Psychosocial Adversity Research Articles

Psychosocial adversity and the developing brain: Findings from the abcd study on 10,000 us children

BackgroundChildhood exposure to social risk has the potential to disrupt brain development and increase vulnerability to adverse mental health outcomes. Here, we examine the effect of adversity on brain structure and psychopathology in the Adolescent Brain and Cognitive Development (ABCD) study, a US population-based sample of 10 year-olds.MethodsPersonal, caregiver, family and neighborhood characteristics were considered in 9299 unrelated children [age: mean (sd)=9.9 y (0.6); 53% males]. Hidden Markov Models were used identify clusters of participants based on their psychosocial exposure. The identified clusters were compared in terms of current psychopathology, lifetime psychiatric diagnosis, intelligence and brain structure.ResultsABCD participants clustered in to a “disadvantaged” group (N=4205) with multiple adverse exposures, and an “enriched” group (N= 5094) with limited exposure to adversity and multiple protective factors. Compared to the enriched group, the disadvantaged group had higher levels of all types of psychopathology and lifetime psychiatric diagnoses; lower scores on fluid and crystallized intelligence; smaller subcortical volumes; thinner sensorimotor cortices and thicker cortex in frontal regions; smaller surface area in temporal regions and larger surface area in the posterior cingulate cortices (all p<0.05 following Bonferroni correction for multiple testing).ConclusionsSocial adversity has significant and wide-ranging consequences for brain development and psychopathology, that shows little specificity for types of symptoms.DisclosureNo significant relationships.

Teenage pregnancies resulting from rape in Sri Lanka – lessons learned

IntroductionRape resulting in pregnancy warrants special attention due to the associated psychosocial and physical adversities. There are no guidelines for the management of teenage pregnancies resulting from rape in Sri Lanka.ObjectivesThis case series aims to describe the experience of four teenagers who became pregnant as a result of rape in Sri Lanka.MethodsThis is a case series of 4 pregnant teenagers who became pregnant as a result of rapeResultsThis case series highlight the deficiencies in services in Sri Lanka such as lack of legal framework to terminate pregnancy following rape, delay in legal procedure leading to prolonged institutionalization of pregnant teenager, not giving the teenage mothers the choice of breastfeeding and lack of awareness about the psychological consequences of rape and teenage pregnancy.ConclusionsFormulating a national guideline on managing rape related pregnancy in teenagers in Sri Lanka, with the involvement of all stakeholders is a need of the hour.DisclosureNo significant relationships.

Why do some pregnant women not fully disclose at comprehensive psychosocial assessment with their midwife?

ProblemWhile comprehensive psychosocial assessment is recommended as part of routine maternity care, unless women engage and disclose, psychosocial risk will not be identified or referred in a timely manner. We need to better understand and where possible overcome the barriers to disclosure if we are to reduce mental health morbidity and complex psychosocial adversity. AimsTo assess pregnant women’s attitude to, and reasons for non-disclosure at, comprehensive psychosocial assessment with their midwife. MethodsData from 1796 pregnant women were analysed using a mixed method approach. After ascertaining women’s comfort with, attitude to, and non-disclosure at psychosocial screening, thematic analysis was used to understand the reasons underpinning non-disclosure. Findings99% of participants were comfortable with the assessment, however 11.1% (N = 193) reported some level of nondisclosure. Key themes for non-disclosure included (1) Normalising and negative self-perception, (2) Fear of negative perceptions from others, (3) Lack of trust of midwife, (4) Differing expectation of appointment and (5) Mode of assessment and time issues. DiscussionFactors associated with high comfort and disclosure levels in this sample include an experienced and skilled midwifery workforce at the study site and a relatively advantaged and mental health literate sample. Proper implementation of psychosocial assessment policy; setting clear expectations for women and, for more vulnerable women, extending assessment time, modifying mode of assessment, and offering continuity of midwifery care will help build rapport, improve disclosure, and increase the chance of early identification and intervention. ConclusionsThis study informs approaches to improving comprehensive psychosocial assessment in the maternity setting.

ELEMENTS THAT CONTRIBUTE TO RESILIENCE IN YOUNG WOMEN FROM A HIGH-RISK COMMUNITY

This article reports on the elements contributing to the resilience of young women living in a high-risk urban community in the North-West province (NW) of South Africa who cope with various forms of adversity. Young Black Africans in South Africa face a myriad of, particularly in informal settlement communities. High-risk factors include psychosocial threats and structural adversity. A qualitative challenges descriptive approach using semi-structured interviews with 14 participants was utilized. Major findings indicated that religion is a protective factor fostering resilience. Strong altruistic tendencies, for instance, to serve as role models and peer mentors to other at-risk young women in the community were presented as internal assets. Maternal figures provide external social support. Communities and practitioners should monitor and make available opportunities for programmes and peer mentorship initiatives supporting the acquisition of personal and social assets, as well as for attaining goals that promote wellbeing of the young, particularly those who are disadvantaged. There should be more focus on cultural practices in research by social workers. This project contributes to South African research on indigenous studies.

Emotion Induced Monoamine Neuromodulator Release Affects Functional Neurological Disorders.

Functional neurologic disorders (FNDs), also called conversion disorder (previously called hysteria), can show almost all the symptoms of other neurological diseases, including both physical (for example, seizure, weakness, fatigue) and psychological (for instance, depression, anxiety) symptoms. In spite of our general knowledge about emotional processes and developmental defects in the formation of these somatic symptoms, there is still no systemic and comprehensive research on the effects of emotional developmental variables in FND. Recently, both experimental and theoretical emotion studies have been greatly increased, such as prediction error, conceptual act model, basic emotional theory, and monoamine neuromodulator based three primary emotions. In addition, a large amount of evidence has confirmed the role of psychosocial adversity (such as stressful life events, interpersonal difficulties) as an important risk factor for FND. Here, we review recent advances about emotional stress on FND, and pay special attention to the effects of monoamine neuromodulators, such as how norepinephrine and serotonin affect behaviors. Then, we discuss the significance of these changes for FND, which may contribute to clarifying the pathogenesis of FND, and thus provide potential therapeutic drug targets or psychological intervention methods in the future.

Childhood Risk Factors and Adulthood Cardiovascular Disease: A Systematic Review

To conduct a comprehensive review of the literature on childhood risk factors and their associations with adulthood subclinical and clinical cardiovascular disease (CVD). A systematic search was performed using the MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science databases to identify English-language articles published through June 2018. Articles were included if they were longitudinal studies in community-based populations, the primary exposure occurred during childhood, and the primary outcome was either a measure of subclinical CVD or a clinical CVD event occurring in adulthood. Two independent reviewers screened determined whether eligibility criteria were met. There were 210 articles that met the predefined criteria. The greatest number of publications examined associations of clinical risk factors, including childhood adiposity, blood pressure, and cholesterol, with the development of adult CVD. Few studies examined childhood lifestyle factors including diet quality, physical activity, and tobacco exposure. Domains of risk beyond "traditional" cardiovascular risk factors, such as childhood psychosocial adversity, seemed to have strong published associations with the development of CVD. Although the evidence was fairly consistent in direction and magnitude for exposures such as childhood adiposity, hypertension, and hyperlipidemia, significant gaps remain in the understanding of how childhood health and behaviors translate to the risk of adulthood CVD, particularly in lesser studied exposures like glycemic indicators, physical activity, diet quality, very early life course exposure, and population subgroups.

Family resilience and protective factors promote flourishing and school engagement among US children amid developmental disorder and adverse psychosocial exposure

Early life psychosocial adversities and developmental disorders are common among children in the United States. However, there is relatively little research on how family processes and neighborhood-level factors may promote well-being among children dually burdened with developmental disorders (DD) and adverse childhood experience (ACE). Using secondary analysis of the National Survey of Children’s Health 2016–2018 (N = 56,831), we examined the associations of family resilience and other protective factors with flourishing and school engagement among subgroups of children with dual exposure to DD and ACE. Results indicate that family resilience, family meals, and mother’s mental health promote flourishing and school engagement amid varying levels of exposure to ACE and DD. Social interventions designed to improve family and neighborhood resources can protect child well-being amid multiple adversities.

Cumulative exposure to socioeconomic and psychosocial adversity and hair cortisol concentration: A longitudinal study from 5 months to 17 years of age

BackgroundExposure to early adversity has been associated with long-lasting risks for poor health and functioning. Prior research suggests that the hypothalamic-pituitary-adrenal (HPA) axis, and its main end-product glucocorticoid hormone cortisol, may be at play. This study tested whether an index of cumulative socioeconomic and psychosocial adversity assessed prospectively, from infancy to adolescence, was associated with hair cortisol concentration (HCC), and if this association differed by sex. MethodsThe sample comprised 556 adolescents (42.0% males) who provided hair for cortisol measurement at 17 years of age. Adversity indicators (young and single motherhood, low socioeconomic status (SES), maternal alcohol use, hostile-reactive parenting, and depressive symptoms, as well as peer victimization and neighborhood dangerousness) were repeatedly reported by mothers or youths between the ages of 5 months and 15 years. ResultsChronic adversity was non-linearly associated with HCC; youth exposed to lower and higher levels of adversity had moderate-to-higher HCC compared to lower HCC noted in participants with moderate levels of adversity, for both males and females. None of the indicators taken separately, except the perception of neighborhood dangerousness, were significantly associated with HCC. ConclusionOur findings support the hypothesis that HPA axis activity varies according to cumulative adversity, albeit non-linearly, which may bear consequences for later health and functioning.

The Rohingya refugees: a conceptual framework of their psychosocial adversities, cultural idioms of distress and social suffering.

Rohingya refugees, a group of religious and ethnic minorities, primarily reside in the South Asian nations. With decades of displacement, forced migration, limited freedom of movement, violence and oppression, they have been termed by the United Nations (UN) as the 'most persecuted minority group' in world history. Literature shows an increased prevalence of psychiatric disorders such as depression, anxiety, post-traumatic stress, insomnia, etc., in this population. However, beyond 'medicalisation', the psychosocial challenges of the Rohingyas need to be understood through the lens of 'social suffering', which results from a complex interplay of multiple social, political, environmental and geographical factors. Lack of essential living amenities, poverty, unemployment, overcrowding, compromised social identity, and persistent traumatic stressors lead to inequality, restricted healthcare access, human rights deprivation and social injustice in this group. Even though the United Nations High Commission for Refugees (UNHCR) has taken a renewed interest in Rohingya re-establishment with well-researched standards of care, there are several pragmatic challenges in their implementation and inclusion in policies. This paper reviews these multi-dimensional psychosocial challenges of the Rohingyas by synthesising various intersecting conceptual models including minority stress, health-stigma-discrimination framework, refugee ecological model and capability approach. Furthermore, it highlights multidisciplinary interventions to mitigate these adversities, improve their living situation and eventually foster healing via means which are culturally relevant and contextually appropriate. These interventions need to involve various stakeholders from a human rights and dignity based lens, including the voices of the Rohingyas and supported by more research in this area.

Impact of Major Depressive Disorder on Psychiatric Comorbidity of Females in Low Income Countries

Nearly one in five individuals can expertise a significant depressive episode at some purpose in their lives. during this review, we have a tendency to discuss knowledge describing however genes, psychosocial adversity in childhood, and in progress or recent psychosocial stress could impact multiple biology systems relevant to major clinical depression. Major clinical depression could also be caused by the additive effects of those three factors on the brain. A major depressive episode is characterised by a coffee mood or associate degree inability to expertise pleasure (anhedonia), or both, for quite two weeks, combined with many psychological feature and vegetative symptoms and therefore the incidence of distress or impairment. A identification of major clinical depression will be created if someone suffers a minimum of one such episode (without ever experiencing mania). However, most of the people with major clinical depression have multiple episodes. Significantly, many medical diseases like polygenic disorder, heart condition, response disorders and pain square measure common comorbid diagnoses. The relation between major clinical depression and these chronic and disabling conditions seems to be two-way as a result of one could influence the prognosis of the opposite.

Relevance of the Indian telemedicine guidelines 2020 in psychogeriatric care: A critical appraisal

Older people with psychiatric illnesses face unique challenges in terms of clinical, sociocultural, and environmental factors. The Ministry of Health and Family Welfare, Government of India (MoHFw, GOI), has released telemedicine guidelines in April 2020, closely followed by a telepsychiatry operational guidelines as a collaborative effort of the National Institute of Mental Health and Neurosciences, Bengaluru, and the MoHFw, GOI. The current article presents a critical analysis of the provisions in these guidelines relevant to psychogeriatric care. The gray areas in the existing protocols which may hamper their applicability and accessibility in older adults include digital connectivity, continuity of care, patient autonomy and capacity assessment, medical comorbidities, evaluation of dementia, confidentiality, and teleconsultations in the institutionalized elderly. Preexisting challenges are seen to be compounded by the coronavirus disease 2019 pandemic, in addition to the onset of newer psychosocial and clinical adversities. The article also highlights certain recommendations for possible modifications of the guidelines in future. The telepsychiatry guidelines provide a paradigm shift in mental health care. However, the lacunae involved in the care of vulnerable groups such as the geriatric population based on these guidelines need to be reconsidered by all levels of stakeholders supported by evidence-based research.

Supplemental Material for Psychosocial Adversity and Allostatic Load Burden in Midlife and Older Ages

Supplemental Material for Psychosocial Adversity and Allostatic Load Burden in Midlife and Older Ages

Implications of the COVID-19 pandemic for patients with schizophrenia spectrum disorders: narrative review.

COVID-19 was declared a pandemic in March 2020, by the World Health Organization. The pandemic has had unprecedented worldwide implications, in particular on marginalized populations. The aim of this study is to review the impact of the pandemic on patients with schizophrenia spectrum disorders. A number of databases were searched for this review, including PubMed, EMBASE, PsycINFO and Google Scholar. Search terms included psychosis and COVID-19, schizophrenia and COVID-19, and severe mental illness and COVID-19. We included all English language papers and preprints. The final search was done on 15 July 2020. Forty-seven relevant studies were identified and included in this review. Studies were summarised into five main subcategories: potential impact of the COVID-19 pandemic on physical health outcomes of patients with schizophrenia spectrum disorders, impact on mental health outcomes, review of case reports and case series to date, treatment recommendation guidelines and risk of increased prevalence of psychosis. Patients with schizophrenia spectrum disorders may be vulnerable to the effects of the COVID-19 pandemic. This patient population has a number of risk factors, including psychosocial adversities and illness related factors. Continuous monitoring and long-term studies of the impact of the pandemic on this patient population are required.

Early Life Conditions, Adulthood Experiences, and Edentulism at Older Ages

The role of childhood in shaping overall adult health has been well documented, especially for physical and mental health, but much less is known about the impact of early disadvantage on oral health in later life. Using data from the 2006 and 2012 Health and Retirement Study, we investigate the link between childhood financial and psychosocial adversity and edentulism over a six-year period among U.S. adults aged 51 and older. We find that those growing up with parents with fewer resources face higher risks of having lost all their tooth at baseline and during the follow-up. Adulthood socioeconomic status and health behaviors are strongly associated with the risk of edentulism, net of childhood conditions. However, the effect of low parental resources on the onset of edentulism persists when accounting for these life course factors. Part of a symposium sponsored by the Oral Health Interest Group.

Psychosocial Adversity in Early Childhood and Language and Literacy Skills in Adolescence: The Role of Speech-Language Pathology in Prevention, Policy, and Practice

PurposeThis clinical focus article outlines key forms of childhood maltreatment (various types of abuse and neglect) and their co-occurrence with other developmental risk factors, such as parental poverty, living in crime-prone communities, and disrupted educational experiences, to focus on their implications for language and literacy skills in adolescence. Children exposed to psychosocial adversity early in life experience a range of poor outcomes in adolescence, relative to their typically developing peers, and language and literacy skills are particularly vulnerable skill sets in the face of this adversity.ConclusionsThe continuum from disrupted schooling to child protection and youth justice involvement is emphasized, and the expanding scope of practice for speech-language pathology at all stages of prevention, assessment, and intervention is outlined. Greater advocacy by speech-language pathologists is needed so that policy makers and practitioners in other service sectors have a better appreciation of the importance of language and literacy skills in early life.

Criminal recidivism and psychosocial adversity in offense-related subtypes of sexually abusive adolescents

ABSTRACT Criminal behaviours vary significantly among juveniles who have sexually offended (JSOs). Offense-related subtypes may differ in criminal persistence and inform clinical practice. In the present study, Latent Class Analysis empirically derived four distinct JSO subtypes based on 10 offense/victim characteristics in a comprehensive sample of 670 JSOs (M age = 14.49, SD age = 1.94): a severe peer/adult-offender subtype (22.4%), a child-offender subtype (30.1%), a touch-offender subtype (27.9%), and a verbal/online-offender subtype (19.6%). Cox regressions indicated that JSOs of the severe peer/adult-offender subtype were at increased risk of sexual and nonsexual criminal recidivism. JSOs of the severe peer/adult-offender subtype as well as the child victim subtype appeared highly burdened with behaviour/social problems and psychosocial adversity/adverse childhood experiences. Our findings show that the variety of offense characteristics, predispositions, and recidivism risks characterising JSOs deserve precise consideration to allow the implementation of effective, individually tailored treatment approaches aimed at reducing future crime.

Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications.

The role of stress, trauma, and adversity particularly early in life has been identified as a contributing factor in both drug and food addictions. While links between traumatic stress and substance use disorders are well documented, the pathways to food addiction and obesity are less established. This review focuses on psychosocial and neurobiological factors that may increase risk for addiction-like behaviors and ultimately increase BMI over the lifespan. Early childhood and adolescent adversity can induce long-lasting alterations in the glucocorticoid and dopamine systems that lead to increased addiction vulnerability later in life. Allostatic load, the hypothalamic-pituitary-adrenal axis, and emerging data on epigenetics in the context of biological embedding are highlighted. A conceptual model for food addiction is proposed, which integrates data on the biological embedding of adversity as well as upstream psychological, social, and environmental factors. Dietary restraint as a feature of disordered eating is discussed as an important contextual factor related to food addiction. Discussion of various public health and policy considerations are based on the concept that improved knowledge of biopsychosocial mechanisms contributing to food addiction may decrease stigma associated with obesity and disordered eating behavior.

Parent Cultural Stress and Internalizing Problems in Latinx Preschoolers: Moderation by Maternal Involvement and Positive Verbalizations.

Parent cultural stress has a pervasive and significant impact on family functioning and increases risk for socioemotional problems among Latinx children. Identifying factors that can protect against the negative influence of cultural stressors and enhance the developmental trajectories of Latinx children early in life is key as these children experience disproportionate risk for psychosocial adversity and internalizing mental health problems. The present study evaluated the effect of maternal cultural stress on young children´s internalizing problems, and the moderating role of maternal parenting behaviors. Participants were 65 Latinx children (3 to 5years old, 50% female) and their mothers (21 to 47years old, 68% immigrants) recruited from three Head Start Centers in the Chicagoland Area. Mother-reported cultural stress predicted young children's internalizing problems. In addition, maternal self-reported involvement and observed maternal positive verbalizations during one-on-one interactions with the child moderated the effect of cultural stress on child internalizing symptoms. Findings are discussed in the context of efforts to promote family and child resilience and implications for culturally sensitive measurement and intervention.

Lifetime stress and war exposure timing may predict methylation changes at NR3C1 based on a pilot study inawarrior cohort in a small-scale society in Kenya.

Candidate gene methylation studies of NR3C1 have identified associations with psychosocial adversity, including war trauma. This pilot study (sample sizes from 22 to 45 for primary analyses) examined NR3C1 methylation in a group of Kenyan pastoralist young men in relation to culturally relevant traumatic experiences, including participation in coalitional lethal gun violence. Adolescent and young adult Samburu men ("warriors") were recruited for participation. DNA was obtained from whole saliva and methylation analyses performed using mass spectrometry. We performed a data reduction of variables from a standardized instrument of lifetime stress using a factor analysis and we assessed the association between the extracted factors with culturally relevant and cross-culturally comparative experiences. Cumulative lifetime trauma exposure and forms of violence to which warriors are particularly susceptible were associated with DNA methylation changes in the NR3C1 1F promoter region but not in the NR3C1 1D promoter region. However, sensitivity analyses revealed significant associations between individual CpG sites in both regions and cumulative stress exposures, war exposure timing, and war fatalities. This study supports the importance of NR3C1 methylation changes in response to challenging life circumstances, including in a global south cultural context that contrasts in notable ways from global north contexts and from the starkly tragic examples of the Rwandan genocide and war-associated rape explored in recent studies. Timing of traumatic exposure and culturally salient means to measure enduring symptoms of trauma remain important considerations for DNA methylation studies.

The possibility of using dissociation to identify mental health service users with more psychosocial intervention needs: rationale and preliminary evidence

ABSTRACT The ability to predict which groups of mental health service users are more likely to require psychosocial care could facilitate intervention planning and optimize the utilization of resources. Dissociation may be a transdiagnostic indicator of psychosocial intervention needs because dissociation is theoretically and empirically associated with psychosocial adversities. This paper explains why that may be the case. We investigated the association of somatoform dissociation with indicators of psychosocial intervention needs (e.g., childhood trauma, poor family well-being, psychosocial-related symptoms) in a convenience sample of mental health service users (N = 111). The preliminary evidence supports the idea that dissociation is a transdiagnostic indicator of psychosocial intervention needs. Dissociation should be regularly assessed in mental health settings because it may help social workers and other psychosocial service providers identify service users who may especially need psychosocial care when there is a lack of resources. Further studies and discussions are needed.