Childhood Trauma Exposure Exacerbates the Impact of Concurrent Exposure to Intimate Partner Violence on Women's Posttraumatic Symptoms.

Although it is well established that intimate partner violence (IPV) is detrimental to women's mental health, it remains unclear to what extent symptoms can be attributed to the proximal effects of IPV exposure itself as opposed to more stable scarring effects or co-occurring risk factors. Heterogeneity in the magnitude of IPV effects further suggests that IPV-exposed individuals are differentially susceptible to disorder, and an investigation of moderating factors that may make women more vulnerable is warranted. We used a prospective longitudinal study of low-income mothers followed from 3 to 18 months postpartum to distinguish the concurrent mental health effects of IPV exposure from overall person-level IPV-mental health associations, as well as to test the moderating role of prior relational traumatic experiences in the form of childhood maltreatment. Multilevel modeling results demonstrated a unique concurrent association between increasing IPV and women's posttraumatic symptoms over time, even after controlling for an overall association between mean IPV and symptom levels. The effects of concurrent IPV were heightened in women who reported a history of childhood maltreatment. Model effects were medium to large, R2 = .27-.35. The implications of these findings for the identification of and intervention with women at the highest risk for relational trauma-related mental health difficulties are discussed.

Are Gender Differences in DSM-5 PTSD Symptomatology Explained by Sexual Trauma?

Although many studies have assessed gender differences in posttraumatic stress disorder (PTSD) prevalence, few examine individual PTSD symptoms (PTSSs). Hypothesizing that trauma differences explain many gender differences in symptomatology, this is the first known study to adjust PTSSs for trauma type, and to compare gender differences in those with sexual traumas. Using a cross-sectional survey methodology in a sample of adult outpatients (n = 775), we examined gender, trauma type, PTSSs, suicide, alcohol, and tobacco. Among those with trauma (n = 483), women generally had more severe symptoms than men, but after adjusting for trauma type, only physical reactivity (p = .0002), excessive startle (p = .0005), external avoidance (p = .0007), internal avoidance (p = .0008), psychological reactivity (p = .0009), and suicide attempts (p = .001) remained significantly worse among women, whereas men more commonly reported alcohol problems (p = .007). Among those with PTSD (n = 164), there were no significant PTSS gender differences. Those with sexual trauma had worse symptoms (particularly amnesia) compared with non-sexual trauma (p < .0001 for PTSD diagnosis and total severity), including within each gender. Among those with sexual trauma (n = 157), men had worse recklessness (p = .004) and more commonly reported tobacco (p = .02), whereas women more commonly attempted suicide (p = .02) and had worse avoidance (p = .04). However, when isolating the effects of sexual trauma beyond other traumas, there were no significant symptom difference-in-differences between genders. Our findings suggest that, while women have higher PTSD rates, men with PTSD present similarly. In addition, while women have higher sexual trauma rates, men may have similarly severe responses. Most gender differences in PTSD presentation appear to be explained by trauma type, particularly women having higher rates of sexual trauma. We discuss potential biopsychosocial explanations.

Latent Classes of Maltreatment: A Systematic Review and Critique.

This article reviews and critically evaluates available research on latent classes of maltreatment. Three major databases (PsycINFO, Web of Knowledge, and Academic Search Complete) were used to identify studies on latent classes of maltreatment published before June 1, 2016. Of 365 potentially relevant studies, 14 met inclusion criteria for review. Our analysis was guided by the following questions: (a) What observed indicators are being used to model classes of maltreatment? (b) What are the most commonly identified classes of maltreatment? and (c) What are the predictors and outcomes of classes of maltreatment? Across the studies, findings demonstrated how person-centered methods (i.e., latent class/profile analysis) may facilitate the study of maltreatment by concurrently addressing several methodological limitations common to the study of maltreatment, while also addressing heterogeneity in experiences of maltreatment. After providing an account of existing trends within the literature employing person-centered methodology in the study of maltreatment, we offer a critique of extant research, note recent methodological developments, and make numerous recommendations for future research using person-centered approaches to understanding maltreatment.

Childhood trauma, family history, and their association with mood disorders in early adulthood.

OBJECTIVE: To assess the prevalence of childhood trauma and types of trauma on mood disorders among young adults in a population-based sample. We further gathered data on family history of mood disorders to test the hypothesis that childhood trauma is a mediating factor for the association between family history of mood disorder and mood disorder in adulthood. METHOD: This is a cross-sectional study, including young adults with bipolar disorder, major depressive disorder, and matched controls without any mood disorder. Childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). The Hicks and Tingley implementation was employed to assess whether trauma is a mediator of the effect of family history on diagnosis of any mood disorder. RESULTS: All types of trauma were associated with both major depression and bipolar disorder, with the exception of sexual abuse, which was only associated with bipolar disorder. Moreover, family history of psychiatric illness was also associated with mood disorder in adulthood and with childhood trauma. Using the presence of any mood disorder as the outcome, a third of the effect of having any family history of mood disorder was mediated via childhood trauma. CONCLUSION: This investigation provides further support, in a population-based sample of young adults, of the association between childhood trauma and mood disorders, with sexual abuse being specifically linked with bipolar disorder. The hypothesis that childhood trauma would function as a partial mediator of the association between family history of mood disorder and mood disorder in adulthood was also confirmed.

Classes and consequences of multiple maltreatment: a person-centered analysis.

While the overwhelming majority of research on the consequences of childhood maltreatment reports differential outcomes of specific maltreatment subtypes (e.g., physical abuse vs. emotional abuse) as though they are independent, maltreatment experiences often occur in combination. The present study evaluated multiple maltreatment experiences in a sample of 2,637 undergraduate students who reported on childhood maltreatment and current adjustment. The authors used latent class analysis to examine predominant patterns of multiple maltreatment experiences and investigated indices of psychosocial adjustment associated with those patterns. Results suggested that specific constellations of multiple maltreatment have qualitatively different associations with adjustment. Emotional abuse, alone or in combination with other maltreatment types, was especially salient for psychopathology (e.g., anxiety, depression), while a combination of physical and emotional abuse was most strongly associated with conduct-related problems (e.g., substance use, risky sexual behavior). These findings have both practical and empirical significance for understanding and classifying experiences of maltreatment.

Heterogeneity of individuals with a history of child sexual abuse: an examination of children presenting to treatment.

The current study examined children and families who presented for treatment through Project SAFE (Sexual Abuse Family Education) following childhood sexual abuse. Pretreatment assessment data were used to develop clusters of participants with significantly differing presentation of symptom outcome following abuse. Four clusters were discovered: (a) a Highly Distressed group, whose members had clinically elevated scores on all self- and parent-report measures; (b) a Problem Behaviors group, whose members had scores within the normal range for self-report measures and elevated scores on all parent-report measures; (c) a Subclinical group, whose participants had scores below the mean and below cutoff scores for all self- and parent-report measures; and (d) a Self-reported Distress group, whose members had elevated scores on self-report measures and scores below clinical cutoffs for all parent-report measures.

Post-traumatic stress disorder moderates the relation between documented childhood victimization and pain 30 years later.

Cross-sectional designs and self-reports of maltreatment characterize nearly all the literature on childhood abuse or neglect and pain in adulthood, limiting potential for causal inference. The current study describes a prospective follow up of a large cohort of individuals with court-documented early childhood abuse or neglect (n=458) and a demographically matched control sample (n=349) into middle adulthood (mean age 41), nearly 30 years later, comparing the groups for risk of adult pain complaints. We examine whether Post-Traumatic Stress Disorder (PTSD) mediates or moderates risk of pain. Assessed prospectively across multiple pain measures, physically and sexually abused and neglected individuals generally showed a significant (p<.05) but notably small (η(2)=.01) increased risk of pain symptoms in middle adulthood. Although PTSD was associated with both childhood victimization (p<.01) and risk of middle adulthood pain (p<.001), it did not appear to mediate the relationship between victimization and pain. However, across all pain outcomes other than medically unexplained pain, PTSD robustly interacted with documented childhood victimization to predict adult pain risk: Individuals with both childhood abuse/neglect and PTSD were at significantly increased risk (p<.001, η(2) generally=.05-.06) of pain. After accounting for the combined effect of the two factors, neither childhood victimization nor PTSD alone predicted pain risk. Findings support a view that clinical pain assessments should focus on PTSD rather than make broad inquiries into past history of childhood abuse or neglect.

Multi-type childhood abuse, strategies of coping, and psychological adaptations in young adults.

AIM: To retrospectively analyze the rate of multi-type abuse in childhood and the effects of childhood abuse and type of coping strategies on the psychological adaptation of young adults in a sample form the student population of the University of Mostar. METHODS: The study was conducted on a convenience sample of 233 students from the University of Mostar (196 female and 37 male), with a median age of 20 (interquartile range, 2). Exposure to abuse was determined using the Child Maltreatment Scales for Adults, which assesses emotional, physical, and sexual abuse, neglect, and witnessing family violence. Psychological adaptation was explored by the Trauma Symptom Checklist, which assesses anxiety/depression, sexual problems, trauma symptoms, and somatic symptoms. Strategies of coping with stress were explored by the Coping Inventory for Stressful Situations. RESULTS: Multi-type abuse in childhood was experienced by 172 participants (74%) and all types of abuse by 11 (5%) participants. Emotional and physical maltreatment were the most frequent types of abuse and mostly occurred together with other types of abuse. Significant association was found between all types of abuse (r=0.436-0.778, P<0.050). Exposure to sexual abuse in childhood and coping strategies were significant predictors of anxiety/depression (R(2)=0.3553), traumatic symptoms (R(2)=0.2299), somatic symptoms (R(2)=0.2173), and sexual problems (R(2)=0.1550, P<0.001). CONCLUSION: Exposure to multi-type abuse in childhood is a traumatic experience with long-term negative effects. Problem-oriented coping strategies ensure a better psychosocial adaptation than emotion-oriented strategies.

[Prevalence of physical abuse in childhood and exposure to parental violence in a Brazilian sample]. / Prevalência de abuso físico na infância e exposição à violência parental em uma amostra brasileira.

The aim of this study was to investigate the prevalence of physical abuse and exposure to parental violence during childhood, in relation to socio-demographic characteristics. Multi-stage sampling was used to select 3,007 individuals 14 years or older in 2005-2006, from all regions of the country. The study detected cases of physical abuse (beating, striking with objects, burning or scalding, threatening and/or using knives or firearms) and exposure to parental violence (witnessing parental threats and/or actual physical aggression) during childhood. Analyses were performed with the Pearson chi-square test. Prevalence of history of physical abuse in childhood was 44.1% (33.8% moderate, 10.3% severe). Prevalence of exposure to parental violence was 26.1% (7.5% witnessed moderate parental violence and 18.6% severe). Combined analyses of these two types of violence showed significant associations between them. The findings may help implement intervention strategies to call the attention of health professionals to the high prevalence of this type of violence.

Prevalência de abuso físico na infância e exposição à violência parental em uma amostra brasileira / Prevalence of physical abuse in childhood and exposure to parental violence in a Brazilian sample

O estudo objetivou avaliar a prevalência de abuso físico e exposição à violência parental na infância, segundo características sócio-demográficas. Um procedimento de amostragem de múltiplos estágios foi usado para selecionar 3.007 indivíduos de 14 anos de idade ou mais, entre 2005/2006, incluindo sujeitos de todas as regiões do país, assim, os resultados são nacionalmente representativos. Foram acessadas experiências de abuso físico (bater, bater com alguma coisa, queimar/escaldar, ameaçar/usar faca ou arma) e exposição à violência parental (testemunhou ameaça e/ou agressão física parental) na infância. Realizaram-se as análises através do teste qui-quadrado de Pearson. A prevalência de história de abuso físico na infância foi de 44,1 por cento, sendo que 33,8 por cento relataram história de abuso físico moderado e 10,3 por cento abuso físico severo. A prevalência de exposição à violência parental foi de 26,1 por cento, sendo que 7,5 por cento testemunharam violência parental moderada e 18,6 por cento testemunharam violência parental severa na infância. Análises combinadas entre estes dois tipos de violência demonstraram significativas associações entre elas. Estes resultados podem ajudar na implementação de estratégias de intervenção alertando profissionais de saúde para alta prevalência deste tipo de violência na população.

The aim of this study was to investigate the prevalence of physical abuse and exposure to parental violence during childhood, in relation to socio-demographic characteristics. Multi-stage sampling was used to select 3,007 individuals 14 years or older in 2005-2006, from all regions of the country. The study detected cases of physical abuse (beating, striking with objects, burning or scalding, threatening and/or using knives or firearms) and exposure to parental violence (witnessing parental threats and/or actual physical aggression) during childhood. Analyses were performed with the Pearson chi-square test. Prevalence of history of physical abuse in childhood was 44.1 percent (33.8 percent moderate, 10.3 percent severe). Prevalence of exposure to parental violence was 26.1 percent (7.5 percent witnessed moderate parental violence and 18.6 percent severe). Combined analyses of these two types of violence showed significant associations between them. The findings may help implement intervention strategies to call the attention of health professionals to the high prevalence of this type of violence.