Childhood Trauma Questionnaire Total Score Research Articles

Relationship of Childhood Trauma with Transcranial Magnetic Stimulation Outcome for Depression

Background: Childhood trauma has lasting effects on treatment outcomes for many illnesses including major depressive disorder (MDD) but the relationship with transcranial magnetic stimulation (TMS) is unknown.Methods: Childhood Trauma Questionnaire (CTQ), a questionnaire to assess severity and type of childhood trauma, was collected in a naturalistic outpatient setting from patients receiving TMS for treatment resistant MDD. Inventory of Depressive Symptomatology Self Report (IDS-SR) was used to assess depression symptom severity, clinical response and remission. Standard treatment was given at 10 Hz stimulation to the dorsolateral left prefrontal cortex at 120% maximum intensity relative to their motor threshold for 3000-4000 pulses/daily for six weeks.Results: 117 patients receiving TMS completed CTQ. More severe trauma showed less improvement after TMS as seen via a negative correlation between IDS-SR %change and CTQ total score (r=-.251, p<0.01). Specifically, less improvement correlated with degree of physical abuse (r=-.245, p<0.01) and physical neglect (r=-.251, p<0.01). Non-responders had significantly worse scores in physical abuse (p<.01), sexual abuse (p<.05), and physical neglect (p<.05) compared to responders. Significant chi-square associations between physical neglect and non-response (χ=8.623, p<0.05); and sexual abuse and non-remission (χ=9.214, p<0.05) were present.Conclusion: Our data show that certain types of trauma may have more impact on TMS outcomes than others. Based on these results, future studies examining the possible biological pathways and mechanisms contributing to the differences in severely depressed patients with and without certain types of childhood trauma could lead to a more personalized treatment algorithm leading to improved efficacy of TMS.Conflicts of Interest: None to reportFunding: This work was supported by grants from the National Institute of Mental Health (NIMH) R25MH101076 (Dr. AM Fukuda) and P20GM130452 (E Tirrell & Dr. LL Carpenter), and by Butler Internal Funding. Background: Childhood trauma has lasting effects on treatment outcomes for many illnesses including major depressive disorder (MDD) but the relationship with transcranial magnetic stimulation (TMS) is unknown. Methods: Childhood Trauma Questionnaire (CTQ), a questionnaire to assess severity and type of childhood trauma, was collected in a naturalistic outpatient setting from patients receiving TMS for treatment resistant MDD. Inventory of Depressive Symptomatology Self Report (IDS-SR) was used to assess depression symptom severity, clinical response and remission. Standard treatment was given at 10 Hz stimulation to the dorsolateral left prefrontal cortex at 120% maximum intensity relative to their motor threshold for 3000-4000 pulses/daily for six weeks. Results: 117 patients receiving TMS completed CTQ. More severe trauma showed less improvement after TMS as seen via a negative correlation between IDS-SR %change and CTQ total score (r=-.251, p<0.01). Specifically, less improvement correlated with degree of physical abuse (r=-.245, p<0.01) and physical neglect (r=-.251, p<0.01). Non-responders had significantly worse scores in physical abuse (p<.01), sexual abuse (p<.05), and physical neglect (p<.05) compared to responders. Significant chi-square associations between physical neglect and non-response (χ=8.623, p<0.05); and sexual abuse and non-remission (χ=9.214, p<0.05) were present. Conclusion: Our data show that certain types of trauma may have more impact on TMS outcomes than others. Based on these results, future studies examining the possible biological pathways and mechanisms contributing to the differences in severely depressed patients with and without certain types of childhood trauma could lead to a more personalized treatment algorithm leading to improved efficacy of TMS. Conflicts of Interest: None to report Funding: This work was supported by grants from the National Institute of Mental Health (NIMH) R25MH101076 (Dr. AM Fukuda) and P20GM130452 (E Tirrell & Dr. LL Carpenter), and by Butler Internal Funding.

The mediating effect of brain-derived neurotrophic factor levels on childhood trauma and psychiatric symptoms in patients with first-episode schizophrenia.

Previous studies have implicated childhood trauma and abnormal brain-derived neurotrophic factor in the pathogenesis of schizophrenia. Here, we explored whether brain-derived neurotrophic factor levels mediated the relationship between childhood trauma and psychopathological symptoms in patients with first-episode schizophrenia. Patients with first-episode schizophrenia (n = 192) and healthy controls (n = 136) were enrolled. Childhood traumatic experiences and psychopathology were assessed by Childhood Trauma Questionnaire and Positive and Negative Syndrome Scale, respectively. Enzyme-linked immunosorbent assay was used to quantify brain-derived neurotrophic factor levels. The patients with first-episode schizophrenia experienced more severe childhood trauma and had lower serum brain-derived neurotrophic factor levels than healthy controls. Emotional abuse and Childhood Trauma Questionnaire total score showed positive correlation with Positive and Negative Syndrome Scale positive, general psychopathological subscore and total score. Emotional neglect showed positive correlation with Positive and Negative Syndrome Scale positive subscore. Physical neglect was positively associated with Positive and Negative Syndrome Scale negative subscore. Emotional neglect and Childhood Trauma Questionnaire total score were negatively correlated with serum brain-derived neurotrophic factor levels. The serum brain-derived neurotrophic factor levels mediated the relationship between both Childhood Trauma Questionnaire total score and Positive and Negative Syndrome Scale total score and negative symptoms in the patients. The brain-derived neurotrophic factor levels also mediated the relationship between emotional neglect and Positive and Negative Syndrome Scale total score in the patients. Childhood trauma might contribute to the clinical symptoms of schizophrenia by affecting brain-derived neurotrophic factor levels. Perhaps we can prevent schizophrenia by reducing childhood traumatic experiences.

Hair-Pulling Does Not Necessarily Serve an Emotion Regulation Function in Adults With Trichotillomania.

Background: Trichotillomania (TTM) has been associated with childhood trauma and perceived stress. While it has been hypothesized that hair-pulling regulate negative emotions, the relationship between childhood trauma, perceived stress, emotion regulation, and hair-pulling has not been well-studied.Methods: Fifty-six adults with TTM and 31 healthy controls completed the Childhood Trauma Questionnaire (CTQ), Perceived Stress Scale (PSS), and Difficulties in Emotion Regulation Scale (DERS). Hair-pulling severity was measured with the Massachusetts General Hospital-Hair Pulling Scale. CTQ, PSS, and DERS total scores were compared across groups using ANCOVA and the correlation between hair-pulling severity and emotion dysregulation was determined. Regression analyses were used to estimate the association of CTQ and PSS totals with DERS, and to determine whether associations between predictors and dependent variable (DERS) differed across groups.Results: TTM patients reported higher rates of childhood trauma (p <= 0.01), perceived stress (p = 0.03), and emotion dysregulation (p <= 0.01). There was no association between emotion dysregulation and pulling severity (r = −0.02, p = 0.89). Perceived stress was associated with emotion dysregulation in both groups (p < 0.01), and no association between childhood trauma and emotion dysregulation in either group. Perceived stress was the only significant predictor of emotion dysregulation in both groups (F = 28.29, p < 0.01).Conclusion: The association between perceived stress and emotion dysregulation is not specific to TTM, and there is no association between emotion dysregulation and hair-pulling severity, suggesting that key factors other than emotion dysregulation contribute to hair-pulling. Alternative explanatory models are needed.

Effect of childhood trauma on disease severity in patients with fibromyalgia: The mediating role of psychological resilience.

Objectives This study aims to investigate the effect of childhood traumas on the disease severity in fibromyalgia and evaluate the mediating role of psychological resilience in this effect.Patients and methods Between June 2017 and January 2018, this study included a total of 80 female patients (mean age: 31.9±4.0 years; range, 20 to 40 years) with fibromyalgia according to the 2010 American College of Rheumatology fibromyalgia diagnostic criteria. All patients were evaluated using the sociodemographic data form, Resilience Scale for Adults (RSA), Childhood Trauma Questionnaire (CTQ), and Fibromyalgia Impact Questionnaire (FIQ).Results A positive correlation was observed between the FIQ and CTQ total scores, emotional abuse, physical abuse, and physical neglect scores. The FIQ was negatively correlated with the RSA scores. Path analysis conducted to evaluate mediating effect of psychological resilience revealed that psychological resilience had a mediator role in the correlation between FIQ and emotional abuse, physical abuse, and physical neglect scores. Conclusion The main finding of this study is the protective effect of psychological resilience -improvable capacity to cope with early life traumas- on fibromyalgia symptoms that leads to negative functioning of several aspects.

Childhood trauma is linked to decreased temporal stability of functional brain networks in young adults

BackgroundBoth childhood trauma and disruptions in brain functional networks are implicated in the development of psychiatric disorders in early adulthood. However, the relationships between these two factors remain unclear. This study aimed to investigate whether and how childhood trauma would relate to changes of functional network dynamics in young adults. MethodsResting-state functional magnetic resonance imaging data were collected from 53 young healthy adults, whose childhood trauma histories were assessed by the Childhood Trauma Questionnaire (CTQ). Network switching rate, a measure of stability of dynamic brain networks over time, was calculated at both global and local levels for each participant. Switching rates at both levels were compared between participants with and without childhood trauma, and further correlated with CTQ total score. ResultsIn the current sample, 19 (35.8%) participants reported a history of childhood trauma. At the global level, participants with childhood trauma showed significantly higher network switching rates than those without trauma (F = 10.021, p = 0.003). A significant positive correlation was found between network switching rates and CTQ scores in the entire sample (r = 0.378, p = 0.007). At the local level, these effects were mainly observed in the default-mode, fronto-parietal, cingulo-opercular, and occipital subnetworks. ConclusionsOur study provides preliminary evidence for a possible long-term effect of childhood trauma on brain functional dynamism. These findings may have potential contributions to psychiatric disorders during adulthood.

Anxiety disorders and childhood exposure to emotional abuse: The mediating role of disgust

IntroductionSeveral studies demonstrate that disgust, defined as a revulsion response aimed at distancing an individual from a potentially harmful or noxious stimulus, is linked to post-traumatic stress following sexual trauma even when accounting for associated fear and anxiety. One of the suggested mechanisms implicated in this association is a feeling of mental contamination. Recent neuroimaging studies demonstrated that exposure to contamination activates the insular cortex. In addition, disgust sensitivity correlates with the activation of the insular cortex.ObjectivesWe aimed to investigate the psychopathological role of the emotion of disgust in the developement of anxiety symptoms in patient with an history of abuse.MethodsWe enrolled 84 patients admitted in Psychiatric Unit of Careggi with diagnosis of Anxiety Disorders. We administered to them: Zung Anxiety Scale (ZSAS), Childhood Trauma Questionnaire (CTQ), Disgust Propensity and Sensitivity Scale-revised (DPSS-r).ResultsResults showed a significant mediation of the association between CTQ emotional abuse scores and total ZSAS scores via DPSS disgust sensitivity scores in patients with anxiety disorders (p=0.022). Total effect and indirect effect of emotional abuse on severity of anxiety symptoms were significant (total effect = 0.494; p=0.051, indirect effect: 0.256, p=0.022), while there was no significant direct effect from emotional abuse to anxiety symptoms in the total model (direct effect: 0.237, p=0.356). The model explained 18% of variance in anxiety symptomatology (R2=0.18).ConclusionsSuch preliminary data suggest a possible mediating role of disgust in development and maintenance of childhood abuse-related anxiety, making it a potential target for psychotherapy.DisclosureNo significant relationships.

Recent versus long-term maternal traumatic life events: Which one impacts prenatal attachment?

IntroductionPrenatal attachment is a strong predictor of post-natal attachment. Identifying factors influencing this bond is important, especially maternal history of stressful life-events.ObjectivesDetermine which type of maternal trauma impacts prenatal attachment.Methods We conducted a transversal descriptive study in a first line clinical practice center and in an university gynecology-obstetrics department. We used Prenatal Attachment Inventory (PAI) to assess maternal-fetal attachment, the Childhood Trauma Questionnaire (CTQ) to evaluate maternal childhood stressful events and the Life-Threatening Events (LTE) to explore traumas during the past 6 months.Results For the 125 pregnant women in our study, the mean age was 30 years and 5 months with 99,2% of them married. Mean gestational age was 33 weeks +1 day. PAI’s mean score was 55,58± 10,20; CTQ‘s mean score was 36,62 ± 9,53 revealing trauma in 28%. Women admitted being victims of IPV in 49,6% with almost the half (48,38%) being exposed to two or more forms of violence. Mean score for recent traumatic events in LTE was 1,87 with 65,2% being exposed to two or more life threatening event. A correlation between the total score of PAI and CTQ was found (p=0.021) particularly subscales of physical and emotional negligence of the CTQ (p=0.023 and p=0.006). We found no statistically significant correlation neither between PAI and IPV (p=0,453) nor between PAI and LTE (p= 0,360).ConclusionsProviding an appropriate training for health care providers can enable them to detect pregnancies at risk in order to refer them to trauma-informed mental health services.

Comparison of developmental trauma between immigrant and non-immigrant psychotic patients

IntroductionMeta-analytic evidence suggests that migrants have higher risk for psychotic disorders. Likewise, growing evidence relate developmental trauma (emotional, sexual, physical abuse and neglect in childhood or adolescence) as a causal factor for psychotic symptoms. However, few studies examine developmental trauma in migrant populations.ObjectivesThe aim of this study is to describe and compare developmental trauma exposure prevalence between immigrant and non-immigrant psychotic patients in Barcelona.MethodsPatients who have presented, according DSM-V criteria, one or more non-affective psychotic episodes, were recruited in Acute and Chronic inpatients units at Hospital del Mar (Barcelona), leading to a total sample of 77 patients. Demographic characteristics of patients, clinical data and main pharmacological treatment were recorded through a questionnaire. Developmental trauma exposure was assessed by Childhood Trauma Questionnaire (CTQ). Comparative analysis was performed with IBM SPSS using Chi-Square Test and t-Student test.ResultsFrom a total of 77 patients, 43 were immigrants and 34 were non-immigrants. Exposure to traumatic events showed significant differences between immigrants and non-immigrant in Child emotional abuse (64,4% immigrants, 35,3% non-immigrant), Child physical abuse (51,2% immigrants, 14,7% non-immigrant), Child Sexual Abuse (41,9% immigrants, 11,8% non-immigrant) and physical neglect (62,8% immigrants, 26,5% non-immigrant). Emotional neglect exposure was no significant between both groups. Total mean CTQ score was 37,53 in immigrants group and 52,60 in non-immigrant group.ConclusionsAccording to our results, there are important and significant differences in developmental trauma exposure between immigrant and non-immigrant psychotic patients. These results should be considered by clinicians in order to design assessment program for this population.DisclosureNo significant relationships.

Differential effect of childhood emotional abuse on present social support in borderline disorder and depression: a cross-sectional study

ABSTRACT Background: Perceived social support (PSS) is a crucial factor in physical and mental health. Previous studies found a negative association between childhood maltreatment (CM) and current PSS. Objective: In this paper, we investigate whether psychopathology moderates this association in a sample of patients with Depressive Disorder (DD) and Borderline Personality Disorder (BPD). Method: Sixty-nine patients with DD and 110 patients with BPD were recruited to inpatient/day clinic treatment programmes for either DD or BPD. All participants completed the Childhood Trauma Questionnaire (CTQ) and the Social Support Questionnaire (F-SozU). Our hypothesis was tested with a moderator analysis in a multiple linear regression model. Results: We found a significant interaction between diagnosis and CM for the CTQ total score and the emotional abuse subscale. Post hoc analyses revealed a significant negative correlation between CM and PSS only for patients suffering from BPD and not for patients with DD. Conclusion: Our results suggest that the negative association between CM and PSS might be more pronounced in certain patient groups, particularly patients with BPD.

Childhood Trauma increases suicidal behaviour in a treatment-resistant depression population: a FACE-DR report

ObjectiveIn addition to heredity, exposure to early-life adversity is an important predisposing risk factor of suicidal behaviour. Although the association between Childhood Trauma (CT) and suicide risk is well documented, interactions between CT and suicidal behaviour in Treatment-Resistant Depression (TRD) populations have received little coverage. This study aimed to evaluate i) association between CT and suicidal behaviour in a TRD population, and ii) the role of personality traits and impulsiveness as potential factors of mediation in these associations. MethodsPatients were recruited from a cohort of the French network of TRD expert centers. Depressive symptom severity, CT, suicidal behaviour, personality traits, and impulsiveness were assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS), the Childhood Trauma Questionnaire (CTQ), the Columbia Suicide Severity Rating Scale (CSSRS), the Structured Clinical Interview for DSM-IV, the Big Five Inventory, and the Barratt Impulsivness Scale (BIS) respectively. ResultsAmong the 256 patients with a baseline CTQ, in relation to suicide risk for the current depressive episode, we found an association with the total CTQ scores mediated by the intensity of the current episode in a model adjusted for age and sex (total effect: β = 0.171; p = 0.011, direct effect: β = 0.135; p = 0.043; indirect effect: β = 0.036; p = 0.048). Focusing on CT subtypes, we detected an association between suicide risk and physical neglect in a model adjusted for age and sex (β = 0.301; p = 0.002), without any mediation by the intensity of the current episode. There was no mediation effect from personality traits nor impulsiveness. With regards to CSSRS to assess suicidal ideation, we did not find any association with the total CTQ score and CT subtype scores. ConclusionWe report a strong association between suicidal behaviour and CT (in particular childhood physical neglect) in a TRD population.

Early-life stress effects on BDNF DNA methylation in first-episode psychosis and in rats reared in isolation

Stressful events during early-life are risk factors for psychiatric disorders. Brain-derived neurotrophic factor (BDNF) is implicated in psychosis pathophysiology and deficits in BDNF mRNA in animal models of psychiatric disease are reported. DNA methylation can control gene expression and may be influenced by environmental factors such as early-life stress. We investigated BDNF methylation in first-episode psychosis (FEP) patients (n = 58), their unaffected siblings (n = 29) and community-based controls (n = 59), each of whom completed the Childhood Trauma Questionnaire (CTQ); BDNF methylation was also tested in male Wistar rats housed isolated or grouped from weaning. DNA was extracted from human blood and rat brain (prefrontal cortex and hippocampus), bisulphite-converted and the methylation of equivalent sequences within BDNF exon IV determined by pyrosequencing. BDNF methylation did not differ significantly between diagnostic groups; however, individuals who had experienced trauma presented higher levels of methylation. We found association between the mean BDNF methylation and total CTQ score in FEP, as well as between individual CpG sites and subtypes of trauma. No significant correlations were found for controls or siblings with child trauma. These results were independent of age, gender, body mass index, BDNF genotype or LINE-1, a measure of global methylation, which showed no significant association with trauma. Isolation rearing resulted in increased BDNF methylation in both brain regions compared to group-housed animals, a correlate of previously reported changes in gene expression. Our results suggest that childhood maltreatment may result in increased BDNF methylation, providing a mechanism underlying the association between early-life stress and psychosis.

The relationship between university students' childhood traumas and their body image coping strategies as well as eating attitudes

BackgroundThis study examined the relationship between university students' childhood traumas and their body image coping strategies as well as eating attitudes. MethodsThis cross-sectional, descriptive, and correlational study was conducted with 654 students who were selected from 6240 university students enrolled during the spring semester of the 2017-2018 academic year and determined using the stratified and simple random sampling method. Introductory Information Form, Childhood Trauma Questionnaire (CTQ), Body Image Coping Strategies Inventory (BICSI), and Eating Attitudes Test (EAT) were used. The reliability coefficients of the scales were 0.93, 0.82, and 0.85, respectively. The data were evaluated using number-percentage distributions and the relationships between the variables were examined using correlation analysis. ResultsOf the students, 56.7% were female. Their mean age was 20.71 ± 1.54. The mean CTQ score (41.14 ± 15.98), BICSI score (71.33 ± 10.32; max.: 116), and EAT score (19.61 ± 14.60) were below average. The study found a low, positive correlation between the CTQ total and subscale mean scores and the BICSI avoidance subscale mean score as well as the EAT mean score (p < 0.05). ConclusionsFew university students reported childhood traumas. Most students referred to positive coping using rational acceptance tendency against body image threats and problems, had low tendencies toward negative eating attitudes, and had no risk for an eating disorder. However, the students with a history of childhood trauma coped with body image threats and problems mostly using an avoidance tendency and had negative tendencies toward eating attitudes.

Clinical Severity and Calcium Metabolism in Patients with Bipolar Disorder.

Parathyroid hormone (PTH), vitamin D and serum calcium play a key role in several physiological and pathological conditions. Vitamin D and PTH receptors are largely expressed in the central nervous system and are involved in the modulation of inflammatory responses. Few studies investigated the association between calcium homeostasis imbalance and psychiatric disorders. This study aims to assess calcium homeostasis imbalance in patients with bipolar disorder (BD) and its impact on clinical outcome. We recruited 199 patients with BD, who were administered with validated assessment instruments to investigate depressive, manic and anxiety symptoms, affective temperaments, childhood trauma and global functioning. Serum calcium, vitamin D and PTH levels were assessed in all patients. Levels of PTH correlated with several clinical characteristics, including the diagnosis of bipolar disorder type I (BD-I), the presence of psychotic symptoms, lithium treatment, suicidality, total number of acute episodes and of hospitalizations (p < 0.0001) and seasonality (p < 0.05). At the regression analyses, higher levels of PTH were predicted by early age at onset, number of hospitalizations, aggressive behaviors (p < 0.05), higher Childhood Trauma Questionnaire total score (CTQ) (p < 0.001) and treatment with lithium (p = 0.01). Our findings suggest that the calcium homeostasis could play a role in BD patients, and that PTH levels are correlated with the clinical severity of the disorder.

The relationship between childhood maltreatment and problematic eating behaviors in bariatric surgery candidates.

It is known that childhood maltreatment and problematic eating behaviors are higher in bariatric surgery patients compared to over- and normal-weight persons. The aim of the study is to investigate the relationship between childhood maltreatment and problematic eating behaviors such as restraint, eating concern, weight concern, shape concern, and emotional eating in bariatric surgery patients. 112 consecutive obese individuals seeking bariatric surgery at a University Hospital were administered asset of scales, including Childhood Trauma Questionnaire (CTQ), Dutch Eating Behavior Questionnaire-Emotional Eating subscale (DEBQ-E), and Eating Disorder Examination-Questionnaire (EDE-Q) and sociodemographic form, cross-sectionally. After descriptive statistics, a regression analysis was conducted to understand the relationships of CTQ scores with EDE-Q total, and subscale scores and DEBQ-E. In the Pearson correlation analysis, a statistically significant positive correlation was found between CTQ total score with EDE-Q total score and all subscales scores. In linear regression analyses, it was found that emotional abuse (β = 0.39, p = 0.02) and physical abuse (β = 0.36, p = 0.01) predicted increased DEBQ-E scores. In addition, sexual abuse was found to significantly predict weight concern (β = 0.26, p = 0.04) and shape concern (β = 0.31, p = 0.01). Our findings showed that the dynamics of problematic eating behaviors may differ depending on the type of childhood trauma. Psychiatric evaluation of bariatric surgery patients is important in understanding the relationship between childhood maltreatment and problematic eating behaviors. Level V,cross-sectional descriptive study.

Childhood maltreatment and HPA axis gene expression in bipolar disorders: A gene network analysis

IntroductionBipolar disorder (BD) is highly associated with childhood maltreatment (CM), the exposure to such early adversity being suggested to disrupt the expression of several biological pathways. This study aims at exploring associations between the mRNA levels of 9 HPA axis genes in lymphoblastoid cell lines from patients with BD according to their self-reported exposure to CM. MethodsThe sample consisted of 33 Caucasian patients with a diagnosis of BD type 1, assessed for the exposure to CM with the Childhood Trauma Questionnaire (CTQ). Quantitative RT-PCR was performed on 9 transcripts of the HPA axis genes: DGKH, FKBP5, NR3C1, SGK1, SGK2, SGK3, SKA2, STAT5A and UCN. RT-qPCR data were analyzed using the method of disjoint gene networks with SARP.compo package for R. ResultsWe found no associations between CTQ total score and the amount of HPA axis transcripts neither in univariate analyses, nor with network analyses. Emotional abuse (EA) was associated with a significant decreased expression of two transcripts, DGKH (p = 0.009) and NR3C1 (p = 0.04). This was confirmed by the disjoint network analysis, which showed that NR3C1 and DGKH were expressed differently from the rest of the HPA axis network in presence of emotional abuse. DiscussionThis study described the expression levels of a comprehensive set of HPA axis genes according to childhood maltreatment in a sample of patients with BD type 1 and suggested that emotional abuse decreased the expression of NR3C1 and DGKH. Our results require further replication in independent larger samples.

Childhood Trauma in Persons With Schizophrenia and a History of Interpersonal Violence.

BackgroundChildhood trauma is a risk factor for psychosis as well for violent behavior and offending later in life. Childhood trauma comprises subdomains of abuse and neglect that may be differently related to later violence among patients with schizophrenia. The aim of this study was to map the subdomains of childhood trauma associated with violent offending in schizophrenia.MethodsInformation on childhood trauma from predominantly male patients with a DSM-IV diagnosis of schizophrenia and a history of violent offending (interpersonal violence) (SCZ-V, n = 19), schizophrenia patients without a history of violence (SCZ-NV, n = 34), and healthy controls (HC, n = 66) was obtained with the Childhood Trauma Questionnaire (CTQ). Differences between groups in total maltreatment scores and the five subdomains including physical, emotional, and sexual abuse, as well as physical and emotional neglect were analyzed.ResultsSCZ-V had the highest median CTQ scores for all sub-domains. SCZ-V reported significantly higher total CTQ scores than SCZ-NV and HC. SCZ-V had significantly higher scores than HC on all subdomains, and significantly higher than SCZ-NV on physical and emotional neglect. SCZ-NV had higher scores on all domains except sexual abuse compared to HC.ConclusionSCZ-V patients had higher exposure to childhood trauma than SCZ-NV, and both schizophrenia groups had higher exposure than HC. The results suggest that childhood physical and emotional neglect may be of specific importance to later violence in schizophrenia.

History of childhood maltreatment is associated with reduced fractional anisotropy of the accumbofrontal 'reward' tract in healthy adults.

The deleterious outcomes associated with exposure to childhood maltreatment (CM) are well known and may be at least partially mediated by self-harm behaviors. It has been suggested that these self-harm behaviors serve as a means of decreasing negative mood states but the effects of CM on health outcomes may be much more sinister. A wealth of data suggest that CM may lead to experience-dependent changes in neural circuits underlying reward processes; processes associated with many harmful behaviors. The present study examined the relationship between a history of CM and the microstructure of a white matter tract that may be central to reward processes. Healthy adults (N = 122) were assessed with a diffusion tensor imaging (DTI) exam and the Childhood Trauma Questionnaire (CTQ). Probabilistic tractography was used to delineate the accumbofrontal "reward" tract, connecting the orbitofrontal cortex and nucleus accumbens, and measures of white matter microstructure were extracted. We then examined whether variation in CTQ scores were associated with variation in the microstructure of this tract as measured by fractional anisotropy (FA). After accounting for the effects of age and sex, the CTQ total score accounted for approximately 6% of the variance of FA in the accumbofrontal tract (F(3, 121) = 5.74; p = .001). Post hoc analyses indicated that the overall severity of CM, rather than a specific type of maltreatment, drove this result. These findings indicate that CM influences white matter microstructure in a fiber tract that is likely central to reward processes and adds to a growing literature implicating CM in long-term health-related outcomes.

Measuring childhood maltreatment: Psychometric properties of the Norwegian version of the Maltreatment and Abuse Chronology of Exposure (MACE) scale.

Adverse childhood experiences in sensitive periods of the developing brain render the individual at a life-long risk for a broad spectrum of aberrant health outcomes. However, there is a lack of scales for the comprehensive assessment of adverse childhood experiences providing information of various types and the age of occurrence. Based on the complete, experimental version of the Maltreatment and abuse chronology of exposure (MACE-X) scale, the present study aimed to develop and psychometrically test a Norwegian version of MACE. The 75-item MACE-X was translated from German to Norwegian and administered as a self-report measure to 90 outpatients and 145 employees at a Division of specialized mental health care in South-Eastern Norway. The outpatients also completed the Childhood trauma questionnaire (CTQ) and the Symptom checklist 90 (SCL-90) to investigate convergent and predictive validity. To investigate test-retest reliability, outpatients completed MACE once more two weeks later. Rasch analysis and Anderson likelihood ratio tests on the combined outpatient and employee data resulted in a 55 item version of the Norwegian MACE. In the outpatient group, test-retest reliability of the MACE-55 was excellent for total scores (ICC ≥ 0.94) and good to excellent for 10 subscale scores (ICC ≥ 0.82). Convergent validity with the CTQ was moderate to high for both total scores (0.63 ≥ r ≥ 0.86) and subscale scores (0.56 ≥ r ≥ 0.82). As compared to CTQ total scores, a MACE total score that combined severity and duration of exposure was numerically more strongly associated with overall psychiatric symptoms and each of nine symptom domains on the SCL-90. The newly developed Norwegian MACE comprehensively assesses past exposure to adverse childhood experiences with high psychometric properties. This scale is a useful tool for research questions addressing sensitive periods for childhood adversities and associated health phenotypes.

Childhood traumas and suicide probability in obsessive-compulsive disorder patients with and without suicide attempts

Objective: The aim of this research is to determine the differences in childhood traumas and the probability of suicide in obsessive-compulsive disorder (OCD) patients with and without suicide attempts. Method: Sixty-five OCD patients without suicide attempt history and 39 OCD patients with a history of suicide attempts were included in the study. To measure the clinical variables The Childhood Trauma Questionnaire (CTQ), Suicide Probability Scale, Yale-Brown Obsessive-Compulsive Scale and Beck Depression Inventory were applied. Results: We found that the OCD group with suicide attempts was significantly higher than the OCD group without a suicide attempt due to emotional neglect, physical neglect, sexual abuse, and CTQ total scores. Aggression and sexual obsessions were higher in the OCD group who has attempted suicide. Obsessive-compulsive symptoms, depression and insight scores of OCD patients with suicide attempts were worse than OCD patients without suicide attempts. Also, correlations were observed between childhood traumas and suicidal probability scores. Conclusion: This study showed that childhood traumas may be a contributing factor to suicide probability and attempt in patients with OCD. Moreover, this study reveals that the current probability of suicide is a higher risk in OCD patients who had previously attempted suicide in the past.

Childhood traumas in euthymic bipolar disorder patients in Eastern Turkey and its relations with suicide risk and aggression

Purpose: The aim of this study was to determine the relationship between childhood trauma and aggression-suicidal behavior in patients with bipolar disorder.Material and Methods: A total of 112 outpatients diagnosed with bipolar disorder in remission in the province of Siirt on the east coast of Turkey were included in this study carried out between January and June 2018. Personal Information Form, Childhood Trauma Questionnaire (CTQ), Buss–Perry Aggression Scale (BPAS) and Suicide Probability Scale (SPS) were used for data acquisition.Results: It was determined that patients with bipolar disorder have 89.3% of physical neglect, 74.1% of emotional neglect, 75.9% of physical abuse, 79.5% of emotional abuse and 40.2% of sexual abuse. The mean score of CTQ was 66.8 ± 19.2, the total score of BPAS was 94.6 ± 28.8 and the total score of SPS was 85.3 ± 17.9. A statistically significant and positive correlation was determined between CTQ, BPAS and SPS (p < 0.05).There was a weak and positive relationship between BPAS, CTQ (r = 0.325**; p < 0.05) and subscales of CTQ which are emotional abuse (r = 0.350**; p < 0.05), physical abuse (r = 0.354**; p < 0.01), physical neglect (r = 0.313**; p < 0.01) and emotional neglect (r = 0.316**; p < 0.01). A statistically significant difference was observed between the regular use of drugs, violence against others and total score of CTQ, BPAS and SPS (p < 0.05).Conclusion: It is suggested that patients diagnosed with bipolar disorder should be evaluated with regards to childhood trauma history by taking into consideration sociodemographic characteristics and psychiatric support in order to prevent their aggression and suicide attempts.