age range 13-19 years old; Mage = 16.1, SD = 1.64) self-reported ACEs (Childhood Trauma Questionnaire-Short Form), psychological maladjustment (Strengths and Difficulties Questionnaire), ET (Epistemic Trust, Mistrust and Credulity Questionnaire), MA (Brief-Mentalized Affectivity Scale for Adolescence), and RF (Reflective Functioning Questionnaire). A multiple mediation regression analysis has been performed to explore the association between ACEs and psychological maladjustment through the interaction with socio-cognitive factors. ACEs are positive predictors of psychological maladjustment later in adolescence. Regardless of gender differences, epistemic mistrust and credulity, processing and expressing emotions, and uncertainty about mental states mediated this association, while epistemic trust, identifying emotions, and certainty about mental states did not configure as significant mediators. Findings suggest that ET disruptions and deficits in RF are risk factors, while MA is a protective factor within the link between ACEs and psychological maladjustment in adolescence. These links help to specify the role of sociocognitive factors in the development of mental problems in adolescents who have been exposed to adverse experiences in childhood.

Suicidal ideation in medical students of Hebei province: prevalence and associated factors.

This study investigated the prevalence of suicidal ideation (SI) among Chinese medical students and its associated risk factors. A total of 6643 medical students (2383 males/4260 females) were recruited from a medical college in Hebei Province, China. Demographic data were collected via a self-administered questionnaire. The Childhood Trauma Questionnaire Short Form (CTQ-SF) was used to evaluate childhood maltreatment (CM), and the Adolescent Self-Rating Life Events Checklist (ASLEC) was used to evaluate the stressful life events. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation (BSSI). Univariate and multivariate logistic regression models were used to analyze the factors affecting SI. The prevalence of SI in medical students was 11.5% (763/6643). Multivariate logistic regression analysis revealed that SI was significantly associated with younger age, a female sex, being lovelorn, being introverted, experiencing CM during childhood, and experiencing stressful life events within the past 12 months. Of the five subtypes of CM, emotional abuse may have the strongest effect on SI (OR=2.76, 95% CI: 1.72-4.42). The joint effects of CM and stressful life events were significantly associated with an increased risk of SI (OR=5.39, 95% CI: 4.15-6.98). The prevalence of SI among medical students is high, and medical students who have experienced CM and stressful life events have a higher tendency towards SI. Screening for both CM and stressful life events may be an effective way of identifying individuals at high risk of SI.

Validation of the Spanish Childhood Trauma Questionnaire-Short Form in adolescents with suicide attempts.

Child maltreatment is associated with a higher probability of mental disorders and suicidal behavior in adolescence. Therefore, accurate psychometric instruments are essential to assess this. To validate the Spanish version of the Childhood Trauma Questionnaire-Short Form (CTQ-SF) in adolescents with suicide attempts. Multisite cohort study of 208 adolescents with suicide attempts using data from the following scales: Mini International Neuropsychiatric Interview (MINI), Columbia Suicide Severity Rating Scale (C-SSRS), Patient Health Questionnaire (PHQ-9), and CTQ-SF. Statistical analysis: CTQ-SF scores analyzed by descriptive statistics. Internal consistency: McDonald's omega and Cronbach's alpha. Concurrent validity with PHQ-9 and C-SSRS scores: Spearman correlation coefficient. Structural validity: Confirmatory factor analysis. Floor and ceiling effects: Physical abuse and neglect as well as sexual abuse demonstrated high floor effects (50.0, 35.1, and 61.1% of adolescents, respectively). No ceiling effects were found. The CTQ-SF had excellent internal consistency (McDonald's omega = 0.94), as did the majority of its subscales (Cronbach's alpha 0.925-0.831) except for physical neglect (0.624). Its concurrent validity was modest, and the emotional neglect subscale had the lowest Spearman correlation coefficients (0.067-0.244). Confirmatory factor analysis: Compared with alternative factor structures, the original CTQ-SF model (correlated 5-factor) exhibited a better fit [S-B χ 2 = 676.653, p < 0; RMSEA (90% CI = 0.076-0.097) = 0.087; SRMR = 0.078; CFI = 0.980; TLI = 0.978]. The Spanish CTQ-SF is a reliable, valid instrument for assessing traumatic experiences in adolescents at high risk of suicide. It appears appropriate for use in routine clinical practice to monitor maltreatment in this group.

Types of childhood maltreatment as predictors of posttraumatic stress disorder severity and complex posttraumatic stress disorder in patients with substance use disorders

ABSTRACT Background: Childhood maltreatment (CM) can be divided into: emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN). CM is associated with (Complex)Posttraumatic stress disorder (PTSD/CPTSD) and substance use disorder (SUD). Objective: This cross-sectional study examined the relationships between CM-subtypes with PTSD-severity and CPTSD in patients with SUD-PTSD. Method: Participants (N = 209) were treatment-seeking SUD-PTSD patients who completed the Childhood Trauma Questionnaire-short form, the Clinician-Administered PTSD Scale for DSM-5 and the International Trauma Questionnaire. Regression analyses and a model selection procedure to select an optimal model were used to examine CM-subtypes as predictors of (C)PTSD, adjusted for sex and age. Results: Total CM and all CM-types significantly predicted PTSD-severity in the univariate regression analysis, with EA begin the strongest predictor. In the multiple regression only SA predicted PTSD-severity. Subsequently, model selection indicated that the optimal model to predict PTSD-severity included EA and SA. In the univariate analyses total CM, EA, and PN significantly predicted CPTSD-classification, and total CM and all CM-types significantly predicted CPTSD-severity. In the multiple regression for CPTSD-classification only EA and PA were significant predictors and for CPTSD-severity EA, PA and SA were significant predictors. In post-hoc multiple regression analyses, only EA was a significant predictor of CPTSD-classification and CPTSD-severity. Finally, in the model selection the most parsimonious model only included EA for both CPTSD-classification and CPTSD-severity. Sex was not a moderator in the relationship between CM and PTSD, nor in CM and CPTSD. Conclusions: These findings indicate that for SUD-PTSD patients, several CM-types have predictive value for (C)PTSD-severity, however SA and especially EA appear to contribute to these complaints. Since EA does not constitute an A-criterion, it is generally more overlooked in PTSD treatment. Its impact should therefore be underlined, and clinicians should be attentive to EA in their treatment.

Childhood emotional maltreatment and internalizing problems in a non-clinical sample of adolescents: a moderated-mediation model of insecure anxious attachment style and gender.

Childhood emotional maltreatment (abuse and neglect) may contribute to the development of internalizing problems in adolescence. However, the mechanisms explaining this association should be examined further. This study explored the mediating role of insecure anxious attachment style in the relationship between emotional maltreatment and internalizing symptoms in a non-clinical sample of adolescents. Analyses were also conducted to determine whether gender moderated the direct and indirect pathways between emotional maltreatment and internalizing problems. We recruited 449 adolescents aged between 14 and 18 years old [(Mage)=16.46, standard deviation (SD)=1.38]. 60.8% of adolescents were female (Mage=16.51, SD=1.43), whereas 39.2% identified as male (Mage=16.39, SD=1.28). Participants completed a survey including socio-demographic information and three selfreport questionnaires: the Childhood Trauma Questionnaire-Short Form, the Attachment Style Questionnaire, and the Youth Self- Report for ages 11-18. Results showed that emotional abuse and neglect were related to internalizing problems both directly and indirectly through anxious attachment style. Girls who experienced higher levels of emotional abuse and who had an anxious attachment style reported more internalizing problems than boys, whereas higher levels of emotional neglect were associated with increasing levels of internalizing problems only for boys. This study expanded our knowledge of the role of anxious attachment in the onset of internalizing problems among adolescents with experiences of childhood emotional maltreatment.

Early traumatic experiences are linked to hypersexual behavior and erectile dysfunction in men through the mediation of body uneasiness and general psychopathology.

Childhood traumatic experiences have been associated with hypersexuality and sexual dysfunctions. However, the mediators of the interactions between these variables should be clarified in men. This study aimed to investigate the interaction of early traumatic experiences, psychopathology, and sexuality with respect to erectile dysfunction (ED) and hypersexual behavior. The hypothesized model expected that traumatic experiences would be associated with hypersexual behavior and reduced sexual functioning through the mediation of body uneasiness and psychological distress. The study was cross-sectional and observational. A total of 317 men were enrolled. Male patients with a primary complaint of ED and an indication for psychiatry referral represented the clinical sample (n = 116; mean ± SD age,42.82 ± 16.89years). Clinical classification was assessed with the Structured Interview on Erectile Dysfunction. The second sample (n = 201, 30.82 ± 11.94years) was recruited from the general population. All participants were administered the following questionnaires: Brief Symptom Inventory, Childhood Trauma Questionnaire-Short Form, Hypersexual Behavior Inventory, Body Uneasiness Test-A, and 5-item International Index of Erectile Function. Psychopathology and sexual functioning were assessed by a dimensional approach, and a multivariate model was computed by structural equation model analysis. When compared with the sample from the general population, the clinical sample exhibited a higher prevalence of early traumatic experiences, as measured by scores on the Childhood Trauma Questionnaire-Short Form (45.08 ± 14.25 vs 39.03 ± 10.22, F = 17.63, P < .001), and a higher tendency to engage in hypersexual behaviors (34.63 ± 13.55 vs 30.79 ± 12.44, F = 6.97, P < .01). Structural equation model analysis showed excellent fit indices indicating that early traumatic experiences predicted hypersexual behaviors and ED through the exacerbating mediating effect of body uneasiness and psychopathology. Clinicians should not limit their attention to the behavioral level when assessing sexual dysfunction in men; rather, they should also consider the complex psychopathologic consequences of childhood trauma. Integrated treatments that address the potential presence of childhood trauma with its wider psychological correlates (eg, emotion dysregulation, body uneasiness) might improve treatment response. The study reports novel data on the relationship among childhood maltreatment, male sexuality, and psychopathologic mediators with a dimensional assessment. However, the assessment was cross-sectional, and causality was mainly derived from previous studies. The present study enriches the current literature, strengthening the hypothesis that childhood traumatic experiences significantly shape development and sexuality. Body uneasiness and psychopathology can both tax sexual functioning, as assessed by erectile functioning or hypersexuality.