History Of Emotional Abuse Research Articles

Perceived severity of childhood emotional, sexual, and physical abuse: Comparisons across psychologists, students, and the general public.

Childhood emotional abuse has been linked with mental and physical health concerns yet may be perceived as less severe than other forms of childhood abuse. The present study aims to (a) understand perceptions of childhood abuse forms across psychologists, general college-level students, and the general public and (b) investigate whether personal emotional abuse history affects perceptions of emotional abuse. Participants (N = 444) completed the Childhood Trauma Questionnaire-Short Form and provided perceived abuse severity and offender responsibility on eight case vignettes of emotional, physical, sexual, and no abuse. Research Question 1 was tested with a two-way (Vignette Type × Participant Type) multivariate analysis of variance performed on perceived severity and offender responsibility scores. Research Question 2 included abuse history as a third factor to examine potential moderation. All three groups perceived scenarios regarding emotional abuse as less severe and the offender less responsible than scenarios regarding sexual or physical abuse. Unexpectedly, psychologists were just as variable in their perceptions of abuse severity across abuse forms, as compared to the general public and college students. However, psychologists with emotional abuse histories provided more severe ratings on emotional abuse items, more in line with general public perceptions. College students' and the general public's relative ratings were roughly equivalent regardless of emotional abuse history. The study calls for more attention to emotional abuse in psychologist training programs. Research and training to increase understanding of emotional abuse and its sequelae could move forward related educational outreach and legal proceedings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Suicidal ideation in patients with diabetes and childhood abuse – The mediating role of personality functioning: Results of a German representative population-based study

AimsSuicidal ideation (SID) in patients with diabetes mellitus is increasingly acknowledged. Still, the underlying mechanisms are unclear. We examined SID prevalences in patients with diabetes, its association with different types of abuse, and a mediating effect of personality functioning. MethodsIn a representative population sample (N = 2,515), diabetes, SID, abuse (ICAST-R), personality functioning (OPD-SQS), and depression/anxiety (PHQ-4) were assessed by self-report. Statistical analyses comprised Chi2-Tests, logistic regression and mediation analyses. ResultsThe prevalence of SID (21.8 %) was three fold higher in patients with diabetes compared to the general population. Abuse further increased the likelihood to report SID in diabetes patients (sexual: 48.1 % vs. 18.2 %; χ2(1) = 12.233, p <.001; emotional: 35.7 % vs. 15.7 %; χ2(1) = 10.892, p <.001). A dose–response relationship between the number of abuse experiences and SID was observed (one abuse experience: OR = 1.138, 95 %-CI [0.433, 2.990], p =.793, >2 abuse experiences: OR = 2.693, 95 %-CI [1.278, 5.675], p =.009). Impaired personality functioning had an indirect effect on the association between emotional abuse and SID (b = 0.25, 95 %-CI [0.037, 0.551]). ConclusionsDiabetes patients experience increased SID prevalences, especially those with emotional or sexual abuse. In individuals with a history of emotional abuse, impaired personality functioning partly explained SID and should therefore be considered and addressed in this patient group.

Predictors of Suicidal Ideation and Continued Substance Use Problems Among Patients Receiving Methadone Maintenance Treatment Who Have Co-Occurring Cocaine Use Disorder

Background Persons with polysubstance use problems are at high suicide risk, which may complicate substance use treatment. The purpose of this study was to a) examine cross-sectional and longitudinal risk factors for suicidality among persons in methadone maintenance treatment who present with co-occurring cocaine use disorder and b) evaluate whether suicidality impacts substance use outcomes independently and differentially depending on treatment type (i.e. standard methadone care [SC] vs. contingency management plus standard care [CM + SC]). Methods Data come from five randomized controlled trials of CM conducted within methadone clinics (N = 562). Participants were categorized (mutually exclusive) as no history of suicidality (56.4%, n=317), past suicidal ideation (SI; 11%, n=62), recent SI (3.6%, n=20), or lifetime suicide attempt (29%, n=163). Results Suicidality groups differed by sex and baseline employment, income, trauma history, and psychosocial functioning. Suicide attempt history was positively associated with years of polysubstance use, prior drug treatments, and unintentional overdose history. Baseline psychological problem severity and emotional abuse history were associated with SI likelihood 12 weeks later. Past SI was associated with longer durations of abstinence than no suicidality. Unexpectedly, those with recent SI reported lower drug use severity at 12 week if they received SC compared to CM + SC. Effects were small to medium. Conclusions Despite greater polysubstance use history, patients with suicide attempts did not show worse substance use outcomes than persons without suicidality. Patients with past SI fared better than those without suicidality on abstinence over 12 wk. Methadone clinics could be key points of entrance and continued services for suicide prevention.

Reported history of childhood trauma, mentalizing deficits, and hypersomnia in adulthood: A mediational analysis in a nonclinical sample.

Existing research has confirmed the link between childhood trauma and poor sleep quality in adulthood. This study focused on the relationship between childhood trauma and hypersomnia specifically, which is understudied. Additionally, childhood maltreatment has been related to mentalizing deficits. The current study examined the role of mentalizing deficits as mediators between childhood trauma and hypersomnia. The study sample of this cross-sectional study consisted of 496 individuals, who participated in the online survey, which contained the following measures: Persian version of the Mini Sleep Questionnaire, Reflective Functioning Questionnaire (RFQ-8), and Childhood Trauma Questionnaire (CTQ). The results from structural equation modeling indicated that emotional abuse positively predicts hypersomnia. Mediation analysis confirmed that hypo-mentalizing partially mediates the association between emotional abuse and hypersomnia. The present study provides primary evidence that experiencing emotional abuse during childhood is associated with hypersomnia in adulthood. This association underlines the importance of prevention. The result from mediation analysis suggests addressing mentalizing impairments in patients with hypersomnia and a history of emotional abuse may be helpful.

Adverse life events in patients with functional seizures: Assessment in clinical practice and association with long-term outcome

BackgroundA history of adverse life events (ALE) is a risk factor for functional seizures (FS). Their influence on long-term outcome remains unclear. International guidelines recommend assessing ALE in patients presenting with associated disorders. It is not clear to what extent patients evaluated for FS are regularly asked about ALE. ObjectivesWe hypothesised that the presence of ALE would relate to worse outcome at follow-up and, that the rate of detection of ALE in clinical work-up would be inferior to that based on self-report questionnaires. Methods53 patients with FS from the National Centre for Epilepsy in Norway, aged 16–62 years were included. Symptom severity, health-related quality of life (HRQoL), and antecedent ALE were assessed at baseline. Medical records were examined for disclosure of ALE. At a mean of 70.45 (SD 29.0, range 22–130) months after inclusion, participants were inquired about FS status, FS-related health care utilization and HRQoL.Findings: A history of emotional abuse documented in the medical record was an independent risk factor for worse HRQoL at follow-up. Prevalence of ALE documented in medical records was lower compared with rates measured by a self-report questionnaire. ConclusionsThese findings indicate an association between antecedent ALE and HRQoL years after diagnosis. A substantial proportion of the adverse life events by a self-report questionnaire had not been documented in the clinical records. Clinical implicationsThe supplemental use of a self-report questionnaire in the diagnostic work-up of patients with FS may be valuable for detecting ALE.

Prevalence and Predictors of Intimate Partner Violence Among Youth With Foster Care Histories.

A small but growing body of research suggests that adolescents and young adults involved with the child welfare system and those transitioning out of foster care are at heightened risk of experiencing intimate partner violence (IPV). Understanding the factors that place youth at risk of IPV is central to prevention and treatment of this public health problem. However, questions remain about the prevalence and correlates of IPV among youth in foster care. Additionally, emotional abuse, a particular form of IPV in intimate partnerships, remains an understudied area in this population. This study aimed to address these gaps in research by exploring factors associated with IPV using longitudinal data from a representative sample of older youth in California Foster Care who participated in the California Youth Transitions to Adulthood Study (CalYOUTH). Our IPV outcome measures included victimization, perpetration, bidirectional IPV, and emotional abuse. Findings suggest that approximately one-fifth (20.4%) of CalYOUTH respondents had experienced some form of IPV at age 23, with emotional abuse and bidirectional violence being the most commonly reported types of IPV. Females reported emotional abuse, as well as bidirectional violence, at nearly double the rates of their male counterparts. Self-identified sexual minority youth (SMY; lesbian, gay, bisexual, transgender, queer, or questioning) were more likely to report IPV victimization, IPV perpetration, and bidirectional violence than their non-SMY peers. Youth with histories of emotional abuse, caregiver IPV victimization, sexual abuse in foster care, placement instability, substance use, anxiety, and incarceration were also at heightened risk of IPV involvement. Emotional abuse was most prevalent with SMY. The findings contribute to the growing research on IPV among transition-age foster youth with important implications for future research, practice, and policy.

The long-term impact of early adverse experience on adaptive functioning: a pilot study integrating measures of mental status, nonverbal communication, and heart rate variability

ABSTRACT Background: Childhood maltreatment (CM) can disrupt the development of behavioural and physiological systems, increasing the risk of physical and psychological adverse outcomes across the lifespan. CM may cause interpersonal dysfunctions that impair social communication and lead to dysfunctional activation of the autonomic nervous system. The present exploratory study analyzed the long-term impact of CM from an integrated perspective through the simultaneous assessment of psychological symptoms, social and behavioural communication, and physiological regulation. Methods: Participants were 55 healthy university students (9 males and 46 females; mean age ± SD = 25.26 ± 2.83 years), who filled out a battery of questionnaires to assess the presence of CM (Childhood Trauma Questionnaire) and psychopathological symptoms (Symptom Check-List-90 Item Revised). Participants were then subjected to a videotaped interview for the assessment of non-verbal behaviour (Ethological Coding System for Interviews) and measurement of tonic heart rate variability (HRV), a measure of physiological adaptability to the environment. We performed Pearson's correlation analysis to evaluate the associations between non-verbal behaviour, HRV, and CM variables. Multiple regression analysis was used to evaluate the independent associations between CM variables on HRV and nonverbal behaviour. Results: We found an association between more severe CM, increased symptoms-related distress (ps < .001), less submissive behaviour (ps < .018), and decreased tonic HRV (ps < .028). As a result of multiple regression analysis, participants with a history of emotional abuse (R² = .18, p = .002) and neglect (R² = .10, p = .03) were more likely to display decreased submissive behaviour during the dyadic interview. Moreover, early experience of emotional (R² = .21, p = .005) and sexual abuse (R² = .14, p = .04) was associated with decreased tonic HRV. Conclusion: Our preliminary findings show the utility of analyzing the long-term effects of adverse early experiences at different levels of ‘adaptive functioning’ (the capabilities needed to respond effectively to environmental demands).

Gaslighting and its application to interpersonal violence

PurposeThe study aims to examine the nature of gaslighting and how it relates to interpersonal aggression.Design/methodology/approachIt does so first through application of a Rapid Evidence Assessment (REA) to understand how gaslighting is understood academically. This RAE captured 50 articles, with 12 retained for thematic review. Results were then used to develop a gaslighting behaviour measure, which was then applied in an online study of adults (n = 386; 77.2% women).FindingsFive themes were identified from the REA: components of gaslighting; gaslighting as a tool for abuse; perpetrators as damaged manipulators; experiences and characteristics of victims; and institutional and racial gaslighting. In the ensuing study, results demonstrated that emotional abuse was broadly related both to the perpetration and experiencing of gaslighting, indicating that it may represent an extension of emotional abuse. The relationship to trait aggression was limited and primarily isolated to victims presenting with higher levels of trait aggression capturing more emotional components (e.g. anger/hostility).Research limitations/implicationsThe importance of context in understanding the relationship between gaslighting, emotional abuse and aggression was indicated, with some complexity found. Suggestions for future research are made.Practical implicationsAccounting for context in understanding gaslighting is key. Developing and validating measures for gaslighting would assist with the evaluation of this behaviour. When working with those who have a history of emotional abuse, considering gaslighting as a further element is potentially important. It should not be assumed that gaslighting has an association with non-emotional aggression; the type of relationship where it is occurring is important.Originality/valueThis study is the first to consider the development of a gaslighting measure, which is informed by a methodological review of the literature.

The impact of traumatic childhood events on functioning in patients with schizophrenia

Introduction A history of adverse childhood experiences (ACEs) can increase the risk of schizophrenia spectrum disorders and might be related to unfavorable clinical and functional outcomes of psychosisObjectivesTo assess the relationship between the history of ACEs and functioning in stabilized patients with schizophrenia or schizoaffective disorder.MethodsWe conducted a cross-sectional, descriptive and analytical study. It was carried out on out patients with stabilized schizophrenia or schizoaffective disorder. The diagnosis of schizophrenia and schizoaffective disorder was established based on DSM-5 criteria. We used the ACEs scale to screen for traumatic events that occurred in the childhood and we used the Functional Assessment Staging Scale (FAST) to assess the patients’ ability to function and perform tasks of daily livingResultsSeventy five patients were included.The mean age was 39.81 ±9.96 years.The sex ratio was 4 .34. The mean score of ACE was 3.55 ± 2.41 and 88% of patients had experienced at least one traumatic event.The mean sore of the FAST scale was 33 ± 14.95.The total score of FAST was significantly higher in case of physical negligence in childhood (p=0.018). No correlation was found with the others ACEs.The FAST sub score of cognitive functioning correlated with the history of parents separation (p= 0.47) and physical negligence (p= 0.03). we also found that The FAST sub score of interpersonal relationships correlated with the history of emotional abuse (p=0.021)ConclusionsOur data has shown that ACEs contribute to functioning impairment in schizophrenia and schizoaffective disorder.This impairment affects mainly the cognitive functioning and the interpersonal relationshipsDisclosureNo significant relationships.

Neutrophil-to-lymphocyte ratio (NLR) variations in relationship with childhood maltreatment in patients with anorexia nervosa: a retrospective cohort study.

Anorexia nervosa (AN) is a serious mental illness. It is frequently accompanied by a history of childhood maltreatment (CM) that may constitute a specific ecophenotype in patients with eating disorders necessitating special assessment and management. This retrospective study tested whether in patients with AN, CM-related chronic stress may manifest through low-grade inflammation reflected by an increase in white blood cell ratios (neutrophil-to-lymphocyte ratio, NLR, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio). Participants (N = 206) were enrolled at an eating disorder daycare unit in Montpellier, France, from March 2013 and January 2020. CM was assessed using the childhood trauma questionnaire (CTQ). The Eating Disorder Examination Questionnaire (EDE-Q) and the MINI were used to assess AN severity and the other clinical characteristics, respectively. NLR was higher in patients with AN and history of CM (p = 0.029) and in patients with AN and history of emotional abuse (p = 0.021), compared with patients with AN without history of CM. In multivariate analysis, emotional abuse (β = 0.17; p = 0.027) contributed significantly to NLR variability. In patients with AN, NLR is a low-grade inflammation marker that is influenced by various sociodemographic, clinical and biological factors. It is more directly affected by some CM types, especially emotional abuse, than by the presence/absence of CM history. Future studies should focus on mediators between CM and increased inflammation, such as interoceptive awareness, emotional dysregulation, food addiction, and stress sensitization. III. Evidence obtained from well-designed cohort or case-control analytic studies.

Screening for ADHD Symptoms among Criminal Offenders: Exploring the Association with Clinical Features.

Background: Attention-deficit/hyperactivity disorder (ADHD) is a disabling disorder. High rates of ADHD have been consistently reported among prisoners. The main objectives were (1) to estimate the prevalence of ADHD symptoms in a sample of male inmates and (2) to investigate the relationship between ADHD symptoms and socio-demographic/clinical features. According to the high prevalence of childhood trauma among inmates, we assessed whether exposition to childhood trauma can be related to the presence of ADHD symptoms. Methods: A total of 159 male prisoners admitted to Monza prison between January 2020 and June 2021 were included. Both Wender Utah ADHD rating scale and adult ADHD self-report scale were administered to assess ADHD symptoms. Moreover, inmates completed the childhood trauma questionnaire. Results: Data were available for 108 inmates. Thirty-five prisoners (32.4%) were found on screening to meet the criteria for symptoms of ADHD. Cocaine use disorder, prescription of mood stabilizers and a history of emotional abuse significantly increased the likelihood of having clinically significant ADHD symptoms. Furthermore, patients who experienced physical neglect resulted in meeting the criteria for ADHD symptoms. Conclusions: ADHD symptoms are widespread among inmates and are associated with specific risk factors. Screening for ADHD should be done to provide appropriate intervention strategies.

Association of childhood abuse with behavioral weight-loss outcomes: Examining the mediating effect of binge eating severity.

The study aims were to (1) document the relationship between a history of childhood abuse and weight change during behavioral obesity treatment and (2) estimate the indirect effect of childhood abuse on weight change through binge eating severity. Participants (n = 431) were enrolled in a behavioral weight-loss intervention. Childhood physical and emotional abuse history and current binge eating severity were self-reported. Percent weight loss at 6 months was calculated using measured weight. Adjusted mediation models examined whether there was an indirect effect of childhood physical and emotional abuse on 6-month percent weight loss that operated through binge eating severity. After covariate adjustment, childhood physical abuse, but not emotional abuse, predicted a lower percent weight loss (B = -1.78%; 95% CI: -3.10% to -0.47%). Although childhood physical and emotional abuse were positively related to baseline binge eating severity, binge eating severity did not mediate the associations between either childhood abuse type and percent weight loss. Individuals with a childhood physical abuse history had a lower percent weight loss than those without such histories during behavioral obesity treatment. This effect was not explained by binge eating severity. Individuals with a history of childhood abuse may benefit from trauma-informed obesity care.

Are Affective Temperaments, Emotional Abuse, and Neglect Involved in Mentalization Abilities in Patients With Psychiatric Disorders?

Patients who have experienced emotional abuse and neglect often develop psychiatric disorders in adulthood. However, whether emotional abuse, neglect, and mentalization abilities relate to one another and the role of possible mediators of this relationship in psychiatric patients are still unknown. We evaluated the potential role of affective temperament as a mediator of the relationship between emotional abuse and neglect and mentalization. We performed a cross-sectional study of 252 adult psychiatric inpatients. The Childhood Trauma Questionnaire, Mentalization Questionnaire, and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) were administered. Results showed a significant indirect effect of emotional abuse and neglect on scores on the Mentalization Questionnaire through the TEMPS-A (b = 0.25, 95% confidence interval [0.143-0.375]), demonstrating that affective temperament mediates the relationship among emotional abuse, neglect, and mentalization impairment in psychiatric patients. A careful evaluation of mentalization abilities in patients with psychiatric disorders and who have a history of emotional abuse and neglect is necessary for a better understanding of psychopathology and for the choice of therapeutic strategies.

A Meta-analysis of the Effects of Mentoring on Youth in Foster Care.

Research suggests that mentoring programs may promote a range of positive outcomes in youth populations. Less is known, however, about the extent to which such programs are effective in specialized youth populations, such as youth involved in the foster care system. The current study aimed to investigate the extent to which mentoring interventions promote positive outcomes among youth involved in the foster care system and to systematically explore factors that may moderate the effectiveness of mentoring interventions. Using a multilevel meta-analytic approach, this study estimated the effect size of nine formal mentoring programs in the United States serving youth involved with the foster care system (total n = 55,561). Analyses revealed a small-to-medium-sized overall effect (g = 0.342). Moderator analyses revealed weaker effects for studies containing higher proportions of youth with emotional abuse histories. Programs deploying near-peer mentors were more than twice as effective as intergenerational mentors. The findings highlight the salience of emotional abuse history, suggesting the utility of providing mentor trainings in trauma-informed care for this population.

Factors Associated with Parent–Adolescent Attachment Relationship Quality: A Longitudinal Study

Background: Attachment to parents during adolescence has been identified as an important indicator of psychosocial adaptation. However, the relative importance of the adolescents’ behavior problems and the larger relational context likely to influence the quality of these relationships remains relatively underexplored. The present study aims to identify the factors associated with the quality of parent–adolescent attachment relationships and to establish their relative contributions. This study also tested, as a complementary objective, the invariance of the models according to sex. Method: 706 (46.9% girls) early adolescents participated in the study at time 1 and then again, two years later. The individual (e.g., behavior problems or temperament) and contextual (e.g., parents’ behaviors, history of abuse or environment stability) associated factors were measured at time 1, while the quality of the parent–adolescent attachment relationship was measured at time 2. Results: The results showed that a history of emotional abuse, inconsistent discipline, externalized behavior problems and the adolescent’s age were negatively associated with the global attachment security score, while internalized behavior problems and peer attachment were positively associated. These variables explained 15.7% of variance. The results also demonstrated that these variables were also associated with the specific dimensions of attachment (trust, communication, alienation). Discussion: The study demonstrates the importance of several relational variables in the development of the parent–adolescent attachment relationship.

Profiles of women participating in an internet-based prenatal mental health platform (HOPE – Healthy Outcomes of Prenatal and Postnatal Experiences)

• Two of three women who registered to participate in this Internet-based prenatal mental health platform reported a history of depression or anxiety. • Rates of current probable depression and anxiety were roughly one in four participants. • The prevalence of borderline personality disorder (BPD) in this study was 12.5% which is notably higher than the reported value of 4.4% in the general population. • Concerning rates of abuse, 27.6% with a history of abuse and 23.4% with a history of emotional abuse. • Almost 40% of women reported dissatisfaction with the support the received from their mother in childhood. As mental healthcare expands to web-apps, smartphones, and other technologies, it is important to understand the psychological profiles of women who self-select to participate in perinatal mental health digital platform randomized control trials. There are concerns that those seeking internet-based mental health treatments may not be representative of the general perinatal populations seeking face-to-face treatments resulting in a lack of generalizability. The aim of this study is to describe the demographic and psychological profiles of prenatal women seeking treatment over the internet for mental health concerns as compared to the general perinatal population seeking mental health treatments. This was a descriptive study involving pregnant women across Alberta, Canada, aged 18–47 years old. Profiles were collected through self-report baseline demographics and mental health information using the Edinburgh Postnatal Depression Scale (EPDS), Antenatal Risk Questionnaire (ANRQ), Depression Anxiety Stress Scale (DASS-21)- Anxiety and Stress Subscales, and Maclean Screening Instrument for Borderline Personality Disorder (MSI-BPD). A total of 887 women completed self-reported baseline demographic data and 590 women completed baseline mental health data. Mean age of women was 31.3 years with a mean pregnancy gestational age of 15.3 weeks). A history of depression was reported by 36.3%, a history of anxiety was reported by 20.8% of women, and a history of abuse and emotional abuse was reported in 27.7% and 23.5% of women. At baseline, 57.6% of women had clinically significant mental health risk scores, 24.3% of women had probable minor depression, and mild to moderate levels of anxiety were reported in 23.2% of women. Borderline personality disorder was reported by 12.5% of women. Overall, this sample of pregnant women has prevalence rates of depression, anxiety, and stress that are comparable to those rates found in pregnant women in the general population. This suggests that there is broad utility for and consumer interest in internet-based mental health treatments.

Mentalizing mediates the association between emotional abuse in childhood and potential for aggression in non-clinical adults

BackgroundEmotional abuse in childhood has been linked to a higher expression of aggressive behavior in adulthood. The identification of protective factors that mitigate this association is needed. Mentalizing—the capacity to understand behavior in terms of intentional mental states—appears to be a promising candidate factor that possibly modifies maladaptive consequences of early emotional abuse. ObjectiveThis study investigated associations between the history of emotional abuse, aggressive behavior in adulthood and mentalizing capacities in a non-clinical sample of adults. Methods214 healthy adults completed questionnaires measuring retrospectively rated experiences of emotional abuse in childhood, mentalizing capacities and aggressive behavior in a cross-sectional design. ResultsResults indicated associations between emotional abuse in childhood, uncertainty about mental states, and aggressive behavior in adulthood. Moreover, certainty about mental states counteracted the negative effect of emotional abuse and partially mediated the associations between emotional abuse and aggressive behavior in adulthood. ConclusionThis study extends current research and sheds further light on the relationship between emotional abuse in childhood, the health-promoting capacity of mentalizing, and aggressive behavior in non-clinical adults.

Trauma Exposure and Suicidality in a Pediatric Emergency Psychiatric Population.

The increasing rates of depression and suicidality in children and adolescents are reflected in the increasing number of mental health-related visits to emergency departments. Despite the high rates of traumatic exposure experienced by high-acuity children and adolescents and a known link to suicidal ideation, the systematic review of trauma history is not a consistent part of emergency department assessments for suicide ideation or attempt. In the present study, we examined the prevalence of suicidality as well as traumatic exposures in children and adolescents presenting to a dedicated pediatric psychiatric emergency department. Suicide ideation, suicide attempts, and trauma exposure history were identified through a retrospective chart review of youth (n = 861) who presented to a dedicated child psychiatric emergency department during a 1-year period. Bivariate analyses comparing demographic and trauma history for children with and without suicidality and a multivariable logistic regression were performed. Childhood adversity was common, with 52% of youth reporting at least one type of trauma exposure. Emotional abuse, physical abuse, and sexual abuse/assault were associated with suicidality. Any trauma exposure and the total number of different trauma exposures were associated with reported suicide attempt. After adjusting for sociodemographic characteristics, children who reported a history of emotional abuse had 3.2-fold increased odds of attempted suicide. Children who reported a history of being a victim of bullying had 1.9-fold increased odds of current suicidal ideation. Traumatic experiences were common in youth presenting with suicidality. Traumatic experiences are frequently underrecognized in treatment settings because they are not part of routine evaluations and are often overlooked when trauma-related symptoms are not the presenting problem. Addressing traumatic experiences underlying depression and suicidal ideation is a necessary step in effective treatment. Emergency departments need to implement routine screening for traumatic exposures in children presenting with suicidal ideation or attempt.

Maltreatment during childhood and risk for common mental disorders among first year university students in South Africa

PurposeChildhood maltreatment elevates risk for common mental disorders (CMDs) during late adolescence and adulthood. Although CMDs are highly prevalent among university students, few studies have examined the relationship between childhood maltreatment and 12 month CMDs in a low- to middle-income countries. This paper describes the prevalence of maltreatment and the relationship between type, number and patterns of maltreatment exposure and 12 month CMDs among first-year university students in South Africa.MethodsMaltreatment and CMD data were collected via well-validated self-report scales (corresponding with DSM-IV diagnoses) in a web-based survey of first-year students from two large urban universities (n = 1290) in South Africa. Various multivariate modelling approaches (additive, restrictive interactive and latent class) were used to examine the relationship between maltreatment and CMDs.ResultsOverall, 48.4% of participants reported childhood maltreatment, the most common type being emotional abuse (26.7%). Regardless of the modelling approach used, emotional abuse was the only type of maltreatment independently associated with 12-month diagnoses of major depressive disorder (MDD), generalised anxiety disorder (GAD) or drug use disorder (DUD) even after adjusting for types and number of types of maltreatment. Similarly, students in the latent class reflecting histories of emotional abuse (either alone or combined with physical abuse) were more likely to meet criteria for 12-month MDD, GAD or DUD.ConclusionFindings confirm the high prevalence of childhood maltreatment among South African students. As this exposure elevates risk for MDD, GAD and DUD, interventions aimed at preventing and treating CMDs among first-year students should address experiences of childhood maltreatment.Electronic supplementary materialThe online version of this article (10.1007/s00127-020-01992-9) contains supplementary material, which is available to authorized users.

Loneliness, Social Isolation and Their Difference: A Cross-Diagnostic Study in Persistent Depressive Disorder and Borderline Personality Disorder.

Background: Interpersonal difficulties are a key feature of persistent depressive disorder (PDD) and borderline personality disorder (BPD). Caught in a vicious circle of dysfunctional interpersonal transaction, PDD and BPD patients are at great risk of experiencing prolonged loneliness. Loneliness, in turn, has been associated with the development of mental disorders and chronic illness trajectories. Besides, several factors may contribute to the experience of loneliness across the lifespan, such as social network characteristics, a history of childhood maltreatment (CM), and cognitive-affective biases such as rejection sensitivity (RS). This cross-diagnostic study approached the topic of perceived loneliness by comparing PDD and BPD patients with healthy controls (HC) in its interplay with symptom burden, social network characteristics, RS as well as CM.Method: Thirty-four PDD patients (DSM-5; 15 female, Mage = 38.2, SD = 12.3), 36 BPD patients (DSM-5; 19 female, Mage = 28.8, SD = 9.2), and 70 age- and gender-matched HC were assessed cross-sectionally using the following self-report measures: UCLA Loneliness Scale, Social Network Index (SNI; size, diversity, and embeddedness), Beck Depression Inventory (BDI-II), Borderline Symptom List (BSL-23), Childhood Trauma Questionnaire (CTQ), and Rejection Sensitivity Questionnaire (RSQ).Results: Both patient groups reported significantly higher levels of perceived loneliness, symptom severity, and smaller social network characteristics compared to HC. Loneliness was significantly correlated with severity of self-reported clinical symptoms in PDD and at trend level in BPD. Besides, loneliness tended to be related to social network characteristics for all groups except PDD patients. Both PDD and BPD patients showed higher RS as well as CTQ scores than HC. A history of emotional abuse and emotional neglect was associated with loneliness, and this association was mediated by RS as demonstrated by an exploratory mediation analysis.Discussion: Loneliness is highly prevalent in PDD and BPD patients and contributes to the overall symptom burden. Interestingly, loneliness showed an association with prior experiences of CM as well as current RS. We therefore propose a comprehensive model on how intra- und interpersonal aspects may interplay in the dynamics of loneliness in light of CM. Finally, this model may have further implications for psychotherapeutic interventions.