Childhood Trauma Research Articles

Adverse childhood experiences and multimorbidity of internalising and cardiometabolic conditions in an older-age population.

BackgroundTackling multimorbidity (ICM-MM) of internalising conditions (IC) and cardiometabolic conditions (CM) is key to improving the future of healthcare. Early life factors such as adverse childhood experiences (ACEs) have been linked to long term, poor mental and physical health conditions. AimsThis study investigated whether: 1) ACEs increase the risk of IC, CM and ICM-MM; 2) the effect of ACEs on risk of developing CM depends on the presence of IC and vice versa; 3) how risk differs by gender, socioeconomic status and ethnicity. MethodsIn UK Biobank, the Childhood Trauma Screener was used to identify 157,256 participants with ACE data. Electronic healthcare records (EHR) and interview data identified those with anxiety or depression (IC) and those with hypertension, obesity, type 2 diabetes, dyslipidaemia or chronic kidney disease (CM). Multivariate logistic regression models were employed to find associations between ACEs and IC, CM and ICM-MM. Covariates included age, gender, ethnicity, socioeconomic status, diet, alcohol intake, smoking behaviour and physical activity. ResultsAll ACEs significantly increase risk for IC (all ACEs, p = <2e-16). Emotional neglect, physical neglect and emotional abuse increase risk of CM (e.g. physical neglect, OR = 1.43, CF = 1.30-1.58, p = 1.88e-13). ACEs appear to increase IC and CM risk independently. ConclusionsThe effects of ACEs last well into adulthood and confer risk for IC and, sometimes, CM. ACE history should be included in routine primary care and the development of therapeutic interventions tailored to older adults with ACEs is key to reducing poor health.

Outcomes of Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome in Pediatric Trauma Patients.

Acute respiratory distress syndrome (ARDS) is associated with high mortality and morbidity. Extracorporeal membrane oxygenation (ECMO) is one of the interventions that have been in practice for ARDS for decades. The purpose of the study was to investigate the outcomes of ECMO in pediatric trauma patients who suffered from ARDS. Observational cohort study. The Trauma Quality Improvement Program database for years 2017 to 2019 and 2021 through 2022 was accessed for the study. All children younger than 18 years old who were admitted to the hospital after trauma and suffered from ARDS were included in the study. Other variables included in the study were patients' demographics, clinical characteristics, Injury Severity Score (ISS), Glasgow Coma Scale (GCS) score, comorbidities, and outcomes. ECMO is the exposure, and the outcomes are in-hospital mortality and hospital complications (acute kidney injury [AKI], pneumonia and deep vein thrombosis [DVT]). Of 453 patients who qualified for the study, propensity score matching found 50 pairs of patients. There were no significant differences identified between the groups, ECMO+ vs. ECMO- on patients' age in years (16 yr; interquartile range [IQR], 13.25-17 yr vs. 16 yr [14.25-17 yr]), race (White; 62.0% vs. 66.0%), sex (male; 78% vs. 76%), ISS (23 [IQR, 9.25-34] vs. 22 [9.25-32]), and GCS (15 [IQR, 3-15] vs. 13.5 [3-15]), mechanism of injury; and comorbidities. There was no difference between the groups, ECMO+ vs. ECMO-, in-hospital mortality (10.0% vs. 20.0%; p = 0.302), hospital complications (AKI 12.0% vs. 2.0%; p = 0.131), pneumonia (10.0% vs. 20.0%; p = 0.182 > ), and DVT (16% vs. 6%; p = 0.228). No difference in mortality was observed in injured children who suffered from the ARDS and were placed on ECMO when compared with patients who were not placed on ECMO. Patients with trauma and ARDS who require ECMO have comparable outcomes to those who do not receive ECMO. A larger sample size study is needed to find the exact benefit of ECMO in this patients' cohort.

Childhood Trauma and Parental Burnout: The Mediating Role of Difficulties in Emotion Regulation and Reflective Functioning.

This study investigated the mediating role of difficulties in emotion regulation and reflective functioning in the association between childhood trauma and parental burnout. The participants included 402 mothers with children ranging in age from 1 to 6years. Mothers completed the Parental Burnout Assessment (PBA) the parental reflective functioning questionnaire (PRFQ), the Difficulties in Emotion Regulation Scale (DERS), and the Childhood Trauma Questionnaire (CTQ). Data analysis was performed using SPSS 26, and Hayes Macro in SPSS was also used to analyze the effects of mediating variables. The results show that although childhood trauma and parental burnout do not have a direct and significant relationship, there is a significant indirect relationship through difficulties in emotional regulation and the two factors of parental reflective functioning, i.e., pre-mentalization, interest and curiosity about mental states. These findings contribute to the understanding of the importance of variables such as difficulties in emotion regulation and reflective functioning, which play a mediating role in the relationship between childhood trauma and parental burnout. This suggests that designing interventions and prevention to reduce parental burnout based on emotion regulation and reflective functioning may be beneficial.

Alterations in fear learning as a mechanism linking childhood exposure to violence with PTSD symptoms: a longitudinal study.

Fear learning is a core component of conceptual models of how adverse experiences may influence psychopathology. Specifically, existing theories posit that childhood experiences involving childhood trauma are associated with altered fear learning processes, while experiences involving deprivation are not. Several studies have found altered fear acquisition in youth exposed to trauma, but not deprivation, although the specific patterns have varied across studies. The present study utilizes a longitudinal sample of children with variability in adversity experiences to examine associations among childhood trauma, fear learning, and psychopathology in youth. The sample includes 170 youths aged 10-13 years (M = 11.56, s.d. = 0.47, 48.24% female). Children completed a fear conditioning task while skin conductance responses (SCR) were obtained, which included both acquisition and extinction. Childhood trauma and deprivation severity were measured using both parent and youth report. Symptoms of anxiety, externalizing problems, and post-traumatic stress disorder (PTSD) were assessed at baseline and again two-years later. Greater trauma-related experiences were associated with greater SCR to the threat cue (CS+) relative to the safety cue (CS-) in early fear acquisition, controlling for deprivation, age, and sex. Deprivation was unrelated to fear learning. Greater SCR to the threat cue during early acquisition was associated with increased PTSD symptoms over time controlling for baseline symptoms and mediated the relationship between trauma and prospective changes in PTSD symptoms. Childhood trauma is associated with altered fear learning in youth, which may be one mechanism linking exposure to violence with the emergence of PTSD symptoms in adolescence.

SP7.6 - Incidence of hepatic pseudoaneurysm formation following blunt and penetrating abdominal trauma in the paediatric cohort: A 6-year retrospective analysis

Abstract Introduction Hepatic pseudoaneurysm (HPA) is a rare but potentially life-threatening sequelae of liver trauma. Little data exists in the literature in regards HPAs in paediatric patients. We aimed to determine the incidence and risk factors of HPA formation in children with blunt and penetrating liver trauma. Methods A retrospective analysis was performed on patients admitted to our institution under the age of 18, found to have liver injury on initial trauma protocoled CT imaging between 2017 & 2022. Patients were identified from The Trauma Audit and Research Network (TARN) database. Data relevant to the study aims was collected. Results 34 patients were identified. (mean age 12 ± 5.4 years 76.5% male 23.5% female) 67.6% of patients suffered blunt injury (mean ISS 34.3 +/- 20.4 95% CI [25.4-43.1] median AAST 3) and 32.4% patients suffered penetrating liver injury (mean ISS 19.5 +/- 9.61 95% CI [12.6-26.4] median AAST 3) Four patients were excluded from further analysis due to loss of life from the primary injury. 18 patients (60%) underwent repeat CT. Of the 12 patients that did not have a repeat scan, 6 patients (50%) had a repeat USS at 6 weeks. follow up CT identified 4 HPAs (11.7%), of which two were treated with embolization. Conclusion HPA formation in paediatric liver trauma presents a significant clinical challenge. While the lack of standardised protocols poses a hurdle, a personalised approach informed by individual patient factors and the use of contrast enhanced ultrasound (CEUS) may optimise HPA detection while minimising radiation exposure.

Neonatal limited bedding and nesting experience may lead to a sex-dependent increase in panic-like defensive behaviours in adult mice.

In humans, adverse physical and/or psychological traumas in childhood may predispose to developing psychiatric disorders in adulthood, including panic disorder. To model early life adversity in mice, we subjected male and female C57BL/6J mice to a limited bedding and nesting (LBN) protocol between postnatal days 2-9 and investigated its effect on responsiveness to panicogenic challenges in adulthood. Panic-like escape behaviour was assessed during exposure to a high concentration of CO2 (20%) or in the beetle mania task (BMT), used to model respiratory and non-respiratory-related types of panic respectively. Neonatal exposure to LBN increased panic-like jumping during the CO2 challenge in male but not female mice. In an initial pharmacological validation of the BMT as a panic-inducing paradigm, undirected jumping and horizontal escape behaviours were reduced significantly by the panicolytic alprazolam (0.05 and 0.1mg.kg-1 i.p.) whilst tolerance to the close proximity of the aversive robo-beetle increased. The anxiolytic diazepam (1mg.kg-1i.p.) reduced only the number of horizontal escape attempts. In both sexes, previous experience of LBN significantly enhanced the number of horizontal escape episodes, indicating a pro-panic phenotype. Directed escape to access a safe ledge on the wall of the test arena, which was seen only in males, was also reduced significantly following LBN. These findings indicate that early life adversity produced by fragmented and unpredictable maternal care promotes a sex-specific increase in susceptibility to panic-like behaviour in adulthood. Whilst non-respiratory-related panic-like behaviour was enhanced in both sexes, females were resilient to respiratory-related challenges.

Survey of pediatric massive transfusion protocol practice at United States level I trauma centers: An AABB Pediatric Transfusion Medicine Subsection study.

Trauma remains the leading cause of pediatric mortality in the United States. Although use of massive transfusion protocols (MTPs) in this population is widespread, optimal pediatric resuscitation is not well established. We sought to assess contemporary pediatric MTP practice in the United States. A web-based survey was designed by the Association for the Advancement of Blood & Biotherapies (AABB) Pediatric Transfusion Medicine Subsection and distributed to select American College of Surgeons (ACS) Level I Verified pediatric trauma centers. The survey assessed current MTP policy, implementation, and recent changes in practice. Response rate was 55% (22/40). Almost half of the respondents were from the South. The median RBC:plasma ratio was 1 (interquartile range 1-1.5). Protocolized fibrinogen supplementation was common while integration of antifibrinolytic therapy into MTPs was infrequent. Viscoelastic testing (VET) was available at most sites, 71% (15/21, one site did not respond), and was generally utilized on an ad-hoc basis. Roughly, a third of sites had changed their MTP in the past 3 years due to blood supply issues, and about a third reported having group O Whole Blood on-site. MTP practice is similar throughout the United States. Though fibrinogen supplementation is common-other emerging interventions such as antifibrinolytic therapy or utilization of routine viscoelastic testing-are not widespread. Pediatric transfusion medicine experts must continue to follow practice change, as contemporary large trials begin to characterize new supportive modalities to optimize resuscitation in pediatric trauma patients.

Irritability in youth: Trauma, maltreatment, and bullying in mood disorders

ObjectiveDisruptive Mood Dysregulation Disorder (DMDD) is characterized by irritability and anger outbursts, categorized under depressive disorders along with Major Depressive Disorder (MDD) in DSM-5. This study aims to investigate exposure to peer bullying and trauma in irritable youth with DMDD and compare it with those with MDD and healthy controls. MethodsThis cross-sectional study included 313 participants aged 12–17 (DMDD: 103, MDD: 105, healthy controls: 105; mean age 15.0±1.6). The diagnosis was established using the Schizophrenia for School-Aged Children Present and Lifetime Version (K-SADS-PL) semi-structured interview. The Olweus Bullying Questionnaire, Childhood Trauma Questionnaire, and sociodemographic forms were utilized. ResultsBoth DMDD and MDD groups experienced significantly more physical, sexual, and emotional abuse, as well as physical and emotional neglect, compared to the healthy control group. Among the DMDD group, 34.9% were bullies, 42.7% were victims, and 18.4% were bully-victims. ConclusionAdolescents diagnosed with DMDD are at increased risk for experiencing peer bullying and trauma. Emotional dysregulation and intense outbursts of anger predispose these individuals to both perpetrate and fall victim to peer bullying, as well as to become bully-victims. Including irritable adolescents in peer bullying intervention programs may be beneficial. Additionally, considering the elevated risk of anger outbursts and irritability in individuals exposed to trauma, they should be closely monitored.

Association between childhood maltreatment and obsessive-compulsive disorder comorbid with eating disorders: a cross-sectional study

BackgroundObsessive-compulsive disorder (OCD) and eating disorders (ED) share common features, including the presence of obsessions and compulsions, and they often co-occur. Additionally, there is a significant comorbidity between ED and childhood traumatic experiences (CTE), as well as between CTE and OCD. Various biological and environmental factors have been proposed to explain the connection between ED, OCD, and CTE. This study explores the link between CTE and the comorbidity of ED and OCD, with the hypothesis that specific types of CTE may increase the risk of developing OCD in individuals with ED.MethodsParticipants (N = 562) were enrolled at an eating disorder unit in Montpellier, France, between March 2013 and January 2020. The Childhood Trauma Questionnaire (CTQ), Eating Disorder Examination Questionnaire (EDE-Q), and Mini International Neuropsychiatric Interview (MINI) were used to evaluate childhood maltreatment, assess clinical characteristics associated with ED, and categorize participants into two groups: patients with and without OCD.ResultsBivariate analysis revealed that patients with comorbid ED and OCD had higher EDE-Q scores (p < 0.001), more anxiety disorders (p < 0.001), depressive disorders (p = 0.02), post-traumatic stress disorder (PTSD) (p < 0.001), and a higher incidence of sexual abuse (p < 0.001) and physical neglect (p = 0.04) compared to those without OCD. Multivariate analysis showed that the association between CTE and OCD was influenced by the presence of an anxiety disorder (p = 0.01) and a higher EDE-Q total score (p = 0.03), with a significant association with a history of sexual abuse (p = 0.04).ConclusionsThis demonstrates that CTE increases the risk of comorbid OCD in ED patients, correlating with more clinically severe ED and a higher likelihood of anxiety disorders.

Shadows of Childhood Trauma: A Psychoanalytic Exploration of Colour, Isolation, and Insecurity in Kamala Das's Literary Work

Shadows of Childhood Trauma: A Psychoanalytic Exploration of Colour, Isolation, and Insecurity in Kamala Das's Literary Work

Shifts in Paediatric Road Trauma Dynamics Pre- vs. Post-COVID-19 Lockdown: Insights from a Major Trauma Centre.

The COVID-19 pandemic has brought unprecedented changes globally, significantly affecting public health sectors, including paediatric road trauma. This study aims to explore the changes in paediatric road trauma presentations and outcomes before and after the COVID-19 lockdown. This retrospective study analysed paediatric trauma data from the Saudi TraumA Registry (STAR) from August 2017 to December 2022, comparing pre- and post-COVID-19 lockdown periods (August 2017-March 2020 and July 2020-December 2022, respectively). The study analysed demographic data, mechanism of injury, severity, ICU admissions, and mortality rates using multivariate logistic regression models. Out of 950 paediatric trauma cases analysed, there was an 44.2 [561/389 = 1.442] % increase in the number of cases post-lockdown. A significant shift was noted in the age group of 5-9 years, with cases increasing from post-lockdown. Head injuries were the most prevalent type of injury, with their proportion slightly increasing from 163 (20.5%) pre-lockdown to 248 (23.2%) post-lockdown. The ICU admission were consistent across both periods, while the definitive care mode of arrival post-lockdown showed a notable shift towards private or government ambulances. Our study provides critical insights into the significant impact of the COVID-19 on paediatric road trauma. The observed increase in trauma cases post-pandemic, particularly among younger children and a notable rise in driver-related injuries among adolescents, underscores the profound effect of lockdown measures and subsequent societal changes on paediatric health. Efforts to reduce paediatric traffic injuries require collaboration among parents, educators, healthcare professionals, policymakers, and the community at large.

Pediatric facial trauma management: Emergency case in a toddler

Background: Facial soft tissue trauma cases are often encountered in the emergency room. Soft tissue trauma, especially to the face, is rarely life threatening. It varies in shape, size, and depth and can also affect surrounding organs. The treatment of soft tissue trauma can be complicated and may have a significant impact on facial function and, especially, facial aesthetics. Children are easily injured due to their active nature. Soft tissue trauma to the faces of toddlers is challenging even for experienced surgeons; however, wound debridement and suture management under general anesthesia should be considered. Purpose: The aim of this article is to deliver a thorough overview of the evaluation and treatment of soft tissue injuries in children, covering initial assessments, physical examinations, the application of antimicrobial therapies, and preparation for surgical procedures. Case: An 11-month-old girl went to the emergency department of Hasan Sadikin General Hospital, Bandung, with injuries to her left cheek and upper left lip sustained when she fell, and her face hit the edge of a cement pot at home. There was no history of unconsciousness, nausea and vomiting. The injury was diagnosed as vulnus laceratum of the left face and upper lip region. Case management: Emergency management was carried out by triage, Tetagam injection, and early wound debridement and suture under general anesthesia because the patient was uncooperative. Wounds on the face and lips were primary sutured layer by layer, returning the wound edges to their normal anatomical position. Conclusion: The management of facial soft tissue injuries in toddlers requires general anesthesia for adequate and accurate wound debridement and suture, so that functional and aesthetic effects can be satisfactorily obtained.

Prevalence of child maltreatment in a nationwide sample of 18 to 31 year-olds in Germany

BackgroundChild maltreatment (CM) can have devastating and potentially lifelong effects for those affected and is a major contributor to mental health problems. To tackle public health problems it is crucial to have reliable data on CM. The aim of this study is to assess the prevalence and predictors of CM in a nationwide sample of the German population of young adults.MethodsThe study population (young adults aged 18 to 31 years) stems from the KiGGS Cohort study, the longitudinal branch of the German Health Interview and Examination Survey for children and adolescents. This sample meets the criteria of the United Nations Sustainable Development Goals (SDG) indicator 16.2.3. The data was collected between 2014 and 2017. CM were assessed with the Childhood Trauma Questionnaire (CTQ) in. In addition, socio-demographic variables and other known risk factors for CM were assessed. A total of 6433 (47.8% female) participants were included in the analyses. Binary logistic regression analyses were used to investigate predictors of maltreatment subtypes. Ordinal regression was used to examine their association with experience of multiple forms of CM.ResultsOverall, 18.4% (f: 20.9%, m: 16.1%) of the participants reported having experienced at least one type of CM; 6.7% (f: 8.8%, m: 4.8%) reported experiences of emotional abuse, 3.7% (f: 3.9%, m: 3.5%) physical abuse, 3.5% (f: 5.3%, m: 1.7%) sexual abuse, 9.0% (f: 9.9%, m: 8.2%) emotional neglect and 8.6% (f: 8.5%, m: 8.7%) physical neglect. Gender, subjective social status, education and household dysfunction (e.g. living with an individual who is using substances) emerged as significant predictors for different types of CM. Additionally, all these factors were significant risk factors for experiencing cumulative CM.ConclusionsCM is common in the German population, with almost one in five people experiencing at least one type of CM. The results reveal important risk factors for the occurrence of CM. In particular, people with lower social status and those who grew up in dysfunctional households are at higher risk of CM. Greater support for this vulnerable population may reduce the prevalence of CM.

Profile of Ocular Trauma in Pediatric Population in a Tertiary Care Hospital

BACKGROUND Ocular trauma is the major cause for preventable monocular blindness and visual impairment worldwide. It accounts for 8%-14% of total injuries in the pediatric age group. Various studies have shown its higher incidence in this age group. They have different patterns of ocular injuries than adults and have age specific type of injuries. The number of blind years that a child lives with compared to an adult is far more. Most of the previous studies have been on ocular trauma among the adult population, specifically the factory workers in the city of Ludhiana. Moreover, this study aimed to derive a relation between the time of presentation from the injury and the final visual outcome which has rarely been reported in other studies. Profile of ocular trauma in an area is a dynamic and ever changing trend. Therefore, we proposed to study the profile of ocular trauma in pediatric population presenting to our hospital. METHODS A total of 60 patients between the age of 0 to 17 years were included in this study. The study was conducted from 15th December 2020 to 31st May 2022. Complete ocular examination was done at the time of presentation and after management; The best corrected visual acuity was noted at the end of three months. RESULTS Among our study subjects 45% belonged to the age group of 11-17 years. A male predominance (68.3%) was noted. For most of the subjects, the duration between time of injury and time of examination was less than 6 hours. The proportion of closed globe type of injury (80%) was significantly higher as compared to open globe (8.3%) and extraocular type of injury (11.7%). At the 3 month follow up, out of the 53 study subjects, 92.45% had good visual outcome (VO), 3.77% had fair VO and 3.77% had poor VO respectively. CONCLUSIONS Most of the pediatric ocular trauma may be avoided, which emphasizes the value of health education, adult supervision, and the implementation of suitable interventions to lessen the frequency and severity of trauma. Better visual outcome is expected with a shorter duration between time of injury and time of presentation.

Childhood maltreatment as predictor and moderator for treatment outcome in patients with major depressive disorders treated with metacognitive therapy or behavioral activation

BackgroundChildhood maltreatment (CM) is a risk factor for developing and maintaining depression. It is unclear whether CM influences the effect of treatments for depression. This study examined CM's predictor and moderator effect in Behavioral Activation (BA) and Metacognitive Therapy (MCT). MethodCM was analyzed in a trial comparing a six months treatment program of either BA or MCT for 122 outpatients with major depressive disorder (MDD). Depression was assessed by the Hamilton Rating Scale for Depression (HRSD-24). CM was assessed using the Childhood Trauma Questionnaire (CTQ). ResultsLinear mixed models showed no predictor or moderator effects for the CTQ total score (all p > .58) but revealed a moderator effect for ‘sexual abuse’ on the reduction of depressive symptoms (β = 10.98, SE = 4.48, p = .015) indicating that patients with experiences of childhood sexual abuse benefited more from BA. There also was a predictor effect for ‘physical neglect’ (β = −3.35, SE = 1.70, p = .049): patients without the experience of physical neglect benefited more from treatment regardless of condition. Exploratory analyses indicated no predictor or moderator effects for the onset or persistence of depression, comorbid anxiety disorders or Cluster-C PDs (all p > .28). LimitationsLimitations include small sample sizes for some of the subsamples. ConclusionChildhood sexual abuse seems to moderate treatment effectiveness in a sample of severely affected outpatients with MDD treated with MCT or BA. If confirmed in further trials, a history of sexual abuse might guide the choice between MCT and BA. Trial registrationGerman Clinical Trials Register DRKS-ID: DRKS00011536 (retrospectively registered on February 13, 2017, without changes to the study protocol).

Stressing the System: Pediatric Trauma Centers May Be Unready to Implement Comprehensive Acute Stress Screening Programs for Pediatric Trauma Patients.

Children experiencing trauma are at risk of developing acute and chronic stress disorders. In 2022, the American College of Surgeons Committee on Trauma required verified pediatric trauma centers to screen at-risk patients and provide mental health provider referrals as needed. The study objective is to assess the current readiness of pediatric trauma centers to meet the new American College of Surgeons requirements. This study used an exploratory, electronic, cross-sectional survey design. The Pediatric Trauma Society distributed a survey on mental health screening practices to its members in February 2023. Results were summarized with descriptive statistics. Chi-square test was used to compare responses of Levels I and II pediatric trauma centers. There were 91 survey responses from the PTS membership of 1247 (response rate of 7.3%). Fifty-nine participants were from Level I and 27 from Level II pediatric trauma centers. 63.8% of Level I and 51.9% of Level II center respondents currently screened for acute stress (χ2(1)=1.09, p =.30). Of these, 75.7% of Level I and 57.1% of Level II center respondents routinely screened all admitted trauma patients (χ2(1)=1.68, p =.19). However, only 32.4% of Level I and 21.4% of Level II respondents reported having outpatient acute stress referral protocols. For pediatric trauma centers currently without screening, 65% of Level I and 46.2% of Level II pediatric trauma center respondents felt they needed more than six months to establish a program (χ2(1)=1.15, p =.28). Most respondents (68.9%) reported staff shortages as a barrier to the delivery of acute stress services. Pediatric trauma center compliance with acute stress screening requirements for verification is variable. Pediatric trauma centers may benefit from technical assistance with acute stress screening.

Trauma, Attachment, Emotions, and Voice Care: Exploratory Research

Abstract: Previous research has indicated that early-life experiences can impact an adult in a variety of ways, from health, to behavior, to voice, to the likelihood of seeking support when needed. The authors, across two preliminary studies, investigate relationships between psychological factors (e.g. childhood trauma, attachment, emotions), Voice Handicap Index (VHI) and Voice-related Quality of Life (VRQOL) measures, and whether participants ever saw a voice specialist. Across samples, we hypothesized that psychological measures would demonstrate relationships with VHI, VRQOL and seeking care. Our predictions were partially supported. These studies open a window to the importance of exploring specific psychological factors in relation to voice and as potential barriers to voice care.

Erratum. The Relationship Between Childhood Trauma, Exercise Addiction, Emotion Regulation Difficulties, and Basic Psychological Needs in Türkiye

Erratum. The Relationship Between Childhood Trauma, Exercise Addiction, Emotion Regulation Difficulties, and Basic Psychological Needs in Türkiye

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

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

Affective neuroscience personality traits in opioid use disorder patients: The relationship with earlier onset of substance use, the severity of addiction, and motivational factors to quit opiate use.

This study aims to explore the relationship between affective personality traits and opioid use disorder (OUD), including factors such as motivation to quit, addiction severity, and age of onset of drug use. This study included 141 patients with opioid addiction (OAP) and 160 age- and sex-matched healthy controls (HC). OAP were interviewed and diagnosed according to DSM-5 criteria. HC were screened for past or current drug use. Participants completed sociodemographic forms and the Affective Neuroscience Personality Scale (ANPS), and the OAP group also completed the Addiction Profile Index (API). SEEK, PLAY, and SADNESS were identified as different affective personality traits between OAP and HC groups. Addiction severity was positively correlated with SADNESS and ANGER, while the age of onset of drug use was correlated with ANGER. Risk factors for OA include family history of substance abuse, low education, and low PLAY scores, whereas risk factors for earlier substance use onset are childhood trauma and high ANGER scores. This study highlights the importance of understanding affective personality traits in OUD. These findings may deepen our understanding of the underlying mechanisms of OUD. The identification of these affective systems may have implications for the development of personalized prevention and treatment strategies.