Early Trauma Research Articles

Transmission of reduced levels of miR-34/449 from sperm to preimplantation embryos is a key step in the transgenerational epigenetic inheritance of the effects of paternal chronic social instability stress

ABSTRACT The transgenerational effects of exposing male mice to chronic social instability (CSI) stress are associated with decreased sperm levels of multiple members of the miR-34/449 family that persist after their mating through preimplantation embryo (PIE) development. Here we demonstrate the importance of these miRNA changes by showing that restoring miR-34c levels in PIEs derived from CSI stressed males prevents elevated anxiety and defective sociability normally found specifically in their adult female offspring. It also restores, at least partially, levels of sperm miR-34/449 normally reduced in their male offspring who transmit these sex-specific traits to their offspring. Strikingly, these experiments also revealed that inducing miR-34c levels in PIEs enhances the expression of its own gene and that of miR-449 in these cells. The same induction of embryo miR-34/449 gene expression likely occurs after sperm-derived miR-34c is introduced into oocytes upon fertilization. Thus, suppression of this miRNA amplification system when sperm miR-34c levels are reduced in CSI stressed mice can explain how a comparable fold-suppression of miR-34/449 levels can be found in PIEs derived from them, despite sperm containing ~50-fold lower levels of these miRNAs than those already present in PIEs. We previously found that men exposed to early life trauma also display reduced sperm levels of miR-34/449. And here we show that miR-34c can also increase the expression of its own gene, and that of miR-449 in human embryonic stem cells, suggesting that human PIEs derived from men with low sperm miR-34/449 levels may also contain this potentially harmful defect.

Algorithm-based modular psychotherapy vs. cognitive-behavioral therapy for patients with depression, psychiatric comorbidities and early trauma: a proof-of-concept randomized controlled trial.

Effect sizes of psychotherapies currently stagnate at a low-to-moderate level. Personalizing psychotherapy by algorithm-based modular procedures promisesimproved outcomes, greater flexibility, and a better fit between research and practice. However, evidence for the feasibility and efficacy of modular-based psychotherapy, using a personalized treatment algorithm, is lacking. This proof-of-concept randomized controlled trial was conducted in 70 adult outpatients with a primary DSM-5 diagnosis of major depressive disorder, a score higher than 18 on the 24-item Hamilton Rating Scale for Depression (HRSD-24), at least one comorbid psychiatric diagnosis according to the Structured Clinical Interview for DSM-5 (SCID-5), a history of at least "moderate to severe" childhood maltreatment on at least one domain of the Childhood Trauma Questionnaire (CTQ), and exceeding the cut-off value on at least one of three measures of early trauma-related transdiagnostic mechanisms: the Rejection Sensitivity Questionnaire (RSQ), the Interpersonal Reactivity Index (IRI), and the Difficulties in Emotion Regulation Scale-16 (DERS-16). Patients were randomized to 20 sessions of either standard cognitive-behavioral therapy alone (CBT) or CBT plus transdiagnostic modules according to a mechanism-based treatment algorithm (MoBa), over 16 weeks. We aimed to assess the feasibility of MoBa, and to compare MoBa vs. CBT with respect to participants' and therapists' overall satisfaction and ratings of therapeutic alliance (using the Working Alliance Inventory - Short Revised, WAI-SR), efficacy, impact on early trauma-related transdiagnostic mechanisms, and safety. The primary outcome for efficacy was the HRSD-24 score at post-treatment. Secondary outcomes included, among others, the rate of response (defined as a reduction of the HRSD-24 score by at least 50% from baseline and a score <16 at post-treatment), the rate of remission (defined as a HRSD-24 score ≤8 at post-treatment), and improvements in early trauma-related mechanisms of social threat response, hyperarousal, and social processes/empathy. We found no difficulties in the selection of the transdiagnostic modules in the individual patients, applying the above-mentioned cut-offs, and in the implementation of MoBa. Both participants and therapists reported higher overall satisfaction and had higher WAI-SR ratings with MoBa than CBT. Both approaches led to major reductions of depressive symptoms at post-treatment, with a non-significant superiority of MoBa over CBT. Patients randomized to MoBa were nearly three times as likely to experience remission at the end of therapy (29.4% vs. 11.4%; odds ratio, OR = 3.2, 95% CI: 0.9-11.6). Among mechanism-based outcomes, MoBa patients showed a significantly higher post-treatment effect on social processes/empathy (p<0.05) compared to CBT patients, who presented an exacerbation on this domain at post-treatment. Substantially less adverse events were reported for MoBa compared to CBT. These results suggest the feasibility and acceptability of an algorithm-based modular psychotherapy complementing CBT in depressed patients with psychiatric comorbidities and early trauma. While initial evidence of efficacy was observed, potential clinical advantages and interindividual heterogeneity in treatment outcomes will have to be investigated in fully powered confirmation trials.

Early childhood trauma exposure and neurocognitive and emotional processes: Associations in young children in a partial hospital program.

Early childhood trauma has been linked to neurocognitive and emotional processing deficits in older children, yet much less is known about these associations in young children. Early childhood is an important developmental period in which to examine relations between trauma and executive functioning/emotion reactivity, given that these capacities are rapidly developing and are potential transdiagnostic factors implicated in the development of psychopathology. This cross-sectional study examined associations between cumulative trauma, interpersonal trauma, and components of executive functioning, episodic memory, and emotion reactivity, conceptualized using the RDoC framework and assessed with observational and performance-based measures, in a sample of 90 children (ages 4-7) admitted to a partial hospital program. Children who had experienced two or more categories of trauma had lower scores in episodic memory, global cognition, and inhibitory control as measured in a relational (but not computerized) task, when compared to children with less or no trauma. Interpersonal trauma was similarly associated with global cognition and relational inhibitory control. Family contextual factors did not moderate associations. Findings support examining inhibitory control in both relationally significant and decontextualized paradigms in early childhood, and underscore the importance of investigating multiple neurocognitive and emotional processes simultaneously to identify potential targets for early intervention.

Blunted Cardiovascular Reactivity to Mental Stress in Black Americans With a Previous Myocardial Infarction: Impact of Childhood Trauma

BACKGROUND: Black Americans who survive a myocardial infarction (MI) experience more psychosocial stress in each stage of life and are more likely to have adverse cardiovascular outcomes than Americans from other racial/ethnic groups. Childhood trauma is associated with blunted cardiovascular reactivity to mental stress, which indicates dysregulation in the stress response system and predicts adverse cardiovascular outcomes. We tested the hypothesis that childhood trauma would be a stronger predictor of blunted cardiovascular reactivity to mental stress among Black relative to White Americans with a previous MI. METHODS: We studied 185 White and 314 Black Americans with a history of MI. Childhood trauma was assessed via the Early Trauma Inventory (range, 0-27), and an established cut point of 7 identified low or high childhood trauma. Heart rate (HR) and blood pressure were measured throughout baseline and a public speaking mental stress task. Based on existing studies, blunted HR, systolic blood pressure, and diastolic blood pressure reactivity (HRR, SBPR, and DBPR) were defined as absolute responses in the lowest quartile. With the lowest risk group (White patients with low childhood trauma) as the referent, we used logistic regression to calculate odds ratios and 95% CIs for associations between the predictors (race/ethnicity and childhood trauma) and blunted reactivity while adjusting for resting HR and BP, sex, age, education, BMI, heart failure, beta blockers, and ACE inhibitors. Relative excess risk due to interaction (RERI) was calculated to assess effect modification of childhood trauma on racial/ethnic disparities in blunted cardiovascular reactivity (RERI &gt; 0 indicates positive effect modification). Results: The mean age for the entire sample was 51±7 years. Black patients had greater childhood trauma scores relative to White patients (8±6 vs 7±5; p&lt;0.01). After adjusting for resting values, Black patients had lower HRR (22±13 vs 29±16 bpm; p&lt;0.01), SBPR (39±17 vs 45±16 mmHg; p&lt;0.01) and DBPR (27±12 vs 29±11 mmHg; p=0.03). Among both groups, childhood trauma scores were associated with lower HRR and SBPR ( p&lt;0.05 for both) but not DBPR ( p=0.13). Black patients with high but not low childhood trauma had higher odds of blunted HRR (OR=2.20 [1.19, 4.08]), SBPR (OR=1.91 [1.03, 3.54]), and DBPR (OR=2.50 [1.33, 4.72]). The estimated joint effect of Black race/ethnicity and high childhood trauma on blunted HRR was greater than their individual effects (RERI=1.51 [0.47, 2.55]); similar findings were observed for SBPR (RERI=0.62 [-0.40, 1.64]) and DBPR (RERI=1.08 [-0.12, 2.27]), though to a lesser extent. CONCLUSION: Black Americans with a prior MI are more likely than their White counterparts to have a blunted cardiovascular response to mental stress that is contingent on greater childhood trauma. Greater emphasis should be placed on preventing childhood trauma in Black Americans to help mitigate cardiovascular heath disparities. This research was supported by NIH grants R01HL109413 and T32HL130025. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Comparison of early risk factors between healthy siblings and subjects with schizophrenia and bipolar disorder.

The following work aims to compare the types and magnitude of risk events in patients with Schizophrenia and Bipolar Disorder and each of those groups with of a group of healthy siblings, exploring differences and similarities of the two psychotic disorders. Retrospective interviews were conducted with 20 families to investigate maternal and obstetric health, social support and the presence of early trauma for the affected family members and healthy siblings. Mothers were interviewed with the Prenatal Psychosocial Profile and each family participant was assessed with the Early Trauma Inventory, Screening Questionnaire of the Genomic Psychiatry Cohort and the Diagnostic Interview for Psychosis and Affective Disorders. Obstetric and gestational history, pregnancy weight changes and early trauma were associated with offspring's mental illness, including statistically significant findings for complications of pregnancy, pregnancy weight changes, general trauma, physical punishment and emotional abuse. These findings highlight the different risk factor exposures that occur within a family, which may increase the risk for severe mental illness.

Liviu Ciulei and The Last Ones: Between Personal Trauma, Psychodrama, and Collective Drama

This paper focuses on an early role in the theatrical career of the actor, director, and scenographer Liviu Ciulei (1923-2011), created on the stage of the theatre gifted to him by his father, the civil engineer Liviu Ciulley, in 1946. The role in question is Pyotr from the play The Last Ones by Russian playwright Maxim Gorky, which premiered at the Odeon Theatre in Bucharest on the 16th of March 1948. My point is that Liviu Ciulei was drawn to this play by a psychodramatic impulse, finding in it issues related to his father who, like the protagonist in Gorky’s play, had embroiled his family in a major scandal when his son was only thirteen years old. The season in which the play premiered was marked by the increasing interference of communist authorities in art, so the intense psychodramatic process through which Liviu Ciulei consciously or unconsciously worked through his early adolescent trauma intertwined with the collective drama represented by the imposition of the Soviet-enforced communist regime in Romania at the end of World War II. Keywords: Liviu Ciulei, The Last Ones, Gorky, psychodrama, Moreno, socialist realism, communism, theatre, Romania.

Serotonin Transporter (SLC6A4) and FK506-Binding Protein 5 (FKBP5) Genotype and Methylation Relationships with Response to Meditation in Veterans with PTSD.

Meditation-based interventions are novel and effective non-pharmacologic treatments for veterans with PTSD. We examined relationships between treatment response, early life trauma exposure, DNA polymorphisms, and methylation in the serotonin transporter (SLC6A4) and FK506-binding protein 5 (FKBP5) genes. DNA samples and clinical outcomes were examined in 72 veterans with PTSD who received meditation-based therapy in two separate studies of mindfulness-based stress reduction (MBSR) and Transcendental Meditation (TM). The PTSD Checklist was administered to assess symptoms at baseline and after 9weeks of meditation intervention. We examined the SLC6A4 promoter (5HTTLPR_L/S insertion/deletion + rs25531_A/G) polymorphisms according to previously defined gene expression groups, and the FKBP5 variant rs1360780 previously associated with PTSD disease risk. Methylation for CpG sites of SLC6A4 (28 sites) and FKBP5 (45 sites) genes was quantified in DNA samples collected before and after treatment. The 5HTTLPR LALA high expression genotype was associated with greater symptom improvement in participants exposed to early life trauma (p = 0.015). Separately, pre to post-treatment change of DNA methylation in a group of nine FKBP5 CpG sites was associated with greater symptom improvement (OR = 2.8, 95% CI 1.1-7.1, p = 0.027). These findings build on a wealth of existing knowledge regarding epigenetic and genetic relationships with PTSD disease risk to highlight the potential importance of SLC6A4 and FKBP5 for treatment mechanisms and as biomarkers of symptom improvement.

The Types of Psychosocial Factors Associated with Suicidality Outcomes for People Living with Bipolar Disorder: A Scoping Review.

Bipolar Disorder is associated with high rates of suicidal thoughts, behaviors, and outcomes, yet the lived experience of suicidality and Bipolar Disorder is not particularly well understood. Understanding the role of psychosocial aetiologies in suicidality outcomes for those living with Bipolar Disorder is key for developing appropriately targeted interventions focusing on factors that are amenable to change. In line with PRISMA guidance, we conducted a scoping review to identify the types of psychosocial factors studied in relation to the experience of suicidality for people living with Bipolar Disorder diagnoses. Systematic literature searches identified a sample of 166 articles from which key study data were extracted and charted. A narrative synthesis of the reviewed literature is presented ordered by the factors investigated across studies, a frequency count of the types of psychological/social aetiologies studied, and a brief overview of the key findings for each aetiology. Most of the identified literature took the form of quantitative cross-sectional studies, with only one qualitative study and 18 quantitative prospective studies. The most studied aetiologies were trauma (specifically early adverse experiences and childhood traumas) and stressful life events, impulsivity (primarily subjective self-reported trait impulsivity), social support and functioning, and personality/temperament factors. Only six studies in the final sample reported basing their research questions and/or hypotheses on an explicit theoretical model of suicide. The literature was primarily focused on using self-report measurements of key aetiologies and on factors which lead to worsened suicidality rather than focusing on potentially protective or buffering factors. Future research needs to better justify the aetiologies investigated in relation to suicidality outcomes for people living with Bipolar Disorder, including a firmer basis in theory and hypothesis testing, more prospective designs, and the use of alternative assessments of psychosocial aetiologies in addition to self-report questionnaires.

Adverse Childhood Experiences

This paper examines the role of Adverse Childhood Experiences on adolescent development. Adverse Childhood Experiences are significant early traumas that affect brain development and can lead to serious physical, mental and emotional issues if left unaddressed. Incorporating evidence from literature reviews, this study demonstrates that these issues can be addressed by nurturing resilience into the lives of children and adults.

Do Religion and Spirituality Buffer the Effect of Childhood Trauma on Depressive Symptoms? Examination of a South Asian Cohort from the USA.

Asian Americans have been identified as a racial group that is disproportionately affected by childhood trauma. The goal of this study was to assess if religion/spirituality moderate the effects of childhood trauma on adult depressive symptoms among a sample of South Asians in the USA. Our analysis drew from the study on stress, spirituality, and health (SSSH) questionnaire fielded in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study (n = 990) during 2016-2018. A series of regression models with multiplicative interaction terms were conducted. Emotional neglect, emotional abuse, and physical neglect were associated with higher depressive symptoms. Higher religious attendance and negative religious coping techniques were found to exacerbate this relationship. There were two findings conditional on gender. Among men, gratitude and positive religious coping also exacerbated the relationship between childhood trauma and depressive symptoms. Negative religious coping also exacerbated the association between childhood trauma and depressive symptoms for women. This is the first community-based study of US South Asians to consider the association between various forms of childhood trauma and depressive symptom outcomes. South Asians remain an understudied group in the religion and health literature, and this study sheds light on the important differences in the function and effectiveness of religion/spirituality for those faced with early life trauma.

Alterations in the immune landscape characterized by inflammatory activation and immune escape within 12 h after trauma

BackgroundTrauma is statistically a significant cause of mortality among patients across countries. Nevertheless, the precise correlation between genetic diagnostic markers and the intricate mechanism of trauma remains indistinct. MethodsOur study exclusively centered on trauma patients and selected three trauma-related datasets from the Gene Expression Omnibus (GEO) database, all of which had blood samples collected within post-traumatic 12 h. Differential gene screening, the WGCNA and Cytoscape software were employed to analyze the two datasets, with a particular emphasis on the top 100 genes selected based on MCC algorithm scores. A logistic diagnostic model was constructed by analyzing the intersection genes in the third dataset, leading to the identification of diagnostic biomarkers with high efficiency. The global immune landscape of these patients was extensively investigated using a multidimensional approach. Meanwhile, the underlying pathological and physiological mechanisms associated with early trauma status are summarized by integrating existing literature. ResultsOut of these two GEO datasets, 21 overlapping genes were identified and incorporated into in the logistic diagnostic model constructed in the GSE36809 dataset. A panel of 9 genes was uncovered as a diagnostic biomarker, and their expression and correlation were subsequently verified. Additionally, by virtue of various algorithms, the findings revealed an upregulation of neutrophil expression and a downregulation of CD8+ T cell expression, indicating characteristic early trauma-induced inflammation activation and immune suppression. The correlation observed between the feature genes and immune cells serves to validate the exceptional diagnostic capability of these 9 genes in identifying trauma status and their promising potential for patients who could benefit from targeted immune interventions. Drawing from these findings, the discussion section offers insights into the underlying pathological and physiological mechanisms at play. ConclusionOur research has discovered a novel diagnostic biomarker and unveiled its association with post-traumatic immune alterations. This breakthrough enables accurate and timely diagnosis of early trauma, facilitating the implementation of appropriate healthcare interventions.

A fight to work with families, rather than against them: exploring social workers’ experiences of working within the family safeguarding model; an IPA analysis

ABSTRACT This qualitative study explores social workers’ experiences of working within the Family Safeguarding Model and its implications for relationships with families and professionals. Semi-structured interviews were completed and Interpretative Phenomenological Analysis (IPA) was used. Three Group Experiential Themes (GET’s) were identified: fighting to work with families, feeling held and protected and breaking at the seams. The model enabled social workers to develop a ”secure base” to build meaningful relationships with families and consider risk in the context of parents’ early trauma. Findings suggest value in consistent in-house multi-agency support, enabling shared responsibility for complex cases. Further research is required.

Association Study of Suicidal Behavior, Early Trauma, and Psychological Pain in Depressed Women

IntroductionThe stress-diathesis model, which indicates an interaction between vulnerability and stress factors is the most acceptable paradigm to explain suicide.ObjectivesTo assess the association between suicidal behavior, early trauma, and psychological pain among women undergoing psychiatric treatment for a major depression episode.MethodsIt was a cross-sectional study approved by the Research Ethics Committee of the State University of Health Sciences of Alagoas (UNCISAL) - Brazil (approval number: 14689219.1.0000.5011). The final sample of 48 women was obtained through non-probabilistic, convenience, and consecutive sampling. Data were collected from depressed adult women undergoing outpatient psychiatric treatment in public services in the State of Alagoas, Brazil. The instruments used included a sociodemographic questionnaire prepared exclusevly for this research, modules A, B, and C of the Mini International Neuropsychiatric Interview (M.I.N.I.7.0.2), the Beck Depression Inventory II (BDI-II), the Psychache Scale (PAS); and the Childhood Trauma Quetionnaire (CTQ). Data were analyzed using SPSS 22. After performing the Kolmogorov-Smirnov test, Student´s t tests were conducted for parametric analyses. Statistical significance was established at a p-value less than 0.05ResultsThe mean age of the total sample was 42.5 years old. 89.6% presented suicidal behavior. 62.5% of the women had major depression and 37.5% had bipolar disorder diagnosis. BDI-II scores were significantly higher among depressed women with suicidal behavior (27.9 ±13.4 vs.16.6 ±6.9; p value:0.04). BDI-II scores were also significantly higher in both passive (29.4±12.6 vs. 13.4±8.5; p value:0.01) and active (31.4±12.2 vs. 18.0±11.3; p value&lt;.01) suicide ideation groups compared to depressed women who did report these thoughts. Psychological pain scores were also hihger in both passive (46.0±12.8 vs. 34.8±14.6; p value:0.03) and active (47.7±12.4 vs. 38.1±12.7; p value:0.02) suicide ideation groups. Women with active suicide ideation were also more prone to report a history of childhood physical neglect compared to those women who did not report active suicide ideation in the last 30 days (12.5±4.6 vs. 9.2±4.0; p value:0.02).ConclusionsThe present study aimed to investigate the association between suicidal behavior, childhood trauma, and psychological pain in depressed women undergoing treatment in outpatient psychiatric public services. The results indicated that suicidal ideation (both passive and active) was associated with a more severe depressive episode and higher scores of psychological pain, demonstrating that psychological pain is an indicator of acute suicide risk in depressed women even when they are undergoing psychiatric treatment. Effectively identifying and addressing psychological pain can play a pivotal role in reducing or mitigating the risk of suicidal behavior.Disclosure of InterestNone Declared

Frequency of early childhood trauma in psychiatric patients: an investigation with the Early Trauma Inventory–Self Report

IntroductionChildhood trauma is an important public health problem but there are limitations in our ability to measure childhood trauma. Early Trauma Inventory is a self-report instrument for the assessment of childhood trauma that is valid but simple to administer.ObjectivesWe aimed to assess the frequency of childhood trauma in patients of a large sample of the Crisis Intervention and Psychiatric Ward in Budapest, Hungary.MethodsData from 279 patients referred to Péterfy Alexander Hospital, Crisis Intervention and Psychiatric Ward, Budapest, Hungary, were analyzed. Most participants were female (n = 202, 72.4%) between the ages of 17 and 86 (M = 38.37 yrs). Half of the participants were diagnosed with major depressive disorder (n = 138, 49.5%) or anxiety disorder (n = 149, 53.4%), while 47 of the participants suffered from bipolar disorder (16.8%). One hundred thirty-eight participants had at least one suicide attempt in their life (49.5%). Childhood traumas were assessed by the Early Trauma Inventory– Self Report (ETI-SR), an instrument for the assessment of physical, emotional, and sexual abuse, as well as general traumas, which measures frequency, onset, emotional impact, and other variables. We assessed the most frequent traumas in the physical, emotional, and sexual abuse, as well as general trauma domains.ResultsFamily mental illness (n = 136, 58.1%), witnessing violence (n = 129, 54.7%), divorce/separation of parents (n = 114, 48.3%), and observing death/serious injury of others (n = 112, 47.5%), were the most frequently experienced general traumas. Out of physical traumas, most of the participants experienced being slapped in the face (n = 169, 73.2%), being spanked with a hand (n = 152, 65.5%), being hit or spanked with an object (n = 93, 40.3%), and being pushed or shoved (n = 81, 33.4%). Among emotional traumas, being often put down or ridiculed (n = 170, 74.2%), the needs being failed to be understood by parents (n = 164, 72.7%), often shouted at or yelled at (n = 154, 67.5%), and being often ignored or made feel like they do not count (n = 109, 46.2%) were the most frequent. From the sexual abuse domain, being exposed to flashing (n = 72, 32.9%), being touched in intimate parts in an uncomfortable way (n = 63, 29.2%), being exposed to inappropriate comments about sex (n = 61, 28.5%), and being rubbed by someone’s genitals (n = 44, 20.3%) were the most common. Further results will be presented at the conference.ConclusionsIt is already recognized and our study also confirms that childhood maltreatment, especially sexual abuse can lead to suicidal behaviour. The precise role of particular types of childhood maltreatment and the mediators of the relationship between childhood maltreatment and suicide is yet to be investigated in more details.Disclosure of InterestNone Declared

Dialectical Behavior Therapy in the Treatment of Trauma

The study aims to introduce Dialectical Behavior Therapy (DBT) as a viable approach to treating post-traumatic stress disorder (PTSD), as well as its comorbidity with borderline personality disorder (BPD). The paper refers to current studies conducted between 2017 and 2023 relating to DBT's efficacy in managing complex and relational early childhood trauma, including sexual abuse and violence. Analyses indicate that DBT helps to reduce PTSD symptoms in various age groups. An integrative approach, which combines DBT and methods such as Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT), or Eye Movement Desensitization and Reprocessing (EMDR), appears to enhance therapeutic effects. Therefore, it is recommended to implement programs based on DBT and evaluate their effectiveness in a group of Polish patients who have co-occurring symptoms of PTSD and BPD or PTSD alone.

GWAS in interaction with childhood traumas implicates novel variants and genes previously associated with suicide-related factors in the background of suicidal ideation

IntroductionAlthough suicide claims more lives than war and homicide, we still have no sufficient and effective methods either for its prediction or for its prevention. Our screening methods are laborous and subjective both on the side of the patient and on the side of the clinician. Understanding the genetic background of suicidal behaviour would help identify biomarkers for screening as well as pathways as potential targets for novel intervention and prevention approaches. However, in spite of a number of GWAS studies, results are few and rarely replicate, and generally accurate phenotyping and sufficient consideration of environmental stressors is also missing.ObjectivesIn our present study we performed a genome-wide analysis study for suicidal ideation in interaction with early childhood traumas in a deep-phenotyped general population sample.MethodsOur analysis used data from 1800 volunteers in the NewMood project. As outcome phenotype the suicidal ideation item of the Brief Symptom Inventory was used. A modified version of the Childhood Trauma Questionnaire was used to assess early adverse experiences. A genome-wide association analysis was performed with Plink 1.9, including a total of 3,474,641 variants after quality control steps, followed by genome-wide by environment interaction analyses. Our models included control variables for sex, age, and the top 10 genomic principal components. Functional annotation of SNPs was carried out using FUMA v1.5.6, gene-based tests were performed using MAGMA v1.08.Results7 SNPs met suggestive significance in main effect analyses, of which 2 reached genome-wide significance including rs79912020 (p=3.21E-10, β=0.746) and rs10236520 (p=1.71E-08, β=0.484), with no significant findings in gene-based tests. Interaction analyses with childhood adversities yielded 31 SNPs that met genome-wide significance, including rs7983955 (p=2.28E-11, β=0.182), rs141039461 (p=3.90E-11, β=0.0541), rs12692827 (p=3.69E-10, β=0.0612) as the top SNPs. In interaction with childhood adversities, 31 genes showed a significant association in gene-based tests, including RBFOX1 (p=1.09E-10), GRM7 (p=1.20E-10), MTCH1 (p=5.59E-09), and CDH13 (p=6.60E-09) as the most significant findings.ConclusionsOur results indicate several important novel SNPs associated with suicidal ideation when considered in interaction with the effect of childhood adversities. Furthermore, gene-based analyses replicate several genes playing a key role in central nervous system function such as GRM7 (encoding metabotropic glutamate receptor 7) or previously implicated in association with suicide (CDH13) or suicide-related factors such as aggression (RBFOX1).Funding: NAP2022-I-4/2022, K143391, 2019-2.1.7-ERA-NET-2020-00005, TKP2021-EGA-25Disclosure of InterestNone Declared

Intérêt de la psychothérapie d’acceptation et d’engagement et de la thérapie fondée sur la compassion pour soutenir le maintien de l’abstinence dans les polyaddictions

Introduction and objectivesAddiction concerns people suffering from great psychological vulnerability due to early trauma and attachment disorders. Although several forms of therapeutic management have been shown to be effective, the relapse rate remains high, and the effects are short-lived. Therefore, the first objective of this study was to integrate the tenets and concepts of compassion-based therapy with acceptance and commitment therapies for the treatment of patients with polyaddictions by conceptualizing a therapeutic program aimed at support for maintaining abstinence. The interest in such an integration has been raised by several authors. The central concept of that integrative approach was the “compassionate flexibility”. Our second objective was to explore the feasibility, acceptability, and therapeutic effects of this intervention for patients with polyaddictions and psychiatric comorbidities, who are particularly resistant to psychotherapies. Material and methodTwelve patients (8 men and 4 women) with polyaddictions (alcohol, cocaine, tobacco, cannabis) of the 24 referred for the study, followed the MyActaddiction program. The A-B multiple-case-series protocol combined qualitative and quantitative measures to monitor feasibility, acceptability, clinical (OCDS, EADS-21) and psychological (AAQ-II, EAC) progress, patient narrative feedback (perception, connection, sense of presence), complemented by follow-up observations on abstinence maintenance. ResultsResults show moderate feasibility, with only 50 % of study referrals accessing psychotherapy, good accessibility, with 66 % of patients completing all sessions, high satisfaction levels and positive qualitative feedback. Pre- and post-treatment assessments showed a significant clinical improvement in craving (obsessive thoughts and OCDS total score) at group level, and these changes were clinically significant at individual level by Reliable Change Index measures, for 70 % of participants. On the EDAS-21 scale, patients who had pathological scores prior to therapy improved their scores to non-pathological thresholds for anxiety, stress and depression. The Reliability Change Index (RCI) showed that the resulting change was clinically significant at the individual level for 83 % of patients on anxiety level, for 58.33 % of patients on depression, and 50 % of patients on the stress level. In terms of the psychological processes targeted by the therapeutic practices, we observed an improvement in psychological flexibility, with a clinically significant reduction in AAQ-II scores after the intervention compared to the pre-treatment score. The RCI indicated that the observed clinical change was significant. There was also a significant increase in post-test versus pre-test for two dimensions of self-compassion: “common humanity” and “mindfulness”, with a high Cohen's d. Regarding individual scores, the scores for “self-compassion” and “common humanity” were below the expected average scores usually observed in the general population. According to the RCI, the increase in post-test scores was robust for 41 % of the patients on “common humanity” dimension, for only on patient on the “mindfulness” dimension, and on patient on the “self-kindness” dimension. The RCI shows that changes are clinically reliable for 50 % of patients for the “common humanity” and “mindfulness” sub-dimensions of self-compassion. Follow-up showed that 66 % of patients-maintained abstinence at one year, while 25 % relapsed, while one patient experienced both variations in consumption and periods of abstinence. ConclusionThe present program combines TFC and ACT for abstinence maintenance in the treatment of addiction. This study could demonstrate the value of process-based approaches to the treatment of complex pathologies such as polyaddiction. These findings suggest that compassion-based psychological interventions and psychological flexibility could be a transdiagnostic protective factor encouraging abstinence maintenance in people with polyaddictions. These results call for further research to explore the active mechanisms of compassion-related components.

Long-term trajectories of depressive symptoms in deployed military personnel: A 10-year prospective study

BackgroundMilitary missions, especially those involving combat exposure, are associated with an increased risk of depression. Understanding the long-term course of depressive symptoms post-deployment is important to improve decision-making regarding deployment and mental health policies in the military. This study investigates trajectories of depressive symptoms in the Dutch army, exploring the influence of factors such as demographics, early-life trauma, posttraumatic stress disorder (PTSD) symptoms, and deployment stressors. MethodsA cohort of 1032 military men and women deployed to Afghanistan (2005–2008) was studied from pre- to 10 years post-deployment. Depressive and PTSD symptoms were assessed using the Symptom CheckList-90 and the Self-Rating Inventory for PTSD. Demographics, early trauma, and deployment experiences were collected at baseline and after deployment, respectively. Latent Class Growth Analysis was used to explore heterogeneity in trajectories of depressive symptoms over time. ResultsFour trajectories were found: resilient (65%), intermediate-stable (20%), symptomatic-chronic (9%), and late-onset-increasing (6%). The resilient group experienced fewer deployment stressors, while the symptomatic-chronic group reported more early life traumas. Trajectories with elevated depressive symptoms consistently demonstrated higher PTSD symptoms. LimitationsPotential nonresponse bias and missing information due to the longitudinal design and extensive follow-up times. ConclusionsThis study identified multiple trajectories of depressive symptoms in military personnel up to 10 years post-deployment, associated with early trauma, deployment stressors, adverse life events and PTSD symptoms. The prevalence of the resilient trajectory suggests a substantial level of resilience among deployed military personnel. These findings provide valuable insights and a foundation for further research.

Childhood trauma and sex addiction among adult men

AbstractThis study explored the relationship between childhood trauma and sex addiction among a sample of adult men (N = 149). Thirty‐eight (25.5%) men screened positive for sex addiction, whereas 111 (74.5%) did not. Using descriptive discriminant analysis, we found that four subscales of early trauma predicted risk of sex addiction group membership to varying degrees, accounting for 22.3% of the variance explained. Sexual and emotional abuse accounted for the most variance explained in the group differences, whereas physical abuse and, to a lesser extent, general trauma also contributed to the group differences. Implications of the study findings are discussed.

Relationship Between Adverse Childhood Experiences, Childhood Obesity And Risk of Colorectal Cancer in Adulthood: A Systematic Review

Background: Adverse childhood experiences are traumatic incidents occurring before the age of 18 years that increases the risk ofadult health problems. Such experiences include various types of abuse; physical and emotional neglect; separation betweenparents; serious household dysfunction; peer violence and community violence.Objective: To determine the risk of colorectal cancer in persons in adult life with exposure to early life trauma. To find relationbetween adverse experiences in childhood and early life obesity.Methods: This systematic review was conducted according to PRISMA guidelines 2020. In this review, 5 independent reviewersextracted the data based on the articles published between 2018 and 2023 with the help of Databases such as PubMed/ Medline andGoogle Scholar. In each database, keywords used were: Adverse Childhood Experiences And Childhood Obesity, Adverse ChildhoodExperiences OR Childhood Obesity AND Colorectal Cancer, Childhood Obesity AND Colorectal Cancer. Studies reported anyrelationship between adverse childhood experiences or childhood obesity and adulthood colorectal cancer were selected..Results: A total of 22 articles were identified. Out of these 13 (59.1%) explained the positive relationship between adverse childhoodexperiences and the development of childhood obesity (increased BMI). The most common childhood adversities related toincreased childhood BMI are Household dysfunction, crime proximity, neglect, bereavement, and abuse. There were 9 (40.9%) ofthe 22 identified articles proved a direct relation between childhood obesity and the development of colorectal carcinoma.Conclusion: Necessary steps must be taken to raise awareness about adverse childhood experiences such as abuse andcommunity-related issues children face and prevent such risk factors from increasing the overall risk of Colorectal Carcinoma, thusalleviating the burden on the health system and provide wellness to the society as a whole.