Trauma In Adulthood Research Articles

Decoding the transcriptomic signatures of psychological trauma in human cortex and amygdala.

Psychological trauma has profound effects on brain function and precipitates psychiatric disorders in vulnerable individuals, however, the molecular mechanisms linking trauma with psychiatric risk remain incompletely understood. Using RNA-seq data postmortem brain tissue of a cohort of 304 donors (N=136 with trauma exposure), we investigated transcriptional signatures of trauma exposures in two cortical regions (dorsolateral prefrontal cortex, and dorsal anterior cingulate cortex) and two amygdala regions (medial amygdala and basolateral amygdala) associated with stress processing and regulation. We focused on dissecting heterogeneity of traumatic experiences in these transcriptional signatures by investigating exposure to several trauma types (childhood, adulthood, complex, single acute, combat, and interpersonal traumas) and interactions with sex. Overall, amygdala regions were more vulnerable to childhood traumas, whereas cortical regions were more vulnerable to adulthood trauma (regardless of childhood experience). Using cell-type-specific expression imputation, we identified a strong transcriptional response of medial amygdala excitatory neurons to childhood trauma, which coincided with dysregulation observed in a human induced pluripotent stem cell (hiPSC)-derived glutamatergic neurons exposed to hydrocortisone. We resolved multiscale coexpression networks for each brain region and identified modules enriched in trauma signatures and whose connectivity was altered with trauma. Trauma-associated coexpression modules provide insight into coordinated functional dysregulation with different traumas and point to potential gene targets for further dissection. Together, these data provide a characterization of the long-lasting human encoding of traumatic experiences in corticolimbic regions of human brain.

Trauma History in a Medium-Secure Adult Male Forensic Mental Health Setting

Forensic services have shifted their focus to the importance of forensic practice becoming more trauma informed. Trauma exposure is pervasive in forensic mental health populations and has been found to negatively impact the course of severe mental illness (SMI) and increase risk of violence. This study aimed to explore the trauma histories of adult male inpatients in a medium-secure psychiatric hospital, and examine childhood and adulthood trauma as predictors of diagnoses, self-harm, suicidality, hospital re-admissions, substance use, and nature of offense. The case files of 85 male patients in a medium secure unit in the UK were reviewed. Eighty-seven percent of patients had a schizophrenia diagnosis and 86% had extensive trauma histories, the most common trauma type being physical violence in childhood (44.7%). One patient had a PTSD diagnosis. Logistic regressions demonstrated that cumulative childhood and adulthood trauma significantly increased the odds of self-harm. Cumulative childhood trauma exposure was found to decrease the likelihood of having a schizophrenia diagnosis. There is a serious under-recognition of the extent and consequences of trauma exposure; trauma histories are likely greater than the findings of this study and existing literature suggests. Implications for clinical practice, trauma-informed care (TiC), and future research are proposed.

The use of serious digital games to talk about grief and finitude with children: reports on the design and evaluation process of two games

The discussion of grief and loss is often avoided, particularly when it comes to conversations involving children. The COVID-19 pandemic has tragically resulted in the loss of relatives and friends for thousands of children, bringing this topic to the forefront. Parents and caregivers have found themselves compelled to broach the subjects of death and grief with children, aiming to provide them with an understanding of the global events unfolding around them. Yet, such discussions remain steeped in taboo. Literature underscores the significance of addressing children's emotions during times of loss, offering guidance on how to navigate such experiences to mitigate the risk of long-term trauma in adulthood. This project introduces the development of two serious games tailored to assist health professionals in (1) guiding children through grief therapies and (2) initiating discussions about finitude with this specific audience. Using the SemTh methodology, which guides the design and evaluation of therapeutic digital games, a multidisciplinary team comprising Health professionals (psychologists and occupational therapists), as well as Computing professionals collaborated on the creation of these games. Implemented on the RUFUS platform, developed by these authors' research group, this platform utilizes predefined templates to guide the game instantiation. Notably, the project contributed two new templates to the platform: narrative and inverse narrative, enabling the construction of games through storytelling. The new templates on the RUFUS platform were assessed through empirical and analytical studies to allow usability and effectiveness of them.

Trauma-related mental health problems among mothers in Taiwan and their relationship with children’s emotional and behavioral problems

ABSTRACT Background: Trauma can give rise to mental health problems and emotional and interpersonal difficulties, which in turn can perpetuate the cycle of trauma and adversity for future generations. However, little is known about the prevalence and potential effects of trauma and trauma-related mental health problems among parents. Objective: The primary goal of this study was to examine childhood and adulthood trauma and trauma-related symptoms among mothers of children aged between 6 and 18. We also conducted exploratory analyses of their potential relationship with children’s emotional and behavioural problems. Method: A total of 817 mothers living with a child aged between 6 and 18 in Taiwan completed standardized self-report assessments of trauma exposure, trauma-related symptoms, and children’s emotional and behavioural problems. A subsample (n = 256) also provided follow-up data after six months. Results: Most surveyed mothers reported at least one childhood traumatic event (74.79%) and one adulthood traumatic event (78.70%); 4.4% met the ICD-11 criteria for PTSD, and 12.1% for complex PTSD; 11.4% reported clinically significant dissociative symptoms. Mothers’ complex PTSD and dissociative symptoms were cross-sectionally correlated with children’s emotional and behavioural problem (rs = .186 to .239, p < .001). After controlling for possible confounding variables and baseline scores, mothers’ childhood non-betrayal trauma reported at baseline was found to be a predictor of children's emotional and behavioural problems reported at follow up. Conclusion: This study is the first to provide data regarding childhood and adulthood trauma and trauma-related disorders, including ICD-11 complex PTSD, among mothers in the community. It calls for more studies to understand the potential effects of intergenerational trauma.

To Explore the Relationship Between Childhood Trauma and Body Dysmorphic Symptoms in Young Adulthood

Abstract: This study is intended to investigate the connection between the child trauma and body dysmorphic disorders as experienced by the youth in 18-25-year-old age-group. Although the research yielded r=0.271 pval &lt; 0.001 for the relationship between childhood trauma and body distortion symptoms, the findings also indicate a non-significant p value of 0.551 which shows the two variables do not have a causal link among this sample. It appears that the cildhood trauma does not have a direct effect on the geness of body dysmorphic symptoms among teenagers. Research into the complex interaction between the developmental period of childhood and the emergence of body dysmorphic symptoms is still necessary, and additionally, one should consider the factors that could affect this engagement positively. Moreover, the range of interventions that addresses body dysmorphic symptoms should move beyond the usual settings to get at the core of the real factors to successfully help the affected individuals.

Associations between trauma exposure and irritability within the family unit: a network approach.

Pediatric irritability is a pervasive psychiatric symptom, yet its etiology remains elusive. While trauma exposure may contribute to the development of irritability, empirical research is limited. This study examined the prevalence of irritability among trauma-exposed children, identified factors that differentiate trauma-exposed children with and without irritability, and employed a network analysis to uncover associations between irritability and trauma exposure in the family unit. Sample included 676 children (56.3% male, mean age = 9.67 ± 3.7 years) and their parents referred by the Connecticut Department of Children and Families to Fathers for Change - a psychotherapy intervention designed to reduce intimate partner violence (IPV) and child maltreatment. Child's trauma exposure, post-traumatic stress disorder (PTSD) symptoms, and irritability were assessed pre-intervention using self- and caregiver-report. Parents self-reported their childhood and adulthood trauma exposures, PTSD symptoms, irritability, psychopathology, and IPV. Across caregiver- and child-reports, 16%-17% of children exhibited irritability. Irritable children experienced greater trauma exposure, interpersonal violence, emotional abuse, and PTSD severity. They had caregivers, particularly mothers, with greater trauma histories, IPV, and psychopathology. Network analysis revealed 10 nodes directly correlated to child's irritability including child's PTSD severity, parental IPV (specifically psychological violence), and parental psychopathology. Results provide initial empirical evidence that pediatric irritability is linked to trauma exposure, suggesting trauma histories be considered in the diagnosis and treatment of irritability. Interventions addressing caregiver trauma, IPV, and psychopathology may ameliorate pediatric irritability. Future studies could benefit from adopting network approaches with longitudinal or time series data to elucidate causality and points of intervention.

Resting heart rate associations with violence exposure and posttraumatic stress symptoms: sex differences in children

BackgroundTraumatic events experienced in childhood can lead to increased risk of cardiovascular disorders in adulthood. Black Americans are disproportionately affected, as they are at increased risk for experiencing childhood trauma and cardiovascular diseases in adulthood. One of the hypothesized mechanisms of this association is through long-lasting dysregulation of the autonomic nervous system, a hallmark physiological biomarker of posttraumatic stress disorder (PTSD), which is twice as prevalent in women compared to men.MethodsNinety-one, majority Black American children, aged 9 were recruited to be a part of our longitudinal study of child development at research centers in Atlanta, GA and Detroit, MI. Resting HR was measured through a electrocardiogram (ECG) recording using the Biopac MP150. Self-report measures of violence exposure and PTSD symptoms were administered by research staff.ResultsChildren with more violence exposure reported increased PTSS as well as lower resting HR. Regression analysis showed evidence of sex modifying this relationship, (B = -0.64, p < 0.05), such that the association between resting HR and PTSS was stronger in girls than in boys. In our exploratory analysis with standard clinical cutoffs of resting HR, the normative HR group was found to significantly moderate the relationship between violence exposure and PTSS in boys, (B = -2.14, p < 0.01), but not girls (B = -0.94, p = 0.27).ConclusionIn our sample of primarily Black urban children, we found that violence exposure was associated with slower, more adult-like HR, that girls showed greater PTSS associated with slower HR while boys did not, and that girls with lower than normative HR showed significantly higher PTSS compared to girls with normative HR. Our sample’s demonstration of psychological consequences in addition to the physiological implications could provide new information about a psychobiological sequelae of violence exposure.

Mediating effect of unhealthy lifestyle and depressive symptom on association between life course factors and ageing health

Objective: To explore the mediating effect of unhealthy lifestyle and depressive symptom on the associations between life course factors and aging health. Methods: The study included 6 217 participants (aged ≥45 years) from the China Health and Retirement Longitudinal Study (CHARLS). We used principal component analysis (PCA) and hierarchical clustering analysis (HCA) to divide participants into six subgroups based on 70 life course factors. Five key life course factors were identified based on correlation analysis and their contribution to aging health. Physiological dysregulation (PD) was calculated by using eight biomarkers in the 2015 CHARLS biomarker dataset. Linear regression, logistic regression, and mediation models were used to explore the complex associations of life course subgroups, key factors, unhealthy lifestyle, depression symptom with PD. Results: Life course subgroups were significantly associated with PD after adjusting chronological age and gender (β: 0.08-0.17, all P<0.05). Life-course subgroups and key factors, including adverse experiences in adulthood and lower education level, were significantly associated with unhealthy lifestyle (β: 0.04-0.52, all P<0.05). Life-course subgroups and key factors, including childhood trauma, parental health in childhood, adverse experiences in adulthood, and lower education level, were significantly associated with depression symptom (OR: 1.16-4.76, all P<0.05). Mediation analysis showed that unhealthy lifestyle had partial mediating effect on the association of life course subgroups and key factors, including adverse experiences in adulthood, and lower education levels, with PD (3.1%-3.6%). Depression symptom had partial mediating effect on the association of life course subgroups and key factors, including childhood trauma, adverse experience in adulthood, and lower education level, with PD (6.0%-16.2%). Conclusions: Unhealthy lifestyle and depression symptom has partial mediating effect on the impact of life course factors on aging health. It is important to pay attention to these two modifiable factors while targeting childhood trauma and adverse experience in adulthood.

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

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

Association Between Psychotic and Dissociative Symptoms: Further Investigation Using Network Analysis

ABSTRACT The association and overlap between psychotic and dissociative phenomena have been increasingly recognized. Previous studies found that psychotic symptoms are closely associated with post-traumatic and dissociative symptoms and that these trauma-related phenomena may mediate the relationship between trauma and psychotic symptoms. It remained less explored which specific post-traumatic and dissociative symptom clusters are particularly associated with psychotic symptoms. This cross-sectional study used a data-driven approach (network analysis) to explore the associations among different psychotic and post-traumatic/dissociative symptom clusters in an online convenience predominantly female sample (N = 468)(59.2% had ever seen a psychiatrist). Participants completed well-established multidimensional measures that assessed different symptom clusters of psychosis, dissociation, and PTSD. In addition, multiple mediation analysis was conducted to examine which post-traumatic/dissociative symptoms could mediate the relationship between childhood and adulthood trauma and different psychotic symptoms. Our results confirmed previous findings that PTSD and dissociative symptoms are closely associated with psychotic symptoms. More importantly, both data-driven and multiple mediation analysis results indicated that identity dissociation was particularly associated with perceptual anomalies and bizarre experiences, while emotional constriction was particularly associated with negative symptoms. It is important to screen for trauma and dissociation and provide trauma-and dissociation-informed care when working with people at risk of or experiencing psychosis. Further longitudinal studies using more representative samples are needed.

Supplemental Material for Sociosexuality and Maladaptive Personality Traits as Mediators of the Relationship Between Childhood Trauma and Sexual Victimization in Adulthood

Supplemental Material for Sociosexuality and Maladaptive Personality Traits as Mediators of the Relationship Between Childhood Trauma and Sexual Victimization in Adulthood

Investigating Differences in Sleep Disturbance, Dissociation, and Anxiety Due to the Severity and Timing of Betrayal Trauma Experienced

Betrayal trauma theory suggests betrayal from a trusted person affects how an event is remembered and processed. Few studies have looked at differences in psychological symptoms due to the severity and timing of betrayal trauma (BT). This study examined whether psychological symptoms, specifically, sleep disturbance, dissociation, and anxiety, differ depending on the severity and timing of BT. Participants (N = 270; 67.8% female) with at least one trauma completed online questionnaires measuring BT severity (low-medium, high), timing (childhood trauma, adulthood trauma), and frequency of psychological symptoms. A two-way between-subjects multivariate analysis of variance (MANOVA) was conducted. BT was prevalent in the sample, with 202 participants (74.8%) reporting a history of high BT. The MANOVA revealed a significant interaction between BT severity and BT timing on all outcome variables [p = .007, η2 p = .05]. Childhood BT participants with low-medium BT history had significantly greater sleep disturbance [p = .008, η2 p = .03], than participants with adulthood BT participants with low-medium BT history. Furthermore, adulthood BT participants with a history of high BT had significantly more dissociation [p = .003, η2 p = .01] and anxiety [p < .001, η2 p = .04] symptoms than childhood BT participants with a history of high BT. The research provides a novel insight into how different psychological symptoms manifest according to BT severity and timing, and the possibility of “rotating betrayal blindness” in which trauma awareness shifts in varying contexts.

Clinical Manifestations.

Despite the well-known deleterious health effects of childhood and adulthood trauma and the aging of the global population, little is known about trauma experiences in older adults. Moreover, childhood trauma may beget adulthood trauma and alter life-course trajectories of trauma exposure, and thus exhibit certain patterns in older adults. Using a national sample, this study aimed to (1) determine patterns of childhood and adulthood trauma, (2) examine their association with cognition and depression, and (3) investigate whether the association between trauma and depression is moderated by cognition. Data were from participants aged 60+ in the Health and Retirement Study in 2008 and 2012. Latent class analysis (LCA) was conducted to identify childhood and adulthood trauma patterns in 2008 (N = 6545). Depressive symptoms were measured by Center for Epidemiological Studies-Depression scale (CESD) and cognition was assessed by total cognition summary score (range 0-35 and cognitive impairment defined as 8 or less) in both 2008 and 2012. The final sample size is 4684. Multiple regressions were conducted to examine cross-sectional and longitudinal associations between trauma patterns, cognition, and depression, while moderation analyses were conducted to examine the moderating role of cognition, adjusting for age, gender, race, education, marital status, and body mass index. Participants had a mean age of 71.5(7.53) years, 58.4% female, and 85.7% White. A 3-class LCA model was determined to be the best fit for the data with three patterns: (1) low trauma exposure (61.04%), (2) family life-threatening events (20.07%) and (3) moderate trauma exposure (i.e., moderate probability of having experienced every type of trauma) (18.89%). Older adults experiencing family life-threatening events or moderate trauma exposure have significantly worse cognition and higher depression. Furthermore, cognition moderated the association between trauma exposure and depression, especially for older adults who experienced family life-threatening events. Findings indicated significant associations between three distinct trauma patterns and depression, and the buffering role of cognition. Educating health professionals about trauma patterns, rather than only considering accumulation, could optimize targeted, integrated public health and clinical strategies to improve cognitive performance and decrease depression in vulnerable older adults who have experienced trauma.

Childhood and Adulthood Trauma Associate With Cognitive Aging Among Black and White Older Adults

The authors examined childhood and adulthood traumatic events in relation to cognition among Black and White older adults in the Health and Retirement Study (HRS). Participants (N = 13,952) aged 55+ had complete lifetime trauma and cognitive testing data at the 2006/08, 2010/12, and/or 2014/16 waves. Trauma indices comprised childhood and adulthood event counts. Outcomes included baseline performance and trajectories on the Telephone Interview for Cognitive Status. Main and nonlinear trauma effects were modeled via linear regression, and overall contributions assessed with omnibus likelihood ratio tests. Black participants (N = 2,345) reported marginally lower adulthood trauma exposure than White participants (N = 11,607) with no other exposure differentials observed. In White participants only, greater childhood trauma exposure predicted worse baseline cognition but slower change over time. Across race, adulthood trauma robustly associated with baseline cognition. Relationships were frequently nonlinear: low but nonzero trauma predicted highest cognitive scores, with much poorer cognition observed as trauma exposure increased. Relationships between adulthood trauma and trajectory were limited to the White sample. Traumatic experiences, particularly in adulthood, may impact late-life cognitive health if not addressed. Findings highlight foci for clinical researchers and providers: adverse life events as a source of cognitive risk, and identification of community-specific resources that buffer behavioral, physical, and mental health sequelae of previous and incident trauma.

A scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health care

Experiences of trauma in childhood and adulthood are highly prevalent among service users accessing acute, crisis, emergency, and residential mental health services. These settings, and restraint and seclusion practices used, can be extremely traumatic, leading to a growing awareness for the need for trauma informed care (TIC). The aim of TIC is to acknowledge the prevalence and impact of trauma and create a safe environment to prevent re-traumatisation. This scoping review maps the TIC approaches delivered in these settings and reports related service user and staff experiences and attitudes, staff wellbeing, and service use outcomes.We searched seven databases (EMBASE; PsycINFO; MEDLINE; Web of Science; Social Policy and Practice; Maternity and Infant Care Database; Cochrane Library Trials Register) between 24/02/2022-10/03/2022, used backwards and forwards citation tracking, and consulted academic and lived experience experts, identifying 4244 potentially relevant studies. Thirty-one studies were included.Most studies (n = 23) were conducted in the USA and were based in acute mental health services (n = 16). We identified few trials, limiting inferences that can be drawn from the findings. The Six Core Strategies (n = 7) and the Sanctuary Model (n = 6) were the most commonly reported approaches. Rates of restraint and seclusion reportedly decreased. Some service users reported feeling trusted and cared for, while staff reported feeling empathy for service users and having a greater understanding of trauma. Staff reported needing training to deliver TIC effectively.TIC principles should be at the core of all mental health service delivery. Implementing TIC approaches may integrate best practice into mental health care, although significant time and financial resources are required to implement organisational change at scale. Most evidence is preliminary in nature, and confined to acute and residential services, with little evidence on community crisis or emergency services. Clinical and research developments should prioritise lived experience expertise in addressing these gaps.

Hypothalamus volume mediates the association between adverse childhood experience and PTSD development after adulthood trauma

The hypothalamus is critical for regulation of the hypothalamic-pituitary-adrenal (HPA) axis and response to stress. Adverse childhood experience (ACE) can affect brain structure, which may contribute to development of posttraumatic stress disorder (PTSD) after subsequent adult trauma. It is unclear, however, if ACE history is particularly associated with aspects of hypothalamic structure which contribute to development of PTSD. To address this issue, the present study longitudinally assessed hypothalamic volumes and their associations with ACE and early post-trauma stress symptoms in subjects who did or did not develop PTSD during 12 months after adult trauma. 109 subjects (18–60 years, F/M = 75/34) completed the PTSD Checklist (PCL) questionnaire for post-trauma stress symptoms, the Childhood Trauma Questionnaire (CTQ) for ACE assessment, and an initial MRI brain scan for hypothalamic volume measurement, within 2 weeks after adult trauma. At post-trauma 12 months, subjects underwent a subsequent PTSD diagnosis interview using the Clinician-Administered PTSD Scale (CAPS), and a follow-up MRI scan. Left and right hypothalamus volumes at 2 weeks after adult trauma negatively correlated with CTQ scores. Right hypothalamus volume at this early time mediated an association between ACE and PTSD symptoms 12 months later. Right hypothalamus volumes also remained persistently smaller from 2 weeks to 12 months after trauma in survivors who developed PTSD. These results suggest that smaller right hypothalamus volume may be related to ACE history in ways that contribute to PTSD development after trauma in adulthood.

The impact of adversities across the lifespan on psychological symptom profiles in late adulthood: a latent profile analysis.

People commonly face adverse circumstances throughout life, which increases risk for psychiatric disorders, such as anxiety, depression, psychosis, and posttraumatic stress disorder (PTSD). Adversities may occur during different periods in life. Especially adversity during early periods has been suggested to put individuals at risk for adverse mental health outcomes. Here, we investigated whether timing of adversity during the prenatal period, childhood, or mid-to-late adulthood differentially impacted classification into late adulthood symptom profiles. We performed sex-stratified Latent Profile Analysis to identify latent profiles regarding anxious, depressive, psychotic, and PTSD symptoms in n = 568 Dutch famine birth cohort members (n = 294 women, n = 274 men, mean age(SD) = 72.9(0.8)). Cross-sectional late adulthood symptomatology, childhood traumatic maltreatment, and adulthood trauma were based on self-report questionnaires. Prenatal adversity was considered present when individuals were prenatally exposed to the 1944-45 Dutch famine. In both men and women we identified one anxious/depressive profile and three profiles with approximately equal severity of all symptom types within each profile, yet differentiating in overall severity (low, mild, high) between profiles. We additionally found a PTSD symptom profile in women. In men, logistic regression models showed significant associations between prenatal, childhood and adulthood adversity, and profile classification, with differential effects depending on timing and most profound effects of child maltreatment. In women, childhood and adulthood adversity significantly increased classification probability into almost all profiles, with no significant effect of prenatal adversity. These findings support a time-dependent and sex-specific impact of adversity during different periods across the lifespan on psychological health, with consequences into late adulthood.

Borderline personality disorder features and their relationship with trauma and dissociation in a sample of community health service users

BackgroundPrevious studies have indicated that borderline personality disorder (BPD) is closely associated with trauma and dissociation. Nevertheless, BPD is a heterogeneous condition, and not all people with BPD have severe dissociation. This study examined whether the relationship of BPD features with trauma and dissociation would remain significant after controlling for some general non-specific mental health distress. We also made the first attempt to explore which specific BPD features would be particularly associated with dissociation.MethodsWe analyzed survey data from a sample of community health service users in Hong Kong (N = 376). Hierarchical multiple regression and data-driven network analysis were used.ResultsThe lifetime prevalence of DSM-5 BPD was 16.0% in our sample. Of participants who met criteria for BPD, 43.3% scored above cutoff on the dissociation measures, thus possibly having clinically significant dissociative symptoms. BPD features were associated with adulthood trauma and psychoform dissociation even after controlling for age, depression and self-esteem. Network analysis showed that some BPD features – including impulsivity, identity disturbance and suicidal/self-mutilation behaviors – were particularly associated with dissociation; other BPD features such as interpersonal-related problems had relatively weak to no connection with dissociation.ConclusionsOur results suggested that some particular BPD features might be dissociative in nature, although further longitudinal research is required. We argue that a trauma-informed perspective should be employed when working with clients presenting with BPD features despite these features being commonly stigmatized. Further research on the intervention needs of the people with BPD who suffer from high levels of dissociation is required.

Trauma in childhood is associated with greater pain catastrophizing but not anxiety sensitivity: a cross-sectional study.

Adverse life experiences have been identified as a possible vulnerability factor for chronic pain. This association could result from the effect of trauma on the psychological state of individuals. Previous studies found childhood trauma to be associated with pain catastrophizing and anxiety sensitivity, both of which have been associated with an increased risk of chronic pain. However, it is unknown whether trauma in adulthood affects these variables and whether the effect on pain catastrophizing is independent of confounds such as depression and anxiety. To test the effect of childhood and adulthood trauma on pain catastrophizing and anxiety sensitivity whilst controlling for depression and anxiety. In the current study, we conducted an online survey in the United Kingdom in a chronic pain sample (N = 138; 123 women; age range 19-78). We analysed whether there is an association between different types of trauma (both in childhood and through the lifespan), pain catastrophizing, and anxiety sensitivity while controlling for anxiety and depression. We found that childhood trauma (particularly emotional abuse) significantly predicts pain catastrophizing, even when controlling for depression and anxiety, whereas it did not have a significant effect on anxiety sensitivity. Trauma through the lifespan (not childhood) did not have a significant effect on anxiety sensitivity nor did it have a significant effect on pain catastrophizing. Our results show that the life stage in which trauma occurs is key in its psychological effects on patients with chronic pain. Furthermore, it shows that trauma affects some psychological variables but not others.

From childhood adversity to latent stress vulnerability in adulthood: the mediating roles of sleep disturbances and HPA axis dysfunction.

Childhood adversity is a prominent predisposing risk factor for latent stress vulnerability, expressed as an elevated likelihood of developing stress-related psychopathology upon subsequent exposure to trauma in adulthood. Sleep disturbances have emerged as one of the most pronounced maladaptive behavioral outcomes of childhood adversity and are also a highly prevalent core feature of stress-related psychopathology, including post-traumatic stress disorder (PTSD). After reviewing the extensive literature supporting these claims, the current review addresses the notion that childhood adversity-induced sleep disturbances may play a causal role in elevating individuals' stress vulnerability in adulthood. Corroborating this, sleep disturbances that predate adult trauma exposure have been associated with an increased likelihood of developing stress-related psychopathology post-exposure. Furthermore, novel empirical evidence suggests that sleep disturbances, including irregularity of the sleep-wake cycle, mediate the link between childhood adversity and stress vulnerability in adulthood. We also discuss cognitive and behavioral mechanisms through which such a cascade may evolve, highlighting the putative role of impaired memory consolidation and fear extinction. Next, we present evidence to support the contribution of the hypothalamic-pituitary-adrenal (HPA) axis to these associations, stemming from its critical role in stress and sleep regulatory pathways. Childhood adversity may yield bi-directional effects within the HPA stress and sleep axes in which sleep disturbances and HPA axis dysfunction reinforce each other, leading to elevated stress vulnerability. To conclude, we postulate a conceptual path model from childhood adversity to latent stress vulnerability in adulthood and discuss the potential clinical implications of these notions, while highlighting directions for future research.