Physical Neglect Research Articles

Childhood trauma types in relation to antipsychotic effectiveness in schizophrenia spectrum disorders: A prospective, pragmatic, randomized controlled study

Treatment with antipsychotics (APs) for schizophrenia spectrum disorders (SSDs) is generally effective, however, a significant proportion does not respond favorably. Childhood trauma (CT) subtypes (physical, sexual, and emotional abuse, physical and emotional neglect) could influence treatment effectiveness; however, research is scarce. Heterogeneity in AP response could be explained by differentiating by CT subtype. The present study was based on the Bergen-Stavanger-Trondheim-Innsbruck (BeSt InTro) study. CTQ-SF assessed CT subtypes in SSDs (n = 98). CT subtypes were examined in relation to psychosis symptoms measured by PANSS during one year of treatment with APs, by means of linear mixed effects (LME) models. Results were significant for CT subtypes, where increased levels of sexual abuse and physical neglect were associated with increased mean levels of psychosis symptoms throughout the course of treatment from baseline to 52 weeks. AP effectiveness may thus be influenced by CT subtype in SSDs. The results support clinical guidelines recommending a focus on assessment and treatment of trauma in SSDs.

Childhood trauma, resilience, psychopathology and social functioning in schizophrenia: A network analysis

The affective pathway to psychosis implicates affective symptoms and neuroticism as mediating steps between childhood trauma and symptoms of schizophrenia. Prior research seldom examined the interplay between childhood trauma, resilience, personality, social functioning and symptoms in schizophrenia patients. This study recruited 290 schizophrenia patients, and constructed a regularized partial correlation network of childhood trauma, resilience, big-five personality traits, symptoms and social functioning. We further applied flow diagram and shortest path analysis to clarify how different childhood trauma types would contribute to and reach different symptoms. In the network, emotional and physical abuse showed the highest expected influence, and resilience showed the highest strength. In flow diagrams, all nodes together contributed two-thirds of variance of social functioning (which had highest predictability). Among childhood trauma types, emotional abuse contributed most to positive symptoms; physical neglect contributed most to negative, depressive and disorganized symptoms. Childhood abuse reached positive symptoms via neuroticism and depressive symptoms, yet it reached negative symptoms via physical neglect and social functioning. Childhood neglect reached positive symptoms via resilience, conscientiousness, neuroticism and depressive symptoms, yet it reached negative symptoms via social functioning. Our findings support that different childhood trauma types contribute to different symptoms, and interacts with resilience, personality and social functioning.

Child maltreatment and behavioral health outcomes in child welfare: Exploring the roles of severity and polyvictimization

BackgroundChild maltreatment and polyvictimization are known risk factors for long-term detrimental health and development outcomes, including behavioral health challenges. However, effects from specific types and combinations of maltreatments are unclear. This study examined the association between maltreatment or polyvictimization and behavioral health in a child welfare sample. Participants and settingMedical records of children with child welfare involvement with at least one behavioral health condition (i.e., mental, behavioral or neurodevelopmental disorder, ICD-10 F01-F99) between 1/1/2018–12/31/2021 were extracted from a large, academic hospital system. MethodsBehavioral health complexity was categorized as non-chronic, non-complex chronic, or complex chronic using the Pediatric Medical Complexity Algorithm. Partial proportional logistic regression models adjusted for age, sex, race/ethnicity, caregiver type, and physical health complexity generated odds of behavioral health complexity by maltreatment type (physical abuse, sexual abuse, neglect) and maltreatment combinations. ResultsThe analytic sample included 3992 participants (mean age 7.6 (Standard Deviation, 5.0) 44 % female, 29 % white, 32 % black, 22 % Hispanic). Participants who experienced physical abuse (Odds Ratio [OR]: 1.79, 95 % Confidence Interval [CI]: 1.10–2.91), or neglect (OR: 1.69, 95 % CI: 1.38–2.07) were more likely to have increasing behavioral health complexity versus those without maltreatment. Participants with both physical abuse and neglect were over twice as likely (OR: 2.44, 95 % CI: 1.88–3.16) to have increasing behavioral health complexity versus those who did not experience maltreatment. ConclusionResults emphasize the differential impacts of maltreatment and polyvictimization exposures on behavioral health complexity among children with child welfare involvement that can guide risk assessment and clinical care.

Exploring the prevalence of childhood adversity among university students in the United Kingdom: A systematic review and meta-analysis.

The focus of this review was to systematically review and meta-analyse the prevalence of ACEs among university students in the UK. The systematic searching of six electronic databases (conducted February 2024) identified ten relevant articles (peer-reviewed articles of a quantitative nature that included ACE prevalence). PROSPERO reference: CRD42022364799. Pooled prevalence for number of ACEs endured was 55.4% (95% CI: 32.4% - 78.4%; I2 > 99.5%) for one or more, and 31.6% (7.5% - 55.6%; I2 > 99.5%) for three or more. Pooled prevalence was: 15.9% (7.0% - 24.7%; I2 > 94.5%) for physical abuse; 27.0% (18.1% - 35.9%; I2 > 94.5%) for emotional abuse; 12.1% (5.2% - 19.0%; I2 > 94.5%) for sexual abuse; 8.4% (1.7% - 15.1%; I2 > 95.4%) for physical neglect, and 30.0% (21.5% - 38.5%; I2 > 95.4%) for emotional neglect. Pooled prevalence for household dysfunction categories were: 34.4% (22.8% - 46.0%) for parental separation; 18.4% (10.1% - 26.8%) for domestic violence; 35.2% (23.6% - 46.8%) for mental health difficulties; 21.4% (12.9% - 29.9%) for substance use; and 5.7% (2.3% - 9.1%) for incarceration (I2 > 88.8% for all household dysfunction items). Significant heterogeneity was observed between studies for most categories of adversity, and it was not possible to explain/reduce this variance by removing small numbers of influential/discrepant studies. Further analyses suggested potential influences of measurement tool used, country of data collection, and age and sex of participants. Results demonstrate considerable, largely unaccounted-for, heterogeneity in estimates of the prevalence of ACEs, impeding confidence in any summary statistics. Conclusions must be tentative due to analyses being underpowered given small numbers of papers, as well as potential confounds, meaning results may not be truly representative. However, results do suggest high prevalence rates which warrant further investigation, with appropriate support offered to students.

Risk factors related to the mental health issues of selected South African adolescent learners living with mild to moderate intellectual difficulties

PurposeThe risk factors related to the mental health issues of adolescents diagnosed with mild to moderate intellectual difficulties (MMID) are not consistently recognised in South Africa. This paper aims to address the scarcity of literature by examining the risk factors linked to the mental health issues of adolescents with MMID.Design/methodology/approachFour hundred and fourteen participants were sampled from adolescent learners attending three special educational needs schools in Gauteng, South Africa. The selected sample included 275 male and 139 female participants with a median age of 16.5 years. The three schools represented Grade 8 with 177 learners and Grade 9 with 237 learners. Data were collected through a biographical questionnaire and an Adverse Child Experiences Questionnaire. A quantitative approach was used to identify the risk factors impacting the mental health of adolescents with MMID. The findings were used to propose intervention programmes for the support of adolescents diagnosed with MMID.FindingsThe findings suggest that risk factors for mental health difficulties issues among adolescents with MMID include family dysfunction, along with experiences of physical, sexual and verbal abuse as well as emotional and physical neglect. The recommendations stemming from the findings advocate empowering teachers, parents and caregivers to provide support for the mental health of learners with MMID.Originality/valueThe study makes a valuable contribution to reducing the existing gap in the literature regarding risk factors impacting the mental health of adolescents with MMID in South Africa. The study served as a platform for adolescents diagnosed with MMID to articulate their challenges. This cohort is occasionally marginalised and this research acts as an active contribution to research that focuses on their experiences. Their insights are crucial for enhancing intervention programmes and promoting their overall well-being.

From Early Trauma to Cardiovascular Risk Among a Nationally Representative Sample of Young Adults.

This study aimed to investigate the connection between childhood abuse history and cardiovascular health indicators among a nationally representative sample of young adults aged 24-32. Using data from waves three and four of the National Longitudinal Study of Adolescent to Adult Health (n = 4, 164) multivariate logistic regression was employed to investigate childhood trauma (i.e., childhood physical abuse, sexual abuse, and neglect) as predictors for cardiovascular disease, hypertension, high cholesterol, diabetes, and obesity. Results showed that adults who reported history of sexual abuse were 4.3 times more likely to report diagnosis of cardiovascular disease and those who reported childhood physical abuse at wave three had 1.4 times the odds of reporting high cholesterol diagnosis. Although trauma history is often calculated as a composite, some forms of childhood abuse may have greater impacts on cardiovascular risk than others.

A Transdiagnostic Network Analysis of Childhood Trauma and Psychopathology.

Psychiatric comorbidities suggest that symptoms overlap across different diagnoses; the transdiagnostic network approach is valuable for studying psychopathology. Childhood trauma is a common transdiagnostic risk factor for psychiatric disorders, but the complex relationship between childhood trauma and psychopathology has seldom been investigated using a large cross-sectional transdiagnostic sample. This study recruited 869 patients with different diagnoses, including 418 schizophrenia, 215 bipolar disorder, and 236 major depressive disorder. Participants completed psychiatric interviews and self-report questionnaires. We constructed dimension- and item-level Least Absolute Shrinkage and Selection Operator-based (LASSO) networks to explore the relationship between childhood trauma, psychopathology, and duration of illness. Moreover, we constructed directed acyclic graphs (DAGs) to tentatively clarify the potential directions of associations among these variables. Network Comparison Tests (NCTs) were conducted for different diagnostic groups and gender-stratified groups. The transdiagnostic LASSO networks showed that different types of childhood trauma exerted distinct impacts on various psychopathological dimensions. Emotional abuse was linked to depressive symptoms, physical abuse to excited symptoms, sexual abuse to positive and disorganized symptoms, emotional neglect to depressive symptoms and motivation and pleasure (MAP) deficits factor of negative symptoms, and physical neglect to MAP factor. The DAG findings generally concurred with the LASSO network. The NCT showed comparable networks. Our findings suggest that childhood trauma is significantly associated with the development of psychopathology across different diagnostic groups. The affective pathway model suggests that early identification and tailored interventions would be needed for people with a history of childhood trauma.

The mediating effects of school bullying victimization in the relationship between childhood trauma and NSSI among adolescents with mood disorders

BackgroundNonsuicidal self-injury (NSSI) is a serious problem in the adolescent population worldwide. Childhood trauma and bullying have been identified as risk factors for NSSI. We explored the relationships among Childhood trauma, Bullying victimization and the severity of NSSI behaviours, and test the effect of Bullying victimization in mediating the association between Childhood trauma and the NSSI behaviours.MethodsA total of 123 adolescents were recruited. They were diagnosed with depression or depressive episodes of bipolar disorder and had experienced NSSI in the last year. They were assessed using the Chinese version of the Childhood Trauma Questionnaire (CTQ-C), the Revised Olweus Bullying Victimization Questionnaire (OBVQ-R), and the Adolescent Self-Harm Questionnaire (ASHQ).ResultsFemales presented a significantly greater prevalence of sexual abuse and relationship bullying than boys. Individuals in the younger age group (10–14 years) presented a greater incidence of emotional neglect, verbal bullying, relationship bullying, and total bullying, and their NSSI score was also higher than that of those in the older age group (15–19 years). Only children show a greater prevalence of sexual abuse than nononly children. Single-parent families scored higher on emotional abuse, emotional neglect, physical neglect and physical bullying than two-parent families. There was a significant positive correlation between each dimension of childhood trauma and all the dimensions of bullying, between childhood trauma and NSSI, and between bullying and NSSI. Childhood trauma can not only directly affect the severity of NSSI but also indirectly aggravate the severity of NSSI through bullying victimization. The mediating effects of bullying victimization on emotional abuse, physical abuse, emotional neglect and physical neglect were 14%, 21%, 20%, 13% and 20%, respectively.ConclusionThere was a significant positive correlation between childhood trauma and bullying, between childhood trauma and NSSI, and between bullying and NSSI. Childhood trauma can not only directly affect the severity of NSSI but also indirectly aggravate the severity of NSSI through bullying victimization. Bullying victimization played the partial mediating effects between Childhood trauma and NSSI.

The impact of childhood abuse on patients with obsessive–compulsive disorder: an Egyptian study

BackgroundThe presence of childhood abuse is expected to have a great impact on several psychological domains on obsessive–compulsive disorder (OCD) patients. This study was designed to assess the psychological impact of history childhood abuse (emotional abuse, physical abuse, sexual abuse, and emotional and physical neglect) on five psychological domains among OCD patients (self-esteem, depression, suicidal risk, cognitive functions, and anxiety).MethodsThis cross-sectional study included 101 OCD patients who were seen in the psychiatric department’s outpatient clinic at Zagazig University Hospital. They were diagnosed according to DSM-IV (SCID-I interview). All the patients were assessed using Childhood Trauma Questionnaire (CTQ-28), the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM-A), Beck’s Suicide Scale, Rosenberg Self-Esteem Scale, and the MoCA scale (Montreal Cognitive Assessment Test).ResultsThe prevalence of childhood abuse in the studied group was 74.3%. 24.8% with emotional abuse, 20.8% with physical abuse, 16.8% with sexual abuse, and 11.9% of patients with emotional and physical neglect. The different types of childhood abuse (emotional, physical, and sexual abuse) were significantly associated with decreased self-esteem and increased depressive symptoms, while emotional and physical neglect were associated with decreased self-esteem only among OCD patients. The most powerful and significant predictor of lower self-esteem and depression was sexual abuse, and it was also the only significant predictor of increased suicidal risk among OCD patients.ConclusionsHistory of childhood abuse was significantly associated with decreased self-esteem and increased depressive symptoms among OCD patients. Only history of sexual abuse was significantly associated with increased suicidal risk. So, evaluation of the childhood abuse history is highly important among OCD patients to be incorporated in the management plan to reduce the suffering of OCD patients and for better improvement.

History of childhood maltreatment associated with hospitalization or death due to COVID-19: a cohort study

BackgroundChildhood maltreatment (CM) has been indicated in adverse health outcomes across the lifespan, including severe infection-related outcomes. Yet, data are scarce on the potential role of CM in severe COVID-19-related outcomes as well as on mechanisms underlying this association.MethodsWe included 151,427 individuals in the UK Biobank who responded to questions on the history of CM in 2016 and 2017 and were alive on January 31, 2020. Binomial logistic regression models were performed to estimate the association between a history of CM and severe COVID-19 outcomes (i.e. hospitalization or death due to COVID-19), as well as COVID-19 diagnosis and vaccination as secondary outcomes. We then explored the potential mediating roles of socio-economic status, lifestyle and pre-pandemic comorbidities, and the effect modification by polygenic risk score for severe COVID-19 outcomes.ResultsThe mean age of the study population at the start of the pandemic was 67.7 (SD = 7.72) years, and 56.5% were female. We found the number of CM types was associated with the risk of severe COVID-19 outcomes in a graded manner (pfor trend < 0.01). Compared to individuals with no history of CM, individuals exposed to any CM were more likely to be hospitalized or die due to COVID-19 (odds ratio [OR] = 1.54 [95%CI 1.31–1.81]), particularly after physical neglect (2.04 [1.57–2.62]). Largely comparable risk patterns were observed across groups of high vs. low genetic risks for severe COVID-19 outcomes (pfor difference > 0.05). Mediation analysis revealed that 50.9% of the association between CM and severe COVID-19 outcomes was explained by suboptimal socio-economic status, lifestyle, and pre-pandemic diagnosis of psychiatric disorders or other chronic medical conditions. In contrast, any CM exposure was only weakly associated with COVID-19 diagnosis (1.06 [1.01–1.12]) while significantly associated with not being vaccinated for COVID-19 (1.21 [1.13–1.29]).ConclusionsOur results add to the growing knowledge base indicating the role of childhood maltreatment in negative health outcomes across the lifespan, including severe COVID-19-related outcomes. The identified factors underlying this association represent potential intervention targets for mitigating the harmful effects of childhood maltreatment in COVID-19 and similar future pandemics.

'The Relationship Between Childhood Traumas and Social Cognition Through Theory of Mind and Alexithymia in Bipolar Disorder'.

This study aimed to investigate the potential differences in childhood trauma (CT), theory of mind (ToM), a significant component of social cognition, and alexithymia in bipolar disorder (BD) patients and healthy controls. The study included 50 BD patients who met the study criteria and were under follow-up at our clinic along with 50 healthy controls. The two groups were matched for age, gender, and educational status. A sociodemographic questionnaire, Childhood Trauma Questionnaire (CTQ), Toronto Alexithymia Scale (TAS), Dokuz Eylul Theory of Mind Index (DEZIKO), Hamilton Depression Rating Scale (HDRS), and Young Mania Rating Scale (YMRS) were applied to all participants. The CTQ-Total, TAS total, and DEZIKO total scores were significantly higher in the BD group compared to the healthy group (p < .001). A significant positive correlation was identified between the TAS total score and CTQ physical neglect (r = 0.472, p = .001), CTQ emotional neglect (r = 0.449, p = .001) and CTQ total scores (r = 0.5, p < .001) in the BD group. A statistically significant negative correlation was identified between the DEZIKO faux pas score and the CTQ physical neglect score (r = -0.437, p = .002). BD patients had more adverse childhood experiences, lower ToM abilities despite being in remission, and more pronounced alexithymic personality features compared to healthy controls. We also identified a relationship between ToM, alexithymia, and adverse childhood experiences in BD.

Childhood Maltreatment and Longitudinal Epigenetic Aging

Child physical and emotional abuse and neglect may affect epigenetic signatures of accelerated aging several years after the exposure. To examine the longitudinal outcomes of early-childhood and midchildhood exposures to maltreatment on later childhood and adolescent profiles of epigenetic accelerated aging. This cohort study used data from the Future of Families and Child Wellbeing Study (enrolled 1998-2000), a US birth cohort study with available DNA methylation (DNAm) data at ages 9 and 15 years (assayed between 2017 and 2020) and phenotypic data at birth (wave 1), and ages 3 (wave 3), 5 (wave 4), 9 (wave 5), and 15 (wave 6) years. Data were analyzed between June 18 and December 10, 2023. Emotional aggression, physical assault, emotional neglect, and physical neglect via the Parent-Child Conflict Tactics Scale at ages 3 and 5 years. Epigenetic accelerated aging (DNAmAA) was measured using 3 machine learning-derived surrogates of aging (GrimAge, PhenoAge, and DunedinPACE) and 2 machine learning-derived surrogates of age (Horvath and PedBE), residualized for age in months. A total of 1971 children (992 [50.3%] male) representative of births in large US cities between 1998 and 2000 were included. Physical assault at age 3 years was positively associated with DNAmAA for PhenoAge (β = 0.073; 95% CI, 0.019-0.127), and emotional aggression at age 3 years was negatively associated with PhenoAge DNAmAA (β = -0.107; 95% CI, -0.162 to -0.052). Emotional neglect at age 5 years was positively associated with PhenoAge DNAmAA (β = 0.051; 95% CI, 0.006-0.097). Cumulative exposure to physical assault between ages 3 and 5 years was positively associated with PhenoAge DNAmAA (β = 0.063; 95% CI, 0.003-0.123); emotional aggression was negatively associated with PhenoAge DNAmAA (β = -0.104; 95% CI, -0.165 to -0.043). The association of these measures with age 15 years PhenoAge DNAmAA was almost fully mediated by age 9 years PhenoAge DNAm age acceleration. Similar patterns were found for GrimAge, DunedinPACE, and PhenoAge, but only those for PhenoAge remained after adjustments for multiple comparisons. In this cohort study, altered patterns of DNAmAA were sensitive to the type and timing of child maltreatment exposure and appeared to be associated with more proximate biological embedding of stress.

Childhood traumatic experiences and complex posttraumatic stress disorder in Chinese adolescents: The mediating role of attachment.

The prevalence of child maltreatment is high in China. Child maltreatment damages children's developing abilities (e.g., emotional functions, self-perception) and is highly associated with a new diagnostic disorder, namely, complex posttraumatic stress disorder (CPTSD). The mechanism of CPTSD is not clear, and attachment might be a crucial factor in the development of CPTSD symptoms. The prevalence of child maltreatment is high in China. Child maltreatment damages children's developing abilities (e.g., emotional functions, self-perception) and is highly associated with a new diagnostic disorder, namely, complex posttraumatic stress disorder (CPTSD). The mechanism of CPTSD is not clear and attachment might be a crucial factor in the development of CPTSD symptoms. To explore the mediating roles of attachment anxiety and attachment avoidance in the relationship between five forms of childhood trauma (i.e., physical abuse, physical neglect, emotional abuse, emotional neglect, sexual abuse) and CPTSD symptoms. The present study included 395 adolescents who had experienced at least one type of traumatic childhood experience. Our findings showed that emotional abuse could predict posttraumatic stress disorder and disturbances of self-organization (DSO) symptoms via attachment anxiety. In addition, childhood neglect experiences (i.e., physical and emotional neglect) could predict DSO symptoms via attachment avoidance. Attachment is an important framework for understanding individuals' CPTSD symptoms following childhood traumatic experiences. Parents and educators should learn effective parenting styles that promote secure attachment, while researchers and clinical practitioners should further explore attachment-based trauma intervention approaches. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Self-stigma mediates the relationships between childhood maltreatment and symptom levels of PTSD, depression, and anxiety

ABSTRACT Background: Childhood maltreatment is a risk factor for developing multiple forms of psychopathology, including depression, posttraumatic stress disorder (PTSD), and anxiety. Yet, the mechanisms linking childhood maltreatment and these psychopathologies remain less clear. Objective: Here we examined whether self-stigma, the internalization of negative stereotypes about one's experiences, mediates the relationship between childhood maltreatment and symptom severity of depression, PTSD, and anxiety. Methods: Childhood trauma survivors (N = 685, Mage = 36.8) were assessed for childhood maltreatment, self-stigma, and symptoms of depression, PTSD, and anxiety. We used mediation analyses with childhood maltreatment as the independent variable. We then repeated these mediation models separately for childhood abuse and neglect, as well as the different subtypes of childhood maltreatment. Results: Self-stigma significantly mediated the relationship between childhood maltreatment and depression, PTSD, and anxiety symptoms. For sexual abuse – but not physical or emotional abuse – a significant mediation effect of self-stigma emerged on all symptom types. For childhood neglect, self-stigma significantly mediated the relationship between both emotional and physical neglect and all symptom types. Conclusion: Our cross-sectional study suggests that different types of childhood maltreatment experiences may relate to distinct mental health problems, potentially linked to increased self-stigma. Self-stigma may serve as an important treatment target for survivors of childhood abuse and neglect.

Impact of alexithymia, attachment styles, and childhood traumas on the severity of body-focused repetitive behavior disorders

It is known that childhood traumas is associated with attachment problems, alexithymia and lead to some psychiatric disease. This study was investigated the relationship of body focused repetitive behavior disorders (BFRBDs) to childhood trauma, attachment styles, and alexithymia, and the impact of these factors on the severity of the disorder. 105 patients with BFRBDs and 90 healthy controls matched for age and sex were comprised in the study. Participants were administered sociodemographic data form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Clinical Global Impression (CGI), Toronto Alexythimia Scale (TAS-20), Experiences in Close Relationships-II (ECR-II) and Childhood Traumatic Experiences Questionnairre (CTQ-28). Presence of childhood trauma, depression and anxious attachment score were found to be risk factors for the occurrence of BFRBDs. Physical neglect was found to have an indirect effect on the disease severity through the high score of externally-oriented thinking. Therefore, it should be kept in mind that patients who tend to present themselves as normal and do not express their problems/conflicts have a high severity of disease. In addition, it may be important to plan therapeutic interventions in patients according to their comorbidities such as alexithymia, attachment and childhood trauma.

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

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

Childhood Physical Maltreatment and Borderline Personality Disorder Features in Adolescents: Mediating and Moderating Effects of Attachment Styles and Gender

ABSTRACT Childhood physical maltreatment may contribute to the onset of borderline personality disorder (BPD) features in adolescence; however, the mechanisms explaining this association warrant investigation. This study focused on insecure attachment styles as mediators in this relationship among a sample of adolescents. Analyses were also conducted to determine whether gender moderated the association between physical maltreatment and BPD features. The sample consisted of 529 Italian adolescents between 14 and 18 years (Mage = 16.48, SD = 1.37). Participants completed a survey including three self-report questionnaires: CTQ-SF, ASQ, and BPI. Physical abuse was related to BPD features through insecure-anxious and insecure-avoidant attachment styles, whereas physical neglect was associated with BPD features only through insecure-avoidant attachment. Gender moderated the pathway between physical maltreatment and BPD features so that boys who experienced childhood physical abuse and neglect reported more BPD features than girls. This study expanded our knowledge of the role of insecure attachment styles in the onset of BPD features among adolescents with early experiences of childhood physical maltreatment. This study also advances our understanding of potential gender differences in the childhood maltreatment-BPD features link in adolescents.

Factor analysis of dissociative personality disorder in Multimedia Communication Engineering students

The objective of this research is to identify a possible relationship between a pathological profile of dissociation in higher education students, with respect to the variables of consumption of addictive substances, violence in childhood, eating disorders, cognitive dysfunctions and work stress. The selected methodology is based on correlational quantitative analysis, under an ex post facto research design. The measurement instruments used are the Dissociative Experiences questionnaire (DES II), the Eating Disorders Inventory (EDI-3), the Addictions test (dast-10), the Mini-Mental (MMSE), the of Child Abuse (CTQ-SF) and the Work Stress Inventory (CPP). With the above, it is suggested that the group diagnosed with a dissociative personality disorder presents significant differences with respect to the five variables evaluated; Furthermore, for this group there is a prevalence with a high index on the stress scales, characterized by a form of compulsion and the presence of discomfort at an organic level. For the group evaluated with a non-dissociative personality profile, incipient cases of abuse, physical neglect and sexual abuse were identified. This condition requires correct channeling and rehabilitation due to its high progression in self-destructive behaviors.

Alexithymia as a mediator between adverse childhood events and the development of psychopathology: a meta-analysis.

Victims of child abuse have an elevated risk of developing mental health issues later in life. Several variables have been suggested as mediators of this correlation, but little is known about the possible influence of alexithymia. Alexithymia is a sub-clinical personality trait that manifests as difficulties recognizing and verbalizing emotions. In this study, two separate meta-analyses were conducted using questionnaire data, and Pearson correlations for overall effects were estimated. The correlation between child abuse and alexithymia showed to be significant (r = .26), as did the correlation between alexithymia and general psychopathology (r = .44). Further analyses revealed no indication for possible publication bias. When investigating differences between various subtypes of child maltreatment, each subtype significantly correlated with alexithymia. Emotional abuse, emotional neglect, and physical neglect had stronger correlations than physical and sexual abuse. These results suggest that alexithymia plays a mediating role, at least in part, in the relationship between experiences of child abuse and general psychopathology in adulthood. Therefore, alexithymia may be relevant to further research and deserves attention in the prevention of and therapy for mental health issues in victims of child abuse.

"What you're born with, you die with." Half a Lifetime of Psychiatric Care for a Traumatized Young Woman With Cystic Fibrosis.

This case report describes 19 years of psychiatric care of a young female survivor of childhood sexual and physical abuse and neglect who also had the misfortune of having a life-compromising and life-limiting physical disease, cystic fibrosis. It summarizes ~ 100 therapeutic contacts from age 21 to age 40 and spans her journey through lung transplantation to the end of her life. The nature of cystic fibrosis and its treatment is reviewed and there is a discussion of the therapeutic process. The case is enriched by emails from the young woman describing her struggles to maintain personal integrity as her lung function declined. The case is presented with the young woman's consent.