Association between childhood trauma and postpartum depression among Brazilian puerperal women / Asociación entre traumas en la infancia y depresión posparto en puérperas brasileñas / Associação entre trauma na infância e depressão pós-parto em puérperas brasileiras

Objective: to evaluate the association between different forms of childhood trauma and postpartum depression in Brazilian puerperal women. Method: this cross-sectional survey included 253 puerperal women who were evaluated using the Edinburgh Postnatal Depression Scale and the Childhood Trauma Questionnaire. Multivariate logistic regression analyses were performed to verify the association of different types of trauma and the co-occurrence of forms of abuse and neglect with postpartum depression. Results: postpartum depression was identified in 93 women (36.8%; 95% Confidence Interval: 30.8-42.7). All forms of childhood trauma assessed (emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse) were independently associated with postpartum depression after adjusting for confounding variables. Emotional abuse remained associated with postpartum depression when the co-occurrence of all forms of childhood trauma was analyzed. Conclusion: the results suggest an association between the different forms of childhood trauma and postpartum depression. In this sense, childhood trauma is an indicator for Nursing professionals to screen for risk factors of postpartum depression during obstetric_follow-up.

Objetivo: evaluar la asociación entre diferentes formas de traumas en la infancia y depresión posparto en puérperas brasileñas. Método: en este estudio transversal se incluyó a 253 puérperas que fueron evaluadas con la Edinburgh Postnatal Depression Scale y el Childhood Trauma Questionnaire . Se realizaron análisis de regresión logística multivariados para verificar la asociación de diferentes tipos de trauma y la coocurrencia de formas de abuso y negligencia con la depresión posparto. Resultados: se identificó depresión posparto en 93 mujeres (36,8%; intervalo de confianza del 95%: 30,8-42,7). Todas las formas de traumas en la infancia que se evaluaron (abuso emocional, negligencia emocional, abuso físico, negligencia física y abuso sexual) estuvieron asociadas de manera independiente con la depresión posparto después de ajustar por variables de confusión. El abuso emocional siguió estando asociado con la depresión posparto cuando se analizó la coocurrencia de todas las formas de traumas en la infancia. Conclusión: los resultados sugieren una asociación entre las diferentes formas de traumas en la infancia y la depresión posparto. En este sentido, los traumas en la infancia son un indicador para que los profesionales de Enfermería detecten factores de riesgo para la depresión posparto en los controles obstétricos.

Objetivo: avaliar a associação entre diferentes formas de trauma na infância e depressão pós-parto em puérperas brasileiras. Método: estudo transversal incluiu 253 puérperas que foram avaliadas pela Edinburgh Postnatal Depression Scale e pelo Childhood Trauma Questionnaire . Análises multivariadas de regressão logística foram realizadas para verificar a associação entre diferentes tipos de trauma e a coocorrência de formas de abuso e negligência com depressão pós-parto. Resultados: a depressão pós-parto foi identificada em 93 mulheres (36,8%; Intervalo de Confiança de 95%: 30,8-42,7). Todas as formas de trauma na infância avaliadas (abuso emocional, negligência emocional, abuso físico, negligência física e abuso sexual) foram independentemente associadas à depressão pós-parto após ajuste para variáveis de confusão. O abuso emocional permaneceu associado à depressão pós-parto quando foi analisada a coocorrência de todas as formas de trauma na infância. Conclusão: os resultados sugerem associação entre as diferentes formas de trauma na infância e depressão pós-parto. Nesse sentido, o trauma na infância é um indicador para os profissionais de Enfermagem rastrearem fatores de risco de depressão pós-parto durante o acompanhamento obstétrico.

Dating violence prevalence and risk factors among adolescents (14-19 years) in urban public schools in Panama.

Background: Adolescent dating violence (ADV) can have lasting effects on youth's well-being and development. However, few studies in Latin America have described its prevalence and risk factors for having experienced ADV. Methods: We conducted a multisite, cross-sectional study using two-stage cluster sampling among adolescents (14-19 years) attending public high schools in the urban districts of Panama, San Miguelito, Colón, and Arraiján/La Chorrera from 2015 to 2018 (N = 2469). All completed a tablet-based, self-administered questionnaire. Random effects logistic regression was used to identify risk factors for each ADV type among adolescent boys and girls separately. Findings: Participants reported experiencing a range of ADV at least once (girls: emotional 61.6%, physical 7.9%, sexual 21.0%; boys: emotional 73.4%, physical 24.1%, sexual 28.9%). In adjusted models, participants with a history of sexual intercourse had greater odds of ADV than those without such history across types (boys: emotional and sexual; girls: emotional, physical, and sexual). Additionally, participants who reported three or more romantic partners in the past year had greater odds of ADV than those with one partner (boys: emotional, physical; girls: physical). Girls with an earlier sexual debut (≤14 years vs ≥15 years) had greater odds of reporting ADV (emotional and sexual violence). No associations were found between reporting dating violence survival and the sex of romantic partners in the past year or the age of the current/most recent sex partner. Interpretation: This study reveals a high prevalence of ADV among adolescents in urban public schools in Panama. These findings support the need for program implementation to address ADV. Funding: Funding to undertake this study was acquired from Panama's Ministry of Economics and Finance, project number 009044.049.

Análise do impacto psicológico ocasionado em mulheres vítimas de violência simbólica: uma revisão de literatura / Analysis of the psychological impact on women victims of symbolic violence: a literature review / Análisis del impacto psicológico en mujeres víctimas de violencia simbólica: una revisión bibliográfica

A violência contra a mulher é um ato ou conduta que pode causar morte ou sofrimento físico, mental e sexual, sendo um problema mundial e antigo que está presente no cotidiano das vítimas e, muitas vezes, é amenizada e até mesmo normalizada pela sociedade. E, com isso, pode resultar grande sofrimento das mulheres envolvidas. Nesse sentido, esta pesquisa tem como objetivo analisar o impacto psicológico de mulheres vítimas de violência simbólica por meio da revisão de literatura. Para isso, utilizou-se como metodologia a revisão integrativa de literatura com abordagem qualitativa, possuindo enfoque nas bases de dados como: LILACS, SciELO, Biblioteca Virtual em Saúde (BVS), Medline entre os anos de 2018 a 2022. Foram utilizados descritores como: psychological violence, violence e emotional abuse resultando em 532 artigos com um total de 10 amostras para análise. Observou-se que um dos principais desafios para o psicólogo é a detecção da violência psicológica, que muitas vezes é invisível e subjetiva. Desse modo, é importante que o psicólogo esteja atento a sinais como a baixa autoestima, ansiedade, depressão, isolamento social, síndrome do pânico, entre outros, que podem indicar a presença de violência psicológica. Além disso, é fundamental que o psicólogo seja capacitado para identificar as diferentes formas de violência psicológica, como a manipulação emocional, a humilhação, a ameaça, o controle, entre outras.

Violence against women is an act or conduct that can cause death or physi- cal, mental, and sexual suffering. It is a worldwide and old problem that is present in the daily lives of victims and is often softened and even normalized by society. And, with this, great suffering of the women involved can result. In this sense, this research aims to analyze the psychological impact of women victims of symbolic violence through a lite- rature review. For this, the methodology used was an integrative literature review with a qualitative approach, focusing on databases such as: LILACS, SciELO, Virtual Health Library (VHL), Medline between the years 2018 and 2022. Descriptors were used as: psychological violence, violence and emotional abuse resulting in 532 articles with a total of 10 samples for analysis. It was observed that one of the main challenges for the psycho- logist is the detection of psychological violence, which is often invisible and subjective. Thus, it is important that the psychologist be aware of signs such as low self-esteem, anxiety, depression, social isolation, panic syndrome, among others, which may indicate the presence of psychological violence. In addition, it is fundamental that the psychologist is trained to identify the different forms of psychological violence, such as emotional manipulation, humiliation, threats, and control, among others.

violencia contra las mujeres es un acto o conducta que puede causar la muerte o sufrimiento físico, mental y sexual, siendo un problema mundial y antiguo que está presente en el día a día de las víctimas y que muchas veces es suavizado e incluso normalizado por la sociedad. Y, con esto, puede resultar en un gran sufrimiento para las mujeres involucradas. En este sentido, esta investigación pretende analizar el impacto psicológico de las mujeres víctimas de violencia simbólica a través de una revisión bibli- ográfica. Para ello, la metodología utilizada fue una revisión bibliográfica integradora con enfoque cualitativo, centrada en bases de datos como: LILACS, SciELO, Biblioteca Vir- tual en Salud (BVS), Medline entre los años 2018 y 2022. Se utilizaron descriptores como: violencia psicológica, violencia y maltrato emocional dando como resultado 532 artículos con un total de 10 muestras para el análisis. Se observó que uno de los principa- les desafíos para el psicólogo es la detección de la violencia psicológica, que a menudo es invisible y subjetiva. Así, es importante que el psicólogo esté atento a señales como baja autoestima, ansiedad, depresión, aislamiento social, síndrome de pánico, entre otras, que pueden indicar la presencia de violencia psicológica. Además, es fundamental que el psicólogo esté capacitado para identificar las diferentes formas de violencia psicológica, como manipulación emocional, humillación, amenaza, control, entre otras.

Esquemas Iniciais Desadaptativos em Adultos com Histórico de Eventos Estressores Precoces / Early Maladaptive Schemas in Adults with a History of Early Life Stressors / Esquemas Maladaptativos Tempranos en Adultos con Antecedentes de Eventos Estresantes Tempranos

Esse estudo teve como objetivo principal investigar a relação entre os subtipos de Eventos Estressores Precoces e os Esquemas Iniciais Desadaptativos em adultos. Foram utilizados o Questionário sobre Traumas na Infância (Childhood Trauma Questionnaire) e o Questionário de Esquemas de Young - forma reduzida (Young Schema Questionnaire - short form) em uma amostra, não-clínica de 200 pessoas, na qual metade (n=100) apontou a presença de Eventos Estressores Precoces. Os dados foram processados no software IBM SPSS Statistics - versão 22, por meio de estatística descritiva, coeficiente de correlação de Pearson, e comparação de médias através do Teste t de Amostras Independentes. As análises de correlação revelaram que cada subtipo de abuso e negligência se relacionou de diferentes formas com os Esquemas Iniciais Desadaptativos, sugerindo que a influência diferencial de cada tipo deve ser estudada. Dentre todos os subtipos de Eventos Estressores Precoces, o abuso emocional se destacou, apresentando maior prevalência e correlações com mais esquemas.

This study aimed to investigate the relationship between the subtypes of Early Life Stressors and the Early Maladaptive Schemas in adults. The Childhood Trauma Questionnaire and the Young Schema Questionnaire (short form) were used in a non-clinical sample of 200 people in which half (n = 100) had a previous history of Early Life Stressors. The data was processed in the IBM SPSS Statistics - version 22 software, using descriptive statistics, Pearson's correlations coefficients and comparison of means by using the Independent Samples t-Test. Correlation analysis revealed that each type of abuse and neglect was related in different ways to the Early Maladaptive Schemes, which suggests that the differential influence of each type should be studied. Among all the subtypes of Early Stressful Events, the emotional abuse was the one that stood out, showing a higher prevalence and correlations with more schemes than other form of maltreatment, such as physical and sexual abuse.

Este estudio tuvo como objetivo investigar la relación entre los subtipos de Eventos Estresantes Tempranos y los Esquemas Maladaptativos Tempranos en adultos. Se utilizaron el "Cuestionario de Trauma Infantil" (Childhood Trauma Questionnaire) y el "Cuestionario de esquemas - forma reducida" (Young Schema Questionnaire - short form) en una muestra no clínica de 200 personas, en la que la mitad (n = 100) indicó la presencia de EEP. Los datos fueron processados en el software IBM SPSS Statistics, versión 22, utilizando estadística descriptiva, coeficiente de correlación de Pearson y comparación de medias utilizando la Prueba t para Muestras Independientes. Los análisis de correlación revelaron que cada subtipo de abuso y negligencia se relacionó de diferentes formas con los Esquemas Maladaptativos Tempranos, sugiriendo que se debería estudiar la influencia diferencial de cada tipo. Entre todos los subtipos de Eventos Estresantes Tempranos, se destacó el abuso emocional, que tuvo una mayor prevalencia y correlaciones con más esquemas.

The invisible scars of emotional abuse: a common and highly harmful form of childhood maltreatment.

BACKGROUND: Childhood maltreatment (CM) is unfortunately widespread globally and has been linked with an increased risk of a variety of psychiatric disorders in adults, including posttraumatic stress disorder (PTSD). These associations are well established in the literature for some maltreatment forms, such as sexual and physical abuse. However, the effects of emotional maltreatment are much less explored, even though this type figures among the most common forms of childhood maltreatment. Thus, the present study aims to investigate the impact of each type of childhood maltreatment, both individually and conjointly, on revictimization and PTSD symptom severity using a nonclinical college student sample. METHODS: Five hundred and two graduate and undergraduate students participated in the study by completing questionnaires assessing lifetime traumatic experiences in general, maltreatment during childhood and PTSD symptoms. Bivariate and multivariate negative binomial regressions were applied to examine the associations among childhood maltreatment, revictimization, and PTSD symptom severity. RESULTS: Our results showed that using bivariate models, all types of CM were significantly associated with revictimization and PTSD symptom severity. Multivariate models showed that emotional abuse was the type of maltreatment associated with the highest incidence rates of revictimization and PTSD symptom severity. CONCLUSIONS: These data provide additional evidence of the harmful effects of childhood maltreatment and its long-term consequences for individuals' mental health. Notably, the findings highlight the importance of studying the impacts of emotional abuse, which seems to be a highly prevalent, understudied, and chronic form of maltreatment that is as toxic as other maltreatment forms.

Callosal abnormalities, altered cortisol levels, and neurocognitive deficits associated with early maltreatment among adolescents: A voxel-based diffusion-tensor imaging study.

INTRODUCTION: Neuroimaging studies have shown callosal abnormalities among maltreated subjects, but little is known about the functional and neurobiological correlates of these supposed developmental alterations. The aim of this study was to investigate childhood maltreatment (CM), neurocognitive functioning, cortisol levels, and corpus callosum (CC) integrity among adolescents. METHODS: One hundred and seven subjects underwent magnetic resonance imaging (MRI) with voxel-based diffusion-tensor imaging (DTI) and the Crossed Finger Localization Test (CFLT). Psychopathology was investigated with the Schedule for Affective Disorders and Schizophrenia (K-SADS-PL); CM was detailed by the Childhood Trauma Questionnaire (CTQ), and salivary cortisol levels were measured by immunoassay. RESULTS: Higher levels of CM were associated with current lower CFLT scores, mainly in the CROSSED condition, involving interhemispheric communication of sensorimotor information (p < .05) and with reduced fractional anisotropy (FA) in the splenium of the CC (p < .01). Deficits in the CFLT were also associated with higher cortisol levels (p < .05). CONCLUSION: The association among CM, neuropsychological abnormalities, callosal microstructure alterations, and cortisol levels suggests an altered pattern of brain interhemispheric connectivity among maltreated adolescents. Further studies are needed to investigate the extent to which these sensorimotor deficits and abnormal cortisol levels may be possible mediators of negative neurodevelopmental trajectories and adult psychopathology.

Childhood trauma and bipolar spectrum: a population-based sample of young adults

Abstract Introduction Childhood trauma has been suggested to be involved in susceptibility to bipolar disorder (BP). However, it remains unclear whether the occurrence of childhood trauma is differently distributed in subthreshold bipolar disorder (SBP). Objective To assess childhood trauma in young adults with SBP, as compared to young adults with BP and population controls (PC). Method This was a cross-sectional, population-based study. The Mini International Neuropsychiatric Interview (MINI) was used to define the groups with BP (subjects with a lifetime or current manic episode or lifetime or current hypomania with a history of a depressive episode), SBP (subjects with a history of hypomanic episode without lifetime or current depressive episode), and subjects without mood disorders (PC). Childhood trauma was assessed using de Childhood Trauma Questionnaire (CTQ). We investigated differences regarding childhood trauma across the three groups (BP, SBP and PC). Result Except for sexual abuse, all subtypes of childhood trauma remained associated with the BP group as compared to PC. Additionally, when we compared SBP and BP, significant differences were found only for emotional abuse. No significant differences were found in relation to childhood trauma between the SBP and PC groups after adjusting for confounding factors. Conclusion These findings suggest that investigating childhood trauma, with a particular focus on emotional abuse, could be considered a preventive measure and potentially improve the prognosis.

Analysis of the relationship between earthquake-related losses and the frequency of child-directed emotional, physical, and severe physical abuse in Haiti.

BACKGROUND: Child abuse is a public health and human rights issue that is prevalent worldwide. All forms of abuse against children can have negative physical and mental health consequences. Under post-disaster situations, where there is a potential for increased stress and decreased social support among caregivers, the risk of child abuse may be higher. OBJECTIVE: To explore the association between earthquake-related losses (family-related and property-related) and the experience of emotional, physical, and severe physical child abuse in the household for children aged 2-14 in Haiti. METHODS: A nationally representative sample of Haitian households from the 2012 Demographic and Health Survey (DHS) was used. Descriptive analyses were summarized using frequencies and measures of central tendency. Associations between earthquake-related loss and child abuse was assessed using log-binomial regression modelling. RESULTS: Two years following the earthquake, and after considering potentially confounding variables, death of a household member was associated with a higher likelihood of a child being victim to emotional (RR = 1.11, 95 % CI: 1.05-1.17) and severe physical abuse (RR = 1.50, 95 % CI: 1.15-1.96). Conversely, injury of a household member was associated with a lower likelihood of a child experiencing emotional abuse (RR = 0.93, 95 % CI: 0.87-0.99). CONCLUSIONS: There were associations between earthquake-related losses and some forms of child abuse; the results were not consistent across all exposures and outcomes. The high prevalence of reported child abuse indicates a need for interventions to reduce child abuse in homes overall. There is also need for further research into the aetiology and influences specific to different types of abuse.

Adaptação e análise da estrutura interna da Escala de Mobbing de Leymann (LIPT45) para o contexto português / Adaptation and analysis of the internal structure of the Leymann Inventory of Psychological Terror (LIPT45) for the Portuguese context / Adaptación y análisis de la estructura interna de la escala de mobbing de Leymann (LIPT45) para el contexto portugués

O objetivo deste trabalho consiste em adaptar e analisar a estrutura interna da versão portuguesa do Leymann Inventory of Psychological Terror (LIPT45). Foi utilizada uma amostra de 404 indivíduos (70,5% mulheres) entre os 18 e os 69 anos (M = 32,9; DP = 12.606). O LIPT45-PV é uma escala de autorrelato composta por 45 itens que avaliam o assédio moral nas organizações, divididos em cinco dimensões: efeitos na autoexpressão; efeitos sobre os contatos sociais; efeitos sobre a reputação pessoal; efeitos sobre a situação ocupacional e qualidade de vida, e efeitos sobre a saúde. Foi utilizada uma análise fatorial confirmatória e o Exploratory Structural Equation Modeling (ESEM), mediante os quais se avaliou um modelo de cinco dimensões, além da confiabilidade do construto e das pontuações. Em conformidade com os resultados da ESEM, o LIPT45-PV apresenta uma estrutura fatorial coerente, assim como uma maior diferenciação entre as suas dimensões. Da mesma forma, os indicadores de confiabilidade do construto e das pontuações foram adequados. Conclui-se que o LIPT45-PV revela características psicométricas (estrutura interna e confiabilidade) que o configura como um instrumento adequado para avaliar o respetivo constructo em adultos.(AU)

The aim of this work was to adapt and analyze the internal structure of the Portuguese version of the Leymann Inventory of Psychological Terror (LIPT45). A sample of 404 individuals (70.5% women) aged between 18 and 69 years (M = 32.9; SD = 12.606) was used. The LIPT45-PV is a self-report scale composed by 45 items that assess mobbing in organizations, divided into five dimensions: effects on self-expression; effects on social contacts; effects on personal reputation; effects on the occupational situation and quality of life, and effects on health. Confirmatory factor analysis and Exploratory Structural Equation Modeling (ESEM) were used, through which a five-dimensional model was evaluated, as well as the reliability of the construct and the scores. According to the results of the ESEM, the LIPT45-PV presents a coherent factor structure, as well as greater differentiation between its dimensions. Likewise, the reliability indicators of the construct and the results were adequate. We can conclude that the LIPT45-PV reveals psychometric characteristics (internal structure and reliability) that configure it as an adequate instrument to evaluate the respective construct in adults.(AU)

El objetivo de este trabajo consiste en adaptar y analizar la estructura interna de la versión portuguesa del Leymann Inventory of Psychological Terror (LIPT45). Fue utilizada una muestra de 404 individuos (70.5% mujeres) entre los 18 y 69 años (M= 32.9; DS = 12.606). El LIPT45-PV es una escala de autoinforme compuesta por 45 ítems que evalúan el acoso laboral en las organizaciones, divididos en cinco dimensiones: efectos en la autoexpresión; efectos sobre los contactos sociales; efectos sobre la reputación personal; efectos sobre la situación ocupacional y calidad de vida, y efectos sobre la salud. Fue utilizado un análisis factorial confirmatorio y el Exploratory Structural Equation Modeling (ESEM), a través de los cuales se evaluó un modelo de cinco dimensiones, además de la confiabilidad del constructo y de las puntuaciones. De acuerdo con los resultados del ESEM, el LIPT45-PV presenta una estructura factorial coherente, así como una mayor diferenciación entre sus dimensiones. Asimismo, los indicadores de confiabilidad del constructo y de las puntuaciones fueron adecuados. Se concluye que el LIPT45-PV presenta características psicométricas (estructura interna y confiabilidad) que lo configuran como un instrumento adecuado para evaluar el constructo mencionado en adultos.(AU)

Experiencias traumáticas y resiliencia en población expuesta a la violencia / Traumatic experiences and resilience in population exposed to violence

El objetivo de este estudio fue examinar la relación entre eventos traumáticos en la infancia y la resiliencia, en población expuesta a la violencia en la región del Urabá antioqueño. Se contó con una muestra final de 86 adultos (53.5%, los hombres, 43% mujeres y 3.5% mujeres transgénero) entre 18 y 60 años. Este es un estudio descrip-tivo, correlacional, de corte transversal, en el cual se midieron eventos traumáticos que fueron evaluados con el Inventario de Experiencias Traumáticas en la Infancia (ETI-SRCol) y niveles de resiliencia con la Escala de Resiliencia en Adultos (ER). Para determinar la relación se usó el coeficiente de correlación de Spearman p<0.005, que fue considerado significativo. Los datos obtenidos del cuestionario ETI-SRCol evidencian puntajes importantes al comparar las medias del grupo de participantes con las del grupo de adaptación de la prueba para la población colombiana en las variables de violencia sociopolítica, abuso sexual, acontecimientos generales y en la de pobreza. Los resultados de este estudio indican correlaciones débiles entre los fac-tores del trauma infantil y los niveles de resiliencia en la edad adulta.

The objective of this study was to examine the relationship between traumatic events in childhood and resilience in a population exposed to violence in the region of Urabá, Antioquia. A final sample of 86 adults (53.5%, men, 43% women and 3.5% transgender women) between 18 and 60 years old. The traumatic events were eva-luated using the Inventory of Traumatic Experiences in Childhood (ETI-SRCol) and resilience levels with the Adult Resilience Scale (ER). Spearman's correlation coefficient was used to determine the relationship, p<0.05 was considered significa-tive. The data obtained from the ETI-SRCol questionnaire showed significant scores when comparing the participant group averages with those of the test adaptation group for the Colombian population pertaining to the variables of sociopolitical violence, sexual abuse, general events and in the variable poverty. Results indicate weak correla-tions between child trauma factors and resilience levels in adulthood.

Emotional and Physical Child Abuse in The Context of Natural Disasters: A Focus on Haiti.

OBJECTIVE: To investigate the social and living conditions of households in Haiti before and after the 2010 earthquake and to determine the prevalence of emotional and physical abuse of children aged 2 to 14 in households after the earthquake. METHODS: Nationally representative samples of Haitian households from the 2005/2006 and 2012 phases of the Demographic and Health Surveys were used. Descriptive data were summarized with frequencies and measures of central tendency. Chi-squared and independent t tests were used to compare pre-earthquake and post-earthquake data. Basic mapping was used to explore patterns of child abuse in relation to proximity to the epicenter. RESULTS: Comparison of pre-earthquake and post-earthquake data showed noteworthy improvements in the education attainment of the household head and possession of mobile phones after the earthquake. The prevalence of emotional, physical, and severe physical abuse in 2012 was estimated to be 78.5%, 77.0%, and 15.4%, respectively. Mapping revealed no conclusive patterns between the proximity of each region to the epicenter and the prevalence of the different forms of abuse. However, the prevalence of severe physical abuse was notably higher in settlement camps (25.0%) than it was in Haiti overall (15.4%). CONCLUSIONS: The high prevalence of child abuse in Haiti highlights an urgent need for interventions aimed at reducing occurrences of household child abuse.

Evidence of concurrent and prospective associations between early maltreatment and ADHD through childhood and adolescence.

PURPOSE: An emerging body of work suggests a link between childhood maltreatment and attention-deficit hyperactivity disorder (ADHD). However, research examining the role of maltreatment in the early course of the disorder lacks robust evidence from longitudinal studies. Our aim was to examine concurrent and prospective associations between maltreatment experiences and ADHD diagnosis and sex differences, and to estimate the association between repetitive maltreatment exposure and ADHD through childhood and adolescence. METHODS: Data were obtained from the Boricua Youth Study, a longitudinal study of 2480 children and adolescents of Puerto Rican background. Neglect, physical, emotional and sexual abuse, and foster placement were regressed on ADHD diagnosis measured at each of three waves using the Diagnostic Interview Schedule for Children-IV. Multilevel regressions estimated the effects of exposure on ADHD, adjusted by age, sex, income, household education, parental psychopathology, comorbidity and ADHD medication status. RESULTS: Emotional abuse and foster placement had robust associations with ADHD diagnosis. For girls, physical abuse had a threefold increase in the odds of having ADHD diagnosis; for boys, associations were observed only for emotional abuse. Prospective models examining the risk of ADHD following maltreatment provided initial evidence for the effects of physical abuse on ADHD, and a linear trend for repetitive exposure suggested increased probability for disorder persistence. CONCLUSIONS: Associations between early maltreatment and ADHD were robust. Different categories of maltreatment increase the likelihood of ADHD for girls and boys. Increased exposure to maltreatment may predict symptom persistence. Interventions addressing ADHD must consider the effects of both sex and family environment.

Relationship Between Depression and Subtypes of Early Life Stress in Adult Psychiatric Patients.

Numerous studies have researched the aggravating and maintainer effect of Early Life Stress in patients adults with psychiatric disorders. This study examined the relationship between depression and subtypes of early life stress among 81 psychiatric patients treated at the inpatient Day Hospital Unit of a University General Hospital. Psychiatric diagnosis was confirmed according to the MINI International Neuropsychiatric Interview (MINI). The Childhood Trauma Questionnaire (CTQ) was used for evaluating as retrospective assessment of the presence of ELS on these patients, and we also evaluated the severity of hopelessness with the Beck Hopelessness Scale (BHS). Our results suggested that the occurrence of depression in adulthood is related to situations of emotional abuse, sexual, and physical neglect during childhood. The analysis between depression and childhood emotional abuse was significant after a multiple logistic regression analysis OR (IC 95%): 4.4 (1.7-11.2), even accounting for gender adjusted OR [AOR] 4.0; (IC 1.5-10.5); psychiatry family history AOR 3.8 (1.4-10.5); previous suicide attempted AOR 3.7; (1.4-10.5) and Hopelessness AOR 3.2 (1.11-9.4). Thus, these findings demonstrate emotional abuse as a significant risk factor to be part of the mechanism involved in the pathogenesis of depression related to early life stress.

Disentangling the mental health impact of childhood abuse and neglect: A replication and extension study in a Brazilian sample of high-risk youth.

Childhood maltreatment is a key predictor of mental health problems across the life span. Yet, how maltreatment types independently and jointly influence the risk for psychiatric problems remains unclear. The aim of the study was two-fold: first, to replicate recent findings regarding the impact of maltreatment types on youth psychiatric symptoms, based on a Brazilian sample of high-risk adolescents (n = 347; age range = 11-17 yrs), and second, to extend existing findings by examining whether this relationship is mediated by bullying victimization and/or perpetration. Measures included self-report ratings of childhood maltreatment and peer victimization, as well as multi-informant reports of internalizing and externalizing symptoms. Consistent with prior research, we found that: (i) maltreatment types often co-occurred; (ii) there was a linear association between number of maltreatment types experienced and symptom severity (i.e. cumulative effect); and (iii) emotional abuse emerged as the most consistent independent predictor of poor mental health across domains, raters, and gender. Additionally, this study extends previous findings by showing that the influence of maltreatment on psychiatric outcomes is partially mediated by peer victimization, but not by bullying perpetration. In conclusion, these findings expand our understanding of the heterogeneity in individual responses to maltreatment as well as highlighting emotional abuse as an important predictor of poor mental health.

Childhood trauma and dimensions of depression: a specific association with the cognitive domain

Objective: To investigate associations between a history of childhood trauma and dimensions of depression in a sample of clinically depressed patients. Methods: A sample of 217 patients from a mood-disorder outpatient unit was investigated with the Beck Depression Inventory, the Hamilton Depression Rating Scale, the CORE Assessment of Psychomotor Change, and the Childhood Trauma Questionnaire. A previous latent model identifying six depressive dimensions was used for analysis. Path analysis and Multiple Indicators Multiple Causes (MIMIC) models were used to investigate associations between general childhood trauma and childhood maltreatment modalities (emotional, sexual, and physical abuse; emotional and physical neglect) with dimensions of depression (sexual, cognition, insomnia, appetite, non-interactiveness/retardation, and agitation). Results: The overall childhood trauma index was uniquely associated with cognitive aspects of depression, but not with any other depressive dimension. An investigation of childhood maltreatment modalities revealed that emotional abuse was consistently associated with depression severity in the cognitive dimension. Conclusion: Childhood trauma, and specifically emotional abuse, could be significant risk factors for the subsequent development of cognitive symptoms of major depression. These influences might be specific to this depressive dimension and not found in any other dimension, which might have conceptual and therapeutic implications for clinicians and researchers alike.

Childhood trauma and suicide risk in a sample of young individuals aged 14-35 years in southern Brazil.

Suicide is among the main causes of death of people aged between 15 and 44 years old. Childhood trauma is an important risk factor for suicide. Hence, the objective of this study was to verify the relationship between childhood trauma and current suicide risk (suicidal behavior and ideation) in individuals aged 14-35 years, in the city of Pelotas, Brazil. This is a cross-sectional, population-based study. Sample selection was performed by clusters. Suicide risk was evaluated using the Mini International Neuropsychiatric Interview (MINI) and Childhood trauma was assessed with the Childhood Trauma Questionnaire (CTQ). Moreover, the participants responded to a questionnaire concerning socioeconomic status, work, and substance use. The sample was composed of 1,380 individuals. The prevalence of suicide risk was 11.5%. The prevalence figures of childhood trauma were 15.2% (emotional neglect), 13.5% (physical neglect), 7.6% (sexual abuse), 10.1% (physical abuse), and 13.8% (emotional abuse). Suicide risk was associated (p<.001) with gender, work, alcohol abuse, tobacco use, and all types of childhood trauma. The odds of suicide risk were higher in women (OR=1.8), people who were not currently working (OR=2.3), individuals who presented alcohol abuse (OR=2.6), and among tobacco smokers (OR=3.4). Moreover, suicide risk was increased in all types of trauma: emotional neglect (OR=3.7), physical neglect (OR=2.8), sexual abuse (OR=3.4), physical abuse (OR=3.1), and emotional abuse (OR=6.6). Thus, preventing early trauma may reduce suicide risk in young individuals.

Personas menores de edad involucradas en conflicto de pareja: implicaciones psicosociales / Minors involved in couple conflict: psychosocial implications

En el ámbito de los conflictos de pareja, cabe la posibilidad ante ciertas circunstancias psicosociales, del establecimiento de conflictos circulares o sin salida en los que pueden quedar atrapadas personas menores de edad. Estos conflictos tienden a extenderse al espacio de sede judicial, administrativo-legal (PANI), profesionales del sector legal en el ejercicio liberal de la profesión y sector salud, en donde en muchas ocasiones y ante la ausencia de mecanismos de comunicación/ coordinación, las necesidades emocionales y sociales de estos niños, niñas y adolescentes no son consideradas, focalizando la atención en el conflicto entre adultos, lo que da como resultado su triangulación. Esta situación, aparte de generar al sistema altos costos económicos de atención (múltiples profesionales intervinientes, procesos de atención prolongados y duplicidad de funciones), provoca un alto costo emocional en quienes la sufren, ya que presentan alta probabilidad de desarrollar una amplia variedad de síntomas compatibles con problemas tales como: desórdenes facticios, trastornos emocionales, de ansiedad y somatomorfos, problemas de ajuste e impulsividad, trastornos alimentarios y del sueño, entre otros.