Severe Abuse Research Articles

How can health practitioners support children and young people in social care?

Abstract Health practitioners are responsible for safeguarding, delivering preventive and responsive care for children and young people in social care settings. However, drivers and determinants that place children in care settings lie outside of the doctor’s office. In fact, primary care health practitioners often deal with children and young people who face or are at risk of severe neglect, abuse or vulnerability outside the care system. Recent findings from the UK’s Millennium cohort study have repeatedly demonstrated that social disadvantage in the early years accounts for more than 2/3 of health inequalities in adolescence. Professor Saxena is a practising GP with 25 years of experience of inner-city primary care and global expert on primary care of children. She will present dilemmas posed in clinical settings for health practitioners and professionals working in a broad range of areas including public health, education settings and social care. What responsibility do health professionals have when they encounter children living in social care settings? What should they be especially alert to? How can they make a difference to reduce health inequality faced by young people growing up in the care system.

Going Insane: Battered Muslim Women Reclaim a Positive Identity.

This study examines the process of identity negotiation of 15 Muslim women who resisted severe abuse by their husbands and extended family by becoming mentally ill and thereafter, divorcing. Content analysis of the interview narratives shows that these women were poor, married young, and endured years of battering, isolation, and silencing for the sake of family honor and children's well-being. Entrapped within a web of sociocultural norms legitimizing wife beating, and abusive extended family relationships that annihilate their voice by branding them as maj'nuna/insane, these women explained that they were terrorized helpless victims fearing the stigma of being labeled insane and the resultant harm to their children. With the deterioration of their health, threat of annihilation, and imminent danger to themselves and their children, these women broke through the normative oppressive framework by becoming maj'nuna/mentally ill. Detached from the extended family and no longer caring to endorse a label that discredited what they said or did, these women overtly resisted by escaping to the family of origin and/or mental health clinic to reveal the abuse, divorce, and seek treatment. Severing all family ties, and now residing in public housing, these women felt safe to renegotiate a favorable identity and reclaim the right to live with dignity. Implications/recommendations: (1) The criminalization of battering and prosecution of batterers is not enough to deter when cultural norms sanction battering, (2) additional diagnostic categories are needed to identify the precursors of battering within the strategies of overt and covert resistance battered women adopt in collectivistic cultures such as mental and neurophysiological dysfunctions, and (3) it is necessary to transcend the individualistic model titling battered women within the false dichotomy of victimization or agency as it fails to reflect battered women's experience in collectivistic cultures and their resistant strategies to abuse in the extended family.

Association of Childhood Abuse with Incident Inflammatory Bowel Disease.

A link between inflammatory bowel disease (IBD), stressful life events and psychological factors has previously been reported. Our objective was to examine the relationship between childhood emotional, physical, and sexual abuse and risk of IBD using a large cohort of female health professionals. We included participants in the Nurses' Health Study II who completed the Physical and Emotional Abuse Subscale of the Childhood Trauma Questionnaire and the Sexual Maltreatment Scale of the Parent-Child Conflict Tactics Scale in 2001. Diagnosis of IBD was determined by self-report and confirmed independently by two physicians through review of medical records. We used Cox proportional hazard modeling to estimate the risk of Crohn's disease (CD) and ulcerative colitis (UC) while adjusting for covariates. Among 68,167 women followed from 1989 until 2017, there were 146 incident cases of CD and 215 incident cases of UC. Compared to women with no history of abuse, the adjusted hazard ratios of CD were 1.16 (95% CI 0.67 - 2.02) for mild, 1.58 (95% CI 0.92 - 2.69) for moderate, and 1.95 (95% CI 1.22 - 3.10) for severe abuse (Ptrend = 0.002). We did not observe an association between childhood abuse and risk of UC. Women who reported early life severe abuse had an increased risk of CD. These data add to the growing body of evidence on the critical role of early life stressors in development of CD.

The mediation role of gray matter volume in the relationship between childhood maltreatment and psychological resilience in adolescents with first-episode major depressive disorder

Previous studies have revealed morphologic alterations in patients with major depressive disorder (MDD) with experiences of childhood trauma. However, the underlying neural mechanisms remain largely unknown. This study aims to explore the brain structural changes and their possible mediation role in the relationship between childhood maltreatment and psychological resilience in drug-naïve adolescents with first-episode MDD. A total of 57 adolescents with first-episode MDD and 36 healthy controls (HCs) completed the T1-weighted magnetic resonance imaging scan. The adverse childhood experiences and current psychological resilience were assessed using the Childhood Trauma Questionnaire-Short Form and the Connor Davidson Resilience Scale, respectively. The voxel-based morphometry approach was applied to examine changes in the gray matter volume (GMV). Compared with the HCs, adolescents with MDD had significantly reduced GMV volumes in the left fusiform gyrus, right orbitofrontal gyrus, right superior temporal gyrus, right calcarine cortex, right middle frontal gyrus, left angular gyrus, right precuneus, right posterior cingulate gyrus, and right posterior central gyrus, as well as significantly increased GMV volumes in the left lenticular putamen and right lenticular pallidum. The GMV of the right calcarine cortex was found to be negatively correlated with the severity of emotional abuse and positively correlated with the level of psychological resilience. Moreover, the GMV of the right calcarine cortex might partially mediate the relationship between childhood maltreatment and psychological resilience. The present study provided further evidence for structural impairments in adolescents with MDD. Our findings also confirmed the important role of depression-related GMV changes in childhood growth experiences and psychological resilience characteristics during adolescent brain maturation.

Examining the measurement of severity of intimate partner violence and its association to mental health outcomes: a narrative synthesis.

The aims of this synthesis were to investigate the relationship between IPV severity and mental health outcomes and shed light to gaps and limitations in existing methodologies used to assess IPV severity and its association with mental health outcomes. We conducted a two-stage narrative synthesis of 76 studies. First, we identified IPV measures used in at least five studies, focusing on their variations and severity score calculation. Then, we analyzed findings of studies correlating IPV severity with mental health outcomes, identifying features of measures and statistical methods influencing result consistency. Measures of intimate partner violence were often modified from their original, potentially impact on the reliability and validity of these measures. The operationalization of violence severity varied across studies, leading to inconsistencies in scoring whereby compromising the consistency of severity levels across studies. We found lack of consistency in applying validated methods for scoring instruments to determine abuse severity. In this review, we consistently found that the severity of IPV and its various subtypes were linked to different mental health outcomes across multiple studies. We discovered evidence suggesting that experiencing more types of IPV was associated with worse mental health outcomes. Generally, higher levels of overall IPV severity and its specific subtypes were correlated with poorer mental health outcomes. However, our analyses did not reveal consistent patterns that would allow for a definitive determination of how individual IPV subtypes differently affect mental health outcomes. Nevertheless, we observed that increasing severity of physical IPV tended to have a notable impact on post-traumatic stress disorder (PTSD). Conversely, increasing severity of psychological IPV was consistently associated with depression. While sexual IPV severity was explored in fewer studies, the evidence regarding its impact on various mental health outcomes was less conclusive. To achieve a comprehensive understanding of the mechanism by which IPV severity is related to mental health it may be time to take an alternative approach to measuring IPV severity. No IPV measures assessed the acceptability of the content to people who have experienced IPV. This is an important omission with significant consequences for the validity of the evidence base.

Refugees' integration and emotional distress over the course of 9 months.

High prevalence rates of mental disorders are reported in refugees due to experiencing substantial pre-, peri-, and post-migration stress. While long-term studies indicated that emotional distress of refugees either stagnates or ameliorates over time, long-term research on refugees' integration and its' interaction with emotional distress is limited. The examined long-term predictors for refugees' emotional distress and integration in this study were, amongst others, severe physical abuse in childhood, residence status and length of stay. The sample included 46 refugees, 91.3% male, mean age 20.8 years. Trained psychologists screened for emotional distress with the use of the Refugee Health Screener in a semi-structured interview. Integration progress was screened using the Integration Index with the subdimensions psychological, economic, political, social, linguistic and navigational integration. Longitudinal differences for emotional distress and integration sub-dimensions were evaluated by sign tests and t-tests. The longitudinal course of integration was evaluated with a Mixed ANOVA. Further, two hierarchical regression analyses were performed to analyze longitudinal predictors of emotional distress and integration. Overall, emotional distress decreased, and integration increased over time. In particular, the sub-dimensions of social, economic, and linguistic integration increased significantly over time. Two regression analyses determined significant predictors of (a) emotional distresst1 (adjusted R2 = 0.46): psychotherapy (ß = 0.35, p = 0.020), emotional distresst0 (ß = 0.34, p = 0.031), and integrationt0 (ß = -0.29, p = 0.043), and one significant predictor of (b) integrationt1 (adjusted R2 = 0.70): integrationt0 (ß = 0.89, p < 0.001). This is the first study to longitudinally examine the Integration Index with all subdimensions. Over the course of 9 months refugees' overall integration, and the sub-dimensions of social, economic, and linguistic integration increased. Whilst the emotional distress of initially highly distressed refugees ameliorated over the course of nine months, their symptom severity remained clinically significant. Results emphasize the importance of early integration for the long-term development of mental health and integration in refugees. Refugees' emotional distress and integration are intertwined and need to be addressed promptly after refugees' entry into the host country.

Altered Gut Microbiota Patterns in Young Children with Recent Maltreatment Exposure

Background: The brain and the intestinal microbiota are highly interconnected and especially vulnerable to disruptions in early life. Emerging evidence indicates that psychosocial adversity detrimentally impacts the intestinal microbiota, affecting both physical and mental health. This study aims to investigate the gut microbiome in young children in the immediate aftermath of maltreatment exposure. Methods: Maltreatment exposure was assessed in 88 children (ages 3–7) using the Maternal Interview for the Classification of Maltreatment [MICM]. Children were allocated to three groups according to the number of experienced maltreatment categories: no maltreatment, low maltreatment, and high maltreatment exposures. Stool samples were collected and analyzed by 16S rRNA sequencing. Results: Children subjected to high maltreatment exposure exhibited lower alpha diversity in comparison to those with both no and low maltreatment exposure (Simpson Index, Tukey post hoc, p = 0.059 and p = 0.007, respectively). No significant distinctions in beta diversity were identified. High maltreatment exposure was associated with the enrichment of several genera from the class Clostridia (Clostridium, Intestinibacter, Howardella and Butyrivibrio) and the depletion of the genus Phocaeicola (class Bacteriodia). Conclusions: Severe maltreatment exposure is associated with alterations in the gut microbiota of young children. Longitudinal trajectories of intestinal microbiota composition in the context of maltreatment may reveal important insights related to psychiatric and somatic health outcomes.

Complex Posttraumatic Stress Disorder (CPTSD) is Uniquely Linked to Suicidality Beyond Posttraumatic Stress Disorder (PTSD) in Adults with Childhood Maltreatment: A Multinational Study Across Four Countries

BackgroundSuicide is a leading cause of death worldwide, with childhood maltreatment identified as a significant risk factor for suicidal behavior in adulthood. The link between childhood maltreatment and suicidality is well-documented; however, the role of complex posttraumatic stress disorder (CPTSD), which includes an additional symptom cluster of disturbances in self-organization (DSO) compared to posttraumatic stress disorder (PTSD), remains underexplored. This study aimed to investigate the association between meeting the criteria for ICD-11 PTSD or CPTSD and suicidality in adults with a history of childhood maltreatment across culturally diverse samples. MethodsData were collected across four sites: the United States, the United Kingdom, China, and Malaysia. The Childhood Trauma Questionnaire (CTQ), Suicidal Behaviors Questionnaire-Revised (SBQ-R), and International Trauma Questionnaire (ITQ) were used to assess childhood maltreatment, suicidality, and PTSD or CPTSD, respectively. Linear regressions were conducted to examine the associations, controlling for demographic variables (age, sex, ethnicity, educational level, and subjective socioeconomic status) as well as the severity of maltreatment (CTQ total scores). ResultsAmong the 1,324 participants who experienced childhood maltreatment, meeting the criteria for CPTSD was significantly associated with higher suicidality compared to not meeting the criteria for either PTSD or CPTSD (B(SE) = 1.68 (0.30), p < .001), or only meeting the criteria for PTSD (B(SE) = 1.38 (0.43), p < .001). In contrast, meeting the criteria for PTSD alone was not significantly associated with suicidality (B(SE) = 0.35 (0.46), p = .45). These associations remained consistent across different cultural settings. ConclusionThe study findings highlight the unique association of CPTSD with suicidality in adults with a history of childhood maltreatment, suggesting that the DSO symptom cluster of CPTSD, which distinguish it from PTSD, play a critical role in the development of suicidality in this population. Targeting these symptoms may be essential for effective intervention strategies. Screening for childhood maltreatment and CPTSD in individuals at risk of suicide is crucial for guiding treatment planning.

Comparison of the Predictive Effects of Individual and Social Factors on Substance Abuse Severity

Amaç: Bu çalışma, madde bağımlılığının önlenmesinde bireysel ve sosyal faktörlerin etkilerini inceleyerek, bu süreçte koruyucu bir rol oynayan faktörleri belirlemeyi amaçlamaktadır. Özellikle, hangi faktörlerin daha etkili olduğunu belirlemek amacıyla yapılan değerlendirmeye odaklanılmıştır. &#x0D; Yöntem: Araştırmaya dahil edilen 18-65 yaş aralığında 101 erkek katılımcıya, “Kişisel Sosyodemografik Bilgi Formu”, “Ailedeki Koruyucu Etkenler Ölçeği”, “Çok Boyutlu Algılanan Sosyal Destek Ölçeği”, “Kısa Psikolojik Sağlamlık Ölçeği”, “Başa Çıkma Stilleri Ölçeği Kısa Formu”, “Kısa Öz Kontrol Ölçeği”, “Bağımlılık Profil İndeksi Kısa Formu” ve “Duygu Düzenleme Ölçeği” anketleri uygulanmıştır. &#x0D; Bulgular: Algılanan sosyal arkadaş desteği, dürtüsellik, duygulara odaklanma ve ortaya koyma, bağımlılık şiddetini en iyi şekilde açıklayan koruyucu faktörler oldukları saptanmıştır. Ayrıca sosyal koruyucu faktörlerin, bireysel koruyucu faktörlere göre madde bağımlılığını açıklama gücü daha yüksek olduğu saptanmıştır.&#x0D; Sonuç: Madde bağımlılığıyla mücadele stratejileri geliştirilirken bireylerin sosyal destek sistemlerini güçlendirmeye, duygusal düzenleme becerilerini artırmaya ve dürtüselliği azaltmaya odaklanmak etkili olabilir. Ayrıca, bu çalışmanın sonuçları, bağımlılıkla mücadelede geniş bir perspektifin önemini vurgulayarak, bireysel ve sosyal faktörler arasındaki etkileşimleri anlamak için daha fazla araştırmaya ihtiyaç olduğunu göstermektedir.

Sexual Abuse, Commercial Sexual Exploitation, and Cumulative Adversity Among Sexually Diverse and Non-Sexually Diverse Girls in the Juvenile Justice System

ABSTRACT Despite awareness about high rates of sexual abuse among girls in the juvenile justice system, little is known about the additional risk conferred upon sexually diverse (SD) youths, as well as the combined vulnerability of sexual abuse and commercial sexual exploitation of children (CSEC) – frequently a survival behavior amplifying disproportionate juvenile justice contact among SD and non-SD juvenile justice-involved (JJI) girls. In a sample of JJI-girls, we compared SD (n = 52) with non-SD (n = 46) JJI-girls on sexual victimization (e.g. sexual abuse occurring within different relationship-types, CSEC), and broader developmental adversity burden disadvantage (cumulative trauma/loss exposure-types) and distress (posttraumatic stress disorder [PTSD]; cumulative stressor-reactivity, grief-specific, and adversity-related symptoms), health distress/impairment, and sexual and physical health-risk indicators. While comparable on childhood sexual abuse frequency, SD JJI-girls reported greater cumulative sexual abuse severity across relationship-types, higher sexual abuse within non-familial contexts, and more CSEC involvement. They also reported more social determinants of health (e.g. trauma/loss exposure-types) and showed elevations on all health-risk indicators, and most cumulative adversity burden indicators, despite comparable PTSD severity. Our findings emphasize the need to consider multiple sexual victimization facets, including the combined vulnerability of sexual abuse and CSEC, and utilize cumulative developmental assessment approaches among youths vulnerable to maltreatment and exploitation.

Understanding "Childhood Poly-Victimization" to help uncover abuse during child investigative interviewing: a systematic review.

It is well established that child victims are some of the most challenging populations to interview. Indeed, children tend to feel ashamed, scared or in denial, leading to difficulties for law enforcement when gathering information, and subsequently with prosecuting offenders. Moreover, with crimes against children increasing, it is common for interviewed victims to have experienced several abuses (poly-victimization). Thus, the main goals of this study are to (1) identify the facets that are included in poly-victimization, in order to (2) provide a clear definition that can be used by law enforcement during child interviews, which could lead to (3) a better identification of cases of abuse to maximize safeguarding and protect children. A systematic review was used to establish the differences in conceptualizations of poly-victimization as well as the measurements chosen by research to measure this concept. The current systematic review included research articles on childhood poly-victimization using a quantitative measuring instrument published as of 2007, that focused on populations under 18 years of age. The findings were divided into (1) conceptual dimensions, (2) characteristics of studies' populations and (3) measures and psychometrics properties. It was found that research used various terms for poly-victimization, yet with numerous definitions implying differences in number of abuses, time frame, and mental health aspects to be considered in the identification of poly-victimization. The included papers (n = 6) were from Europe, Asia, and the United States. Over half of the studies used the Juvenile Victimization Questionnaire (JVQ) but adapted either (i) to the study's population, (ii) possible answers, (iii) wording of questions, or (iv) by the removal of questions. Our findings highlight the need for a more theoretically coherent definition of childhood poly-victimization. Questions regarding number of abuses, time consideration (past year vs. lifetime), mental health and severity of abuse should be addressed to develop a unified definition of poly-victimization. Rapport-based interviews should be the focus to uncover the truth and to avoid a secondary trauma in the crisis of a child's disclosure of abuse. A new definition of "Childhood Poly-Victimization" is proposed by the authors as well as a "Decision Tree for Identifying Childhood Poly-Victimization" designed to be used by law enforcement during child investigative interviews.

Intimate partner violence among pregnant women attending a low-resource primary care facility in Ghana.

Intimate partner violence in pregnancy is a significant public health issue that has several detrimental effects. Pregnant women subjected to intimate partner violence (IPV) have a higher risk for adverse pregnancy outcomes. The aim of the study was to determine the prevalence, patterns and factors associated with intimate partner violence among pregnant women attending a primary care antenatal clinic. A quantitative cross-sectional study design was employed to study intimate partner violence among 269 pregnant women in Accra, Ghana between July and October 2021. Participants were selected by systematic sampling technique. The self-reported Composite Abuse Scale was used to assess and classify intimate partner violence. Socio-demographic, clinical (obstetric) and behavioural characteristics were obtained with a structured questionnaire. Associations were determined between independent and dependent variables using the chi-squared test, and logistic regression with adjusted odds ratio (AOR). The statistical significance level was set at a p-value ≤ 0.05. The prevalence of IPV was 11.2%. The prevalence of emotional/psychological abuse, harassment/controlling behaviour, physical abuse, sexual abuse and severe combined abuse were 12.3%, 13.0%, 8.2%, 3.3% and 8.9% respectively. Pregnant women who were employed had reduced odds of experiencing IPV [AOR = 0.16 (95%CI: 0.05-0.47), p = 0.001], however, the past experience of violence [AOR = 4.9 (95%CI: 1.06-22.96), p = 0.042], alcohol use by women [AOR = 7.8 (95%CI: 1.63-37.42), p = 0.01], and partners' alcohol consumption [AOR = 10.0 (95%CI: 3.22-31.26), p<0.001] were associated with increased odds of IPV. There is a high prevalence of IPV among pregnant women in this study from a resource-limited setting. The factors found to be associated with IPV in pregnancy were the employment status of women, alcohol consumption by women or their partners and a previous history of violence. Healthcare providers in primary care need to recognize IPV as a medical condition that can occur in pregnancy and be ready to assist and manage the victims when it is detected.

Association between childhood abuse and risk of post-COVID-19 conditions: Results from three large prospective cohort studies

BackgroundSignificant early life adversities, such as childhood sexual and physical/emotional abuse, are associated with risk of poor health outcomes but are understudied risk factors for post-COVID-19 conditions. In this prospective study, we examined the associations between combined exposure to sexual and physical/emotional abuse during childhood with risk of post-COVID-19 conditions in adulthood. Additionally, we explored the extent to which lifestyle, health-related and psychological factors explain this association. MethodsWe used data from three large, ongoing cohorts: Nurses’ Health Study (NHS)-II, NHS3, and the Growing Up Today Study. Between April 2020 and November 2021, participants responded to periodic COVID-19 surveys. Participants were included if they responded to a questionnaire about childhood abuse, subsequently tested positive for SARS-CoV-2 infection and responded to questions about post-COVID-19 conditions. Childhood sexual abuse was measured before the COVID-19 pandemic with the Sexual Maltreatment Scale of the Parent-Child Conflict Tactics Scale, and physical/emotional abuse was measured with the Physical and Emotional Abuse Subscale of the Childhood Trauma Questionnaire. Post-COVID-19 conditions, defined as COVID–19–related symptoms lasting 4 weeks or longer (e.g., fatigue, dyspnea), were self-reported in the final COVID-19 questionnaire in November 2021. Sexual abuse and physical/emotional abuse were examined separately and jointly in relation to post-COVID-19 conditions. Data on key lifestyle (e.g., cigarette smoking), health-related (e.g., asthma, diabetes), and psychological factors (e.g., depression and anxiety) were obtained. ResultsOf 2851 participants, the mean age (range) was 55.8 (22.0–75.0) years; 2789 (97.8 %) were females, and 2750 (96.5 %) were whites. We observed a dose-dependent relationship between severity of childhood abuse and post-COVID conditions (p-trend:<0.0001); participants with severe versus no childhood abuse had a 42 % higher subsequent risk of post-COVID conditions [relative risk (95 % confidence interval): 1.42 (1.25 to 1.61)]. Key lifestyle, health-related, and psychological factors mediated 25.5 % of this association. Both sexual and physical/emotional abuse, were independently associated with post-COVID conditions. ConclusionsIn this prospective study of 2851 participants, childhood abuse was significantly associated with increased risk of post-COVID conditions. Biological pathways connecting childhood abuse with subsequent risk of post-COVID conditions should be investigated.

Altered dynamic functional connectivity of nucleus accumbens subregions in major depressive disorder: the interactive effect of childhood trauma and diagnosis.

Major depressive disorder (MDD) with childhood trauma represents a heterogeneous clinical subtype of depression. Previous research has observed alterations in the reward circuitry centered around the nucleus accumbens (NAc) in MDD patients. However, limited investigations have focused on aberrant functional connectivity (FC) within NAc subregions among MDD with childhood trauma. Thus, this study adopts analyses of both static FC (sFC) and dynamic FC (dFC) to examine neurobiological changes in MDD with childhood trauma. The bilateral nucleus accumbens shell (NAc-shell) and nucleus accumbens core (NAc-core) were selected as the seeds. Four participant groups were included: MDD with childhood trauma (n = 48), MDD without childhood trauma (n = 30), healthy controls (HCs) with childhood trauma (n = 57), and HCs without childhood trauma (n = 46). Our findings revealed both abnormal sFC and dFC between NAc-shell and NAc-core and regions including the middle occipital gyrus (MOG), anterior cingulate cortex, and inferior frontal gyrus in MDD with childhood trauma. Furthermore, a significant correlation was identified between the dFC of the left NAc-shell and the right MOG in relation to childhood trauma. Additionally, abnormal dFC moderated the link between childhood abuse and depression severity. These outcomes shed light on the neurobiological underpinnings of MDD with childhood trauma.

Learning to Trust: Two Clinical Journeys

In this paper, the author seeks to honor Joseph Palombo’s legacy through presenting two treatments of young women whose severe child abuse has caused not only PTSD, but also damage to their capacity to develop an integrated and positive identity with stable self-esteem. To provide a context for the clinical material, a brief overview of self psychology is presented. When what is called the “empathic mode of listening” is consistently utilized by the therapist, patients generally develop selfobject transferences, which function to temporarily stabilize the patient’s fragmented self. Over time, the psychoanalytic exploration of these transferences gradually leads to their internalization in the form of more integrated psychic structure, more stable self-esteem, and less vulnerability to fragmentation. The therapeutic journeys of Emily and Maia, including my own at times intense internal responses to them, illustrate in detail and depth how this process has enabled them to begin to feel an integrated sense of self and enhanced self-esteem, despite the traumatic impact of their extreme child abuse and severe PTSD. They also illustrate how a self psychologically informed treatment, often in conjunction with medication, can be a powerful tool in promoting recovery from even extreme child abuse.

The Impact of Childhood Trauma on the Negative Symptoms of Schizophrenia.

Schizophrenia is a debilitating mental health disorder that imposes profound economic, societal, and personal burdens. The negative symptoms of schizophrenia ( i.e. , blunted affect, alogia, anhedonia, asociality, and avolition) are highly prevalent and pervasive in the psychotic disorder and pose significant resistance to available treatment options. Traumatic childhood experiences are strongly linked with the risk of developing schizophrenia. Most prior studies have primarily focused on positive symptoms of schizophrenia ( e.g. , hallucinations and delusions), whereas less attention has been given to negative symptoms. The current study investigated the relationship between childhood trauma ( i.e. , physical abuse, sexual abuse, and emotional abuse and neglect) and negative symptoms in a sample of schizophrenia outpatients and healthy controls ( n = 159 participants, including 99 patients with schizophrenia). The observations from the current study revealed that schizophrenia patients experienced a significantly greater degree of childhood trauma and negative symptoms than the control individuals. The results of the current study also indicated that more severe experiences of total childhood trauma ( i.e. , summation of all trauma types), physical abuse, and emotional neglect may increase the risk of schizophrenia patients reporting negative symptoms. However, childhood sexual and emotional abuse was found to have no impact on the degree of negative symptoms experienced by schizophrenia patients. Implications and limitations of the current study are discussed. In conclusion, we found that the severity of overall childhood trauma, physical abuse, and emotional neglect may play an important role in increasing the likelihood of schizophrenia patients reporting negative symptoms.

Course and Prediction of Dissociation in Patients with Borderline Personality Disorder and Personality-Disordered Comparison Subjects: A 24-Year Follow-Up Study

ABSTRACT The first purpose of this study was to determine the course of dissociation among patients with borderline personality disorder (BPD) and personality-disordered comparison subjects (OPD) over 24 years of prospective follow-up. The second purpose was to determine clinically meaningful predictors of dissociation among patients with BPD. The Dissociative Experiences Scale (DES) was administered to 290 patients with BPD and 72 personality-disordered comparison subjects at baseline, and then once every two years over 24 years of prospective follow-up. Baseline predictors were assessed with the Revised Childhood Experiences Questionnaire (CEQ-R), the SCID-I, and the Shipley Institute of Living Scale. Time-varying predictors were assessed at baseline and every subsequent two years by means of the Abuse History Interview (AHI). Patients with BPD had higher baseline dissociation scores than personality-disordered comparison subjects. Whilst dissociation decreased significantly over time for both patient groups, the BPD group showed a steeper decline. Severity of childhood sexual abuse, adult history of rape, adult history of partner violence, and IQ were multivariate predictors of dissociation among patients with BPD. Taken together, the present findings suggest that a combination of interpersonal trauma exposure and cognitive abilities may contribute to the severity of dissociation in adult patients with BPD.

The Impact of Yoga on Athletes' Mental Well-Being: An Experimental Study.

Background Athletes have a variety of obstacles that might shrink their chances of getting adequate rest, including competing and training times, travel, stress, academic responsibilities, and overtraining. Furthermore, athletes have been reported to have poor self-reports of their sleep length and quality. The study aims to assess the impact of yoga practice on sleep quality, stress, anxiety, psychological rigidity, and experience avoidance. Methods A pre- and post-testrandomized design was applied for the research. Forty-four recreational athletes (age 18-45 years)were selected per the inclusion criteria from the athletes studying at Banaras Hindu University. Exclusion criteria are a likely severe psychiatric disorder, chronic illness, substance abuse, disability, endocrine or metabolic disorders, and history of using psychotropic drugsand smoking. The Yogic intervention contains the Pranayama and meditation, which was practiced for six weeks in the intervention group. Outcome variables were stress, sleep, anxiety, mindfulness, psychological rigidity, and experience avoidance. The Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index (PSQI),Sport Competition Anxiety Test, Mindful Attention AwarenessScale (MAAS), and Acceptance and Action Questionnaire-II (AAQ-II) were applied to measure the outcomes. Results The majority of the participants(30 (68%)) were male, and 44 (100%) had more than two years of sports experience. Of the participants, 18 (40.90%) had a habit of 3-5 hours of internet surfing. We noticed that there was a significant mean difference from pre- to post-intervention in terms of stress, sleep, anxiety, mindfulness, psychological rigidity, and experience avoidance (p < 0.0001). Conclusion The results concluded positive effects of yoga on athletes' stress, sleep, anxiety, mindfulness, psychological rigidity, and experience avoidance in athletes.Stress alleviationand reduced anxiety are the strongest predictors of improving psychological flexibility skills in athletes' daily lives. Improving mindfulness and supporting good sleep patternscould be good indicators of improving psychological rigidity and experience avoidance.

In silico and in vitro screening of selected antimicrobial compounds for inhibiting drug efflux pumps to combat threatening MRSA

The rapid emergence of antibiotic-resistant bacteria is occurring worldwide due to severe antibiotic abuse in the past few decades; among them, Methicillin-resistant Staphylococcus aureus (MRSA) is of major concern. Study examines potent antimicrobial compounds against Methicillin resistance Staphylococcus aureus (MRSA) efflux system. Interactome data serves as a primary focal point for global MRSA infection control initiatives. We employed CB Dock and Discovery Studio for performing docking analysis on specific antimicrobial compounds against NorA, NorB, and NorG. Additionally, we conducted molecular dynamics simulations using myPresto. In vitro validation was done by agar-based EtBr cartwheel method to assess the efflux pump activity of MRSA. Out of the eight screened antimicrobial compounds, quercetin exhibited favorable binding energies. Subsequently, molecular dynamics simulations were conducted on quercetin complexes with NorA, NorB, and NorG. In vitro result revealed that the quercetin is active at concentration of 60 µg/ml ±10 against MRSA to inhibit efflux mechanisms. Quercetin demonstrated the most promising binding affinity with the efflux pumps and their regulators of MRSA, making it the prime candidate for use with antibiotics. In-vivo experiments must be performed to validate the in-silico and in vitro analysis.

Understanding Post-Traumatic Growth in Adolescent Survivors of Childhood Sexual Abuse

Post-traumatic growth (PTG) involves a positive transformation in the survivor’s cognitive, emotional, and behavioral responses to life. However, little is known about the factors facilitating PTG in adolescent survivors of childhood sexual abuse. This study examined how potential variables (self-concept, dissociation, the severity of the abuse, and distress symptoms) contribute and interact to account for perceived PTG in a sample of 70 Israeli adolescents, all survivors of childhood sexual abuse, along with one of their parents. It also explored how survivors’ self-concept, the tendency for dissociation, and distress symptoms moderated the association between abuse severity and PTG. Regression decision trees and linear regression models addressed the study’s questions. The results of the regression trees indicated that survivors with low global self-concept had lower levels of PTG, whereas survivors with high global self-concept and low tendencies for dissociation displayed higher levels of PTG. The linear regression analysis also pointed to the contribution of abuse severity and survivors’ global self-concept to PTG. A positive association was only found between abuse severity and PTG for survivors with moderate to high global self-concept. The discussion centers on the combined pivotal role of positive global self-concept, low dissociation, and abuse severity in facilitating adolescents’ PTG.