The risk of common mental disorders in Indigenous Australians experiencing traumatic life events

Background Experiencing traumatic life events is associated with an increased risk of common mental disorders (CMDs), but studies investigating this association within Indigenous populations are limited. Aims The aim of this study was to investigate associations between trauma and CMDs after controlling for other exposures. Method Trauma exposures and CMD diagnoses were determined in a broadly representative sample of 544 Indigenous Australians, using a diagnostic clinical interview. Associations were determined by multivariate logistic regression. Results Trauma exposure independently predicted CMDs. After adjustment for potential confounders, trauma exposure was associated with a 4.01-fold increased risk of a diagnosis of a CMD in the past 12 months. The increased risks were 4.38-, 2.65- and 2.78-fold of having an anxiety disorder, mood disorder or a substance use disorder, respectively. Trauma exposure and comorbid post-traumatic stress disorder was associated with a 4.53-fold increased risk of a diagnosis of a mood disorder, 2.47-fold increased risk of a diagnosis of a substance use disorder, and 3.58-fold increased risk of any diagnosis of a CMD, in the past 12 months. Experiencing both sexual and physical violence was associated with a 4.98-fold increased risk of a diagnosis of an anxiety disorder in the past 12 months. Conclusions Indigenous Australians experience significantly increased exposure to potentially harmful trauma compared with non-Indigenous Australians. Preventing and healing trauma exposure is paramount to reduce the high burden of CMDs in this population.

Association of polygenic risk scores, traumatic life events and coping strategies with war-related PTSD diagnosis and symptom severity in the South Eastern Europe (SEE)-PTSD cohort

Objectives Posttraumatic stress disorder (PTSD) is triggered by extremely stressful environmental events and characterized by high emotional distress, re-experiencing of trauma, avoidance and hypervigilance. The present study uses polygenic risk scores (PRS) derived from the UK Biobank (UKBB) mega-cohort analysis as part of the PGC PTSD GWAS effort to determine the heritable basis of PTSD in the South Eastern Europe (SEE)-PTSD cohort. We further analyzed the relation between PRS and additional disease-related variables, such as number and intensity of life events, coping, sex and age at war on PTSD and CAPS as outcome variables. Methods Association of PRS, number and intensity of life events, coping, sex and age on PTSD were calculated using logistic regression in a total of 321 subjects with current and remitted PTSD and 337 controls previously subjected to traumatic events but not having PTSD. In addition, PRS and other disease-related variables were tested for association with PTSD symptom severity, measured by the Clinician Administrated PTSD Scale (CAPS) by liner regression. To assess the relationship between the main outcomes PTSD diagnosis and symptom severity, each of the examined variables was adjusted for all other PTSD related variables. Results The categorical analysis showed significant polygenic risk in patients with remitted PTSD and the total sample, whereas no effects were found on symptom severity. Intensity of life events as well as the individual coping style were significantly associated with PTSD diagnosis in both current and remitted cases. The dimensional analyses showed as association of war-related frequency of trauma with symptom severity, whereas the intensity of trauma yielded significant results independently of trauma timing in current PTSD. Conclusions The present PRS application in the SEE-PTSD cohort confirms modest but significant polygenic risk for PTSD diagnosis. Environmental factors, mainly the intensity of traumatic life events and negative coping strategies, yielded associations with PTSD both categorically and dimensionally with more significant p-values. This suggests that, at least in the present cohort of war-related trauma, the association of environmental factors and current individual coping strategies with PTSD psychopathology was stronger than the polygenic risk.

The Effect of Maternal Traumatic Life Events and Social Support on Maternal-Child Interaction at Child Age 3 Years

Introduction: Becoming a parent is a very important role and responsibility in people’s lives and knowing the role traumatic life events (TLEs) may play on a mother-child relationship is a very important area to explore. TLEs are known to have adverse effect on individuals; however, little is known regarding the effect of maternal TLEs on maternal-child interaction. Social support has been known to positively affect the overall wellbeing of individuals, but little is known about the effect of social support on mothers who experienced TLEs and interaction with their children thus the need for this study. This study examines the effect of maternal TLEs and social support on maternal-child interaction. The Child Health Assessment Model and the Barnard Model will be used in this study. This study will examine the occurrence and severity of maternal TLEs and levels of social support and their relationship with sociodemographic factors of mothers and their 3-year-olds. It will examine the relationship between maternal TLEs, and maternal-child interaction measured by the NCAST Parent-Child Interaction (PCI) Teaching scale at child age 3 years; maternal social support and maternal-child interaction at child age 3 years; maternal TLEs and social support with maternal-child interaction at child age 3 years. Method: This study was a secondary analysis of data from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study, a longitudinal cohort study designed to improve the health, development, and well-being of children in Shelby County, Tennessee. Researchers recruited 1503 women in their second trimester of pregnancy. Data were collected at the 2nd and 3rd trimesters, at the child's birth, and from mother-child dyads at different points through child age three years. Nine hundred and eighty-six mother-child dyads were included in this analysis. Data analysis was performed using R version 4.0.3 (2020-10-10). The CANDLE Study Publications and Presentations Committee approved a Manuscript Analysis Plan Proposal prior to conducting this study. Results: Children and mothers were largely Black/African American (65.2%), and 34.8% were White. TLEs were associated with sociodemographic variables such as age, education, race, marital status, and child sex—with increased TLEs among Black/African American mothers, divorced/separated/widowed mothers, and mothers without college/professional degree, older mothers reported a lower number of ACEs than younger mothers. Mothers of male children reported fewer events associated with fear and helplessness than mothers of female children. Mother Total score and Contingency score were associated with several sociodemographic variables. Mothers with private health insurance for children ages 2- and 3-years had higher PCI Teaching scale scores. Mothers with at least a college degree at enrollment, child age 2, and child age 3 had higher PCI Teaching scale scores than mothers with no college degree. In the univariate analysis, we did not observe a significant association between maternal TLEs in the third trimester and maternal-child interaction at child age 3 years. When both maternal traumatic life events at the third trimester and social support are included, both were significantly associated with maternal-child interaction at child age 3 years. Although the associations between TLEs and PCI Teaching scale scores were non-significant the number of individuals providing social support was associated with PCI Teaching scale scores. More individuals providing social support was associated with increased PCI Teaching scale Mother-child Total (p < 0.0001) and Mother-child Contingency scores (p < 0.0001). Health insurance was associated with PCI Teaching scale scores — having private insurance was associated with increased Child Total scores at ages 2 (p = 0.037 and 3 (p = 0.004) years. Conclusion: The association between the number of individuals providing social support and mother-child interaction reinforces the need to provide resources such as home visitation programs to mothers and their young children. Each additional person providing social support in the third trimester was associated with increased PCI Teaching scale scores on both the Mother Total scores and Mother-child Total scores. This points to the relationship between support during the third trimester and the long-term outcome related to maternal-child interaction. The lack of association between TLEs and PCI Teaching scale scores before and after controlling for sociodemographic variables may reflect mothers' resilience. The interaction effect between TLEs and social support on maternal child interaction is notable and shows the need for an upstream approach to prevent TLEs since its interaction with social support diminishes the effect of support on maternal-child interaction.

Individuals with Major Depressive Disorder Report High Scores of Insecure-Avoidant and Insecure-Anxious Attachment Styles, Dissociative Identity Symptoms and Adult Traumatic Events

Objective: Individuals with major depressive disorder (MDD) report more issues in social interaction compared to the general population. Moreover, dimensions of dissociation are considered dysfunctional strategies to cope with adverse life events. In this regard, current symptoms of MDD could be associated with traumatic events that occurred in childhood and in adult life. Given this background, the aim of the present study was to explore the associations between attachment styles as a proxy of quality of social interaction, dimensions of dissociation, and childhood and adult traumatic life events among individuals with MDD. Method: A total of 300 individuals with MDD (mean age: 31.31 years; 58.7% female) took part in this study. They completed a series of questionnaires on sociodemographic information, attachment styles, dimensions of dissociation, and childhood and adult traumatic life events. Results: Prevalence rates for attachment styles were as follows: anxious/ambivalent attachment style—71.7%; avoidant/dependent attachment style—13%; secure/close attachment style—15.3%. Compared to the general population, the participants reported higher prevalence rates of insecure attachment styles. Current symptoms of dissociation were associated with adult but not childhood traumatic life events. An anxious attachment style was associated with higher scores of dissociation. Conclusion: Psychotherapeutic treatment of individuals with MDD should consider the individuals’ challenging attachment styles and their risk of dissociation. While it is important to consider both adult and childhood traumatic events, in this research, more recent trauma occurring in adulthood was associated with current symptoms of dissociation.

Prevalence of Various Traumatic Events Including Sexual Trauma in a Clinical Sample of Patients With an Eating Disorder

Objective: Eating disorder (ED) and trauma have often been associated, and there is evidence that early experiences of traumatic events are associated with subsequent ED. Research results point toward an increased prevalence of sexual trauma in individuals with ED, and it has been suggested that sexual trauma precedes and contributes to the development of ED. The aim of this study was to assess the prevalence of sexual trauma as well as other types of traumatic life events in a clinical sample of children, adolescents, and adults with ED.Method: Patients (N = 329), median age 16.9 [Interquartile Range (IQR):4.5], diagnosed with various EDs in a specialized ED unit were included.Results: The majority (67%) of patients with ED reported at least one traumatic life event at time of assessment such as bullying (32%), loss (24%), or accidents (11%). Nineteen per cent of the patients reported having been the victim of a sexual trauma or another sexual traumatic event distributed as follows in terms of severity: 13% had been the victim of a negative experience associated with sex; 57% reported having experienced sexual assault other than rape; and 30% had been the victim of severe forms of sexual assault. The median time between the sexual trauma and the ED diagnosis was 3.4 years (IQR: 6.6). The median time between the sexual trauma and the onset of ED symptoms was 0 years (IQR: 5). The study results imply that the sexual trauma could be experienced either prior to or after onset of ED symptoms.Conclusions: Sixty-seven per cent of the patients with an ED reported traumatic life events at time of assessment, whereby 19% reporting negative sexual experiences or sexual abuse. However, sexual trauma does not necessarily play a causal role in the development of EDs.