The impact of childhood trauma on psychosocial functioning and physical health in a non-clinical community sample of young adults

Objective: Given the fundamental emotional, social and physical development that occurs during the early years of life, childhood experiences are formative in shaping a person’s life trajectory. Childhood trauma is a prevalent, multifaceted issue with well-documented long-term adverse health effects in clinical populations however; the impact of childhood trauma in the community is less clear. To address this, this study investigated how childhood trauma may impact physical and psychological health, sleep quality and autonomic function in a non-clinical community sample of adults. Method: Participants completed questionnaires, an in-laboratory autonomic assessment (including stress reactivity to mental and physical stressors) and overnight autonomic and sleep monitoring. Overall childhood trauma and its subtypes (e.g. physical abuse, emotional neglect) were defined using the Childhood Trauma Questionnaire. Results: We identified 22 childhood trauma cases (total score > 36) and, of the 89 non-childhood trauma cases, some individuals also experienced significant levels of trauma in one or more of the childhood trauma subtypes. Childhood trauma and some trauma subtypes were significantly correlated with a myriad of negative physiological and physical health outcomes including elevated psychological distress, increased sleep disturbances, reduced emotional wellbeing and lower perceived social support. Autonomic dysregulation was found in those with high levels of childhood trauma, which was reflected in an increased stress response to laboratory tasks. Notably, the experience of physical abuse in childhood was significantly associated with alterations in nocturnal heart rate and heart rate variability. Conclusion: Together, these results highlight that childhood trauma can have lasting detrimental consequences on an individual’s emotional and physical health, sleep quality and stress reactivity.

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Do you mind if I take your blood pressure? Physical health monitoring of children and young people on ADHD medication amidst a pandemic

BJPsych Open ◽

10.1192/bjo.2021.497 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S183-S184

Author(s):

Emma Davies ◽

Maham Khan ◽

Claire Jones

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Young People ◽

Physical Health ◽

Health Monitoring ◽

Neurodevelopmental Disorder ◽

Adhd Medication ◽

Children And Young People ◽

Nice Guidance ◽

The Impact

AimsTo establish whether physical health monitoring for CYP on ADHD medication is according to NICE guidance (2018).To determine the impact of COVID-19 pandemic restrictions on physical health monitoring for CYP on ADHD medication.Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, characterised by a persistent pattern of inattention and/or hyperactivity-impulsivity, directly impacting on academic, occupational, or social functioning. It affects between 1-5% of children and young people (CYP) most often presenting in early-mid childhood.Pharmacological treatment can be considered in CYP if certain criteria are met, where licensed medications include methylphenidate, dexamfetamine, lisdexamfetamine, atomoxetine and guanfacine. Stimulant and non-stimulant medications require frequent physical health monitoring due to their side effects including an increase in blood pressure and/or heart rate, loss of appetite, growth restriction and tics.MethodStandards and criteria were derived from the NICE guidance (2018), whilst local trust policies were reviewed, demonstrating discrepancies. Standards were expected to be met for 100% of patients.Electronic patient records were reviewed retrospectively from a representative cohort of CYP reviewed by clinicians in a community CAMHS service during March-November 2020. Data were entered manually into a spreadsheet for evaluation.ResultA total of 27 CYP records were reviewed, average age 13yo, on a range of stimulant/non-stimulant preparations.5 (19%) had height checked every 6 months, with 4 delayed to 7-8 months.For those >10yo, only 5 (19%) had weight checked every 6 months.Only 2 (7%) had their height and weight plotted on a growth chart and reviewed by the healthcare professional responsible for treatment.Just 4 (15%) had heart rate and blood pressure recorded before and after each dose change, whilst similarly only 4 (not the same) had these parameters recorded every 6 months.17 patients were reviewed by telephone/video call, where 5 patients provided physical health parameters (measured at home).ConclusionAcross all parameters, standards are not being met for the required physical health monitoring for CYP on ADHD medication.The COVID-19 pandemic has significantly changed the working conditions for community teams, impacting face to face reviews, creating challenges for physical health monitoring.Our ongoing implementations for change include the use of a proforma for physical health measurements, improving psychoeducation for families, exploring potential barriers with senior colleagues and collaborating with pharmacy colleagues to update local guidelines in accordance with the latest NICE recommendations. We aim to re-audit in June 2021.

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Increased Backward Wave Pressures Rather than Flow Explain Age-Dependent Heart Rate Effects on Central, But not Peripheral Arterial Pressure

Hypertension ◽

10.1161/hypertensionaha.121.18271 ◽

2021 ◽

Author(s):

Nonhlanhla Mthembu ◽

Gavin R. Norton ◽

Vernice R. Peterson ◽

Ravi Naran ◽

Suraj M. Yusuf ◽

...

Keyword(s):

Heart Rate ◽

Community Sample ◽

Characteristic Impedance ◽

Clinical Importance ◽

Central Pressure ◽

Time To Peak ◽

Relative Contribution ◽

Filling Time ◽

Age Dependent ◽

The Impact

Through both backward (Pb) and forward (Pf) wave effects, a lower heart rate (HR) associates with increased central (PPc), beyond brachial pulse pressure (PP). However, the relative contribution to Pf of aortic flow (Q) versus re-reflection of Pb, has not been determined. Using central pressure, aortic velocity and diameter measurements in the outflow tract (echocardiography), we constructed central pressure waveforms that account for the relative contribution of Q versus re-reflection to Pf. We thus evaluated the mechanisms of HR-PPc relations in a community sample (n=824) and the impact of age thereon. Inverse HR-PPc ( P <0.0001), but not HR-brachial PP ( P =0.064) relations were noted. The slope of HR-PPc relation was increased in older adults ( P <0.005). HR was inversely associated with ventricular filling time, ejection duration, stroke volume, and peak Pf ( P <0.001 to P <0.0001). However, an increased Q and hence pressures generated by the product of aortic characteristic impedance and Q did not account for Pf effects. Age-dependent HR-PPc and Pf relations were both accounted for by enhanced Pb ( P <0.0001) with an increased Pf mediated by increments in wave re-reflection ( P <0.0001). The lack of impact of ejection duration on PPc was explained by an increased time to peak Pb ( P <0.0001). In conclusion, increases in PPc and Pf at a decreased HR are accounted for by an enhanced Pb rather than by a prolonged ejection or filling duration and hence flow (Q). These effects at a young-to-middle age are of little clinical significance, but at an older age, are of clinical importance.

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Clinic risk associated with comorbidity of (subclinical) psychosis, anxiety and depressive symptoms: A case for stratified medicine in psychiatry

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.913 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S49-S49 ◽

Cited By ~ 1

Author(s):

M. van Nierop ◽

I. Myin-Germeys ◽

R. van Winkel

Keyword(s):

Quality Of Life ◽

Social Functioning ◽

Childhood Trauma ◽

Life Stress ◽

Stress Reactivity ◽

Daily Life ◽

Clinical Severity ◽

Psychotic Symptoms ◽

The Impact

BackgroundMeta-analyses link childhood trauma to depression, mania, anxiety, and psychosis. It is unclear, however, whether these outcomes truly represent distinct disorders following childhood trauma, or that childhood trauma is associated with admixtures of affective, psychotic, anxiety and manic psychopathology throughout life.AimTo investigate the impact of trauma on psychopathological phenotype, functional outcome, and daily life stress reactivity.MethodsWe used data from a representative general population sample (NEMESIS-2; n = 6646), of whom respectively 1577 and 1120 had a lifetime diagnosis of mood or anxiety disorder, as well as from a sample of patients with a diagnosis of schizophrenia (GROUP; n = 825). Multinomial logistic regression was used to assess whether childhood trauma was more strongly associated with isolated affective/psychotic/anxiety/manic symptoms than with their admixture. Additionally, we examined these groups in terms of social functioning, clinical severity, and quality of life. In a separate sample (n = 621), daily life (emotional and cortisol) stress reactivity was assessed, using ambulatory assessment.ResultsIn all samples, childhood trauma was considerably more strongly associated with an admixture of symptoms of depression, anxiety, psychosis, and mania, rather than with these symptoms in isolation. Individuals exposed to childhood trauma, who also had an admixture of symptoms, had a lower quality of life, more help-seeking behaviour, higher prevalence of substance use disorders, and lower social functioning, compared with individuals not exposed to trauma, without an admixture of symptoms, or neither. Furthermore, trauma-exposed individuals with an admixed psychopathological phenotype show a higher daily emotional stress reactivity.ConclusionChildhood trauma increases the likelihood of a specific admixture of affective, anxiety and psychotic symptoms cutting across traditional diagnostic boundaries. Stratifying according to childhood trauma exposure thus identifies an admixed phenotype, possibly induced by continuous daily life stress reactivity, that has important clinical relevance. Identification of functionally meaningful aetiological subgroups may aid clinical practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Negative Emotion Differentiation Attenuates the Within-Person Indirect Effect of Daily Stress on Nightly Sleep Quality Through Calmness

Frontiers in Psychology ◽

10.3389/fpsyg.2021.684117 ◽

2021 ◽

Vol 12 ◽

Author(s):

Tanja Lischetzke ◽

Lea Schemer ◽

Julia A. Glombiewski ◽

Tina In-Albon ◽

Julia Karbach ◽

...

Keyword(s):

Sleep Quality ◽

Indirect Effect ◽

Affect Regulation ◽

Protective Factor ◽

Stress Reactivity ◽

Negative Emotion ◽

Community Sample ◽

Emotional States ◽

Daily Stress ◽

Emotion Differentiation

The ability to differentiate between negative emotional states [negative emotion differentiation (NED)] has been conceptualized as a trait that facilitates effective emotion regulation and buffers stress reactivity. In the present research, we investigated the role of NED in within-person processes of daily affect regulation and coping during times of stress (the first COVID-19-related pandemic lockdown in April 2020). Using intensive longitudinal data, we analyzed whether daily stress had an indirect effect on sleep quality through calmness in the evening, and we tested whether NED moderated this within-person indirect effect by buffering the link between daily stress and calmness in the evening. A non-representative community sample (n = 313, 15–82 years old) participated in a 21-day ambulatory assessment with twice-daily surveys. The results of multilevel mediation models showed that higher daily stress was related to within-day change in calmness from morning to evening, resulting in less calmness in the evening within persons. Less calmness in the evening, in turn, was related to poorer nightly sleep quality within persons. As expected, higher NED predicted a less negative within-person link between daily stress and calmness in the evening, thereby attenuating the indirect effect of daily stress on nightly sleep quality through calmness. This effect held when we controlled for mean negative emotions and depression. The results provide support for a diathesis-stress model of NED, and hence, for NED as a protective factor that helps to explain why some individuals remain more resilient during times of stress than others.

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Losing Sleep Over It: Sleep in Basketball Players Affected by Game But Not Training Workloads

International Journal of Sports Physiology and Performance ◽

10.1123/ijspp.2019-0676 ◽

2020 ◽

Vol 15 (8) ◽

pp. 1117-1124

Author(s):

Jordan L. Fox ◽

Aaron T. Scanlan ◽

Robert Stanton ◽

Cody J. O’Grady ◽

Charli Sargent

Keyword(s):

Heart Rate ◽

Sleep Quality ◽

Sleep Duration ◽

Sleep Onset ◽

Onset Time ◽

Rating Of Perceived Exertion ◽

Self Report ◽

Basketball Players ◽

Time In Bed ◽

The Impact

Purpose: To examine the impact of workload volume during training sessions and games on subsequent sleep duration and sleep quality in basketball players. Methods: Seven semiprofessional male basketball players were monitored across preseason and in-season phases to determine training session and game workloads, sleep duration, and sleep quality. Training and game data were collected via accelerometers, heart-rate monitors, and rating of perceived exertion (RPE) and reported as PlayerLoad™ (PL), summated heart-rate zones, and session RPE (sRPE). Sleep duration and sleep quality were measured using wrist-worn activity monitors in conjunction with self-report sleep diaries. For daily training sessions and games, all workload data were independently sorted into tertiles representing low, medium, and high workload volumes. Sleep measures following low, medium, and high workloads and control nights (no training/games) were compared using linear mixed models. Results: Sleep onset time was significantly later following medium and high PL and sRPE game workloads compared with control nights (P < .05). Sleep onset time was significantly later following low, medium, and high summated heart-rate-zones game workloads, compared with control nights (P < .05). Time in bed and sleep duration were significantly shorter following high PL and sRPE game workloads compared with control nights (P < .05). Following low, medium, and high training workloads, sleep duration and quality were similar to control nights (P > .05). Conclusions: Following high PL and sRPE game workloads, basketball practitioners should consider strategies that facilitate longer time in bed, such as napping and/or adjusting travel or training schedules the following day.

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Heart Rate Reactivity, Neighborhood Disadvantage, and Antisocial Behavior

Crime & Delinquency ◽

10.1177/0011128720926110 ◽

2020 ◽

Vol 66 (10) ◽

pp. 1392-1418

Author(s):

Jill Portnoy ◽

Adrian Raine ◽

Anna S. Rudo-Hutt ◽

Yu Gao ◽

Khadija Monk

Keyword(s):

Heart Rate ◽

Antisocial Behavior ◽

Stress Reactivity ◽

Community Sample ◽

Neighborhood Disadvantage ◽

Neighborhood Environment ◽

Lower Heart Rate ◽

Heart Rate Reactivity ◽

Males And Females ◽

The Relationship

This article examines whether heart rate stress reactivity interacts with neighborhood disadvantage to predict antisocial behavior. Antisocial behavior was assessed in a community sample of 445 males and females ( Mage = 11.92 years), using respondent and parent measures of antisocial behavior. Heart rate stress reactivity interacted with neighborhood disadvantage to predict parent-reported antisocial behavior. Specifically, the relationship between neighborhood disadvantage and antisocial behavior was stronger among children with lower heart rate reactivity. This study is the first to find that heart rate stress reactivity interacts with the neighborhood environment to predict antisocial behavior. Findings demonstrate the importance of examining biological factors in conjunction with the broader environmental context to understand the development of antisocial behavior.

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Differentiation of Physical Loads in Female Students of Different Motor Ages

Teorìâ ta Metodika Fìzičnogo Vihovannâ ◽

10.17309/tmfv.2021.2.09 ◽

2021 ◽

Vol 21 (2) ◽

pp. 158-166

Author(s):

Eduard Doroshenko ◽

Antonina Hurieieva ◽

Anastasiia Symonik ◽

Olena Chernenko ◽

Andrii Chernenko ◽

...

Keyword(s):

Heart Rate ◽

Physical Health ◽

Activity Index ◽

Heart Rate Recovery ◽

Maximal Oxygen Consumption ◽

Dynamic Strength ◽

Female Students ◽

Experimental Program ◽

General Level ◽

The Impact

Purpose: To develop and evaluate the impact of a program of sectional recreational aerobics classes, taking into account the differentiation of physical loads in female students of different motor ages. Materials and Methods. Participants: In the ascertaining experiment, 145 second-year female students were examined, in the formative experiment – 42 female students. The following indicators were measured: biological age (years) using V. P. Voitenko’s method (1991), motor age (years) and the general level of physical conditions (points), heart rate (bpm), heart rate recovery time after 20 squats in 30 s (min, s), the level of physical health (points), physical activity index (c. u.), the level of general physical working capacity (PWC170, kgm ∙ min-1); VO2 max (ml ∙ kg ∙ min-1) – maximal oxygen consumption. The level of motor qualities development: 2,000 m run (min, s), 4×9 m shuttle run (s), standing long jump (cm), sit-ups in 1 min (times), push-ups (times), seated forward bend (cm). Results. The study developed and tested an experimental program of recreational aerobics classes, taking into account a differentiated approach to dosing physical loads in female students of different motor ages. Data factorization revealed a rational combination of means for developing motor qualities: strength endurance – 15.88%, dynamic strength – 12.86%, speed and strength endurance – 8.72%, static endurance – 17.87%, flexibility – 12.69%, speed abilities – 14.66%, and coordination abilities – 17.32%. The study found a moderate negative correlation between motor age and the level of physical health (r = -0.68 at p < 0.01). Three levels of motor age with respect to the levels of physical health were identified. Conclusions. Taking into account female students’ motor age during recreational aerobics classes ensures optimal motor activity and increases the level of physical fitness.

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