Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent...Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent and cumulative effects of ACEs exposure on the likelihood of Posttraumatic Stress Disorder (PTSD) and a Complex PTSD (CPSTD) diagnosis in Indian adolescents. Methods: A sample of 411 schoolchildren participated in the study. It was collected data on exposure to ACEs, PTSD, CPTSD, and attachment styles. Results: It was found that exposure to bullying and threats of violence was significantly associated with PTSD and CPTSD diagnosis, and exposure to physical violence and serious illness was associated with CPTSD diagnosis. Exposure to one ACE and exposure to 2 - 3 ACEs were associated with PTSD and CPTSD diagnosis, while exposure to 4 - 5 ACEs was associated with CPTSD diagnosis. Preoccupied and fearful attachment styles were significantly associated with PTSD and CPTSD diagnosis. Conclusion: The results of the study suggest that biological, psychological, and social factors interact and contribute to the differential prevalence of ACE, attachment styles, and PTSD/CPTSD. This study emphasizes the need of addressing childhood trauma as a public health priority in India.展开更多
Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to ex...Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to examine the association between ACEs and a range of HRBs,including substance use,sexual risk behavior,suicidal ideation,physical inactivity,and violence.Methods:This cross-sectional study used self-administered questionnaire and cluster sampling in seven junior high schools in Samarinda,Indonesia,with a sample size of 534 students.Data analysis using descriptive statistics,the Chi-square test,the independent t-test,ANOVA,binary logistic regression,and mediation analysis with macro-PROCESS.Results:The most common ACEs were community violence(68.0%),physical neglect(52.8%),psychological/emotional abuse(52.6%),physical abuse(50.4%),and peer bullying(45.9%).Adolescents with more than five ACEs showed significantly higher involvement in smoking/vaping(67.9%),suicidal ideation(75.2%),sexual risk behavior(57.7%),bullying(64.3%),and physical fighting(59.7%)(p<0.001).ACEs were significantly correlated with EF deficits(r=0.471,p<0.01)and HRB(r=0.578,p<0.01).Regression analysis confirmed that ACEs predicted EF deficits(β=0.466,p<0.001)and HRB(β=0.469,p<0.001),with EF deficits partially mediating this relationship(β=0.107,95%CI[0.045,0.094]).In addition,two subdomains of EF deficits,self-motivation(β=0.042)and self-regulation of emotion(β=0.032),significantlymediated the relationship between ACEs and HRBs.Conclusion:These findings suggest an important role for EF deficits in linking childhood adversity to engagement in risky behaviors.Addressing ACEs and EF deficits(self-motivation and self-regulation of emotion)through early intervention may be important in reducing long-term health risks among Indonesian adolescents.展开更多
Early rearing experiences are important in one＇s whole life, whereas early adverse rearing experience（EARE） is usually related to various physical and mental disorders in later life. Although there were many studie...Early rearing experiences are important in one＇s whole life, whereas early adverse rearing experience（EARE） is usually related to various physical and mental disorders in later life. Although there were many studies on human and animals, regarding the effect of EARE on brain development, neuroendocrine systems, as well as the consequential mental disorders and behavioral abnormalities, the underlying mechanisms remain unclear. Due to the close genetic relationship and similarity in social organizations with humans, non-human primate（NHP） studies were performed for over 60 years. Various EARE models were developed to disrupt the early normal interactions between infants and mothers or peers. Those studies provided important insights of EARE induced effects on the physiological and behavioral systems of NHPs across life span, such as social behaviors（including disturbance behavior, social deficiency, sexual behavior, etc）, learning and memory ability, brain structural and functional developments（including influences on neurons and glia cells, neuroendocrine systems, e.g., hypothalamic-pituitary-adrenal（HPA） axis, etc）. In this review, the effects of EARE and the underlying epigenetic mechanisms were comprehensively summarized and the possibility of rehabilitation was discussed.展开更多
Adverse childhood experiences(ACEs)can negatively affect mental health,whereas character strengths seem to be positively correlated with mental health.Detailed information on the history of ACEs among university stude...Adverse childhood experiences(ACEs)can negatively affect mental health,whereas character strengths seem to be positively correlated with mental health.Detailed information on the history of ACEs among university students in China and the extent which mental health is associated with ACEs and character strengths can contribute to the needed empirical evidence for relevant stakeholders.Objectives of this study are 1)to estimate the prevalence of ACEs among undergraduate students in Southern China;and 2)to assess the extent which mental health outcomes(positive growth,well-being,and depression)are associated with ACEs and character strengths among undergraduate students in Southern China.We conducted a self-administered survey amongfirst and second-year students at a university in Southern China and analyzed data using descriptive statistics and linear regression analyses.Among the 779 students who completed the questionnaire,283 were males,439 were females,and 57 did not indicate their gender.The prevalence of ACEs among the participants was 32.1%.History of ACEs was associated with lower positive growth score(Adjusted Beta=-0.20;95%CI=-0.37,-0.02;p=0.030)and lower well-being score(Adjusted Beta=-1.13;95%CI=-2.04,-0.23;p=0.014).Vitality domain of character strength was associated with all three mental health outcomes after adjusting for covariables(all p-values<0.001).Our studyfindings provide empirical evidence for stakeholders in university mental health.However,caveats regarding lack of temporality,selection bias,social desirability bias,and lack of generalizability should be considered in the interpretation of the studyfindings.展开更多
<strong>Objectiv</strong><strong>e</strong><strong>:</strong><span style="font-family:""><span style="font-family:Verdana;"> Children with fetal...<strong>Objectiv</strong><strong>e</strong><strong>:</strong><span style="font-family:""><span style="font-family:Verdana;"> Children with fetal alcohol spectrum disorder (FASD) are overrepresented in early intervention programs, foster care, special education, juvenile corrections, and mental health services. In this study, we examine relationships between FASD and non-FASD controls for adverse childhood experiences (ACEs), and neurodevelopmental disorders. </span><b><span style="font-family:Verdana;">Methods:</span> </b><span style="font-family:Verdana;">A chart review was conducted among patients seen at our clinic from 2010-2017 with data on FASD, ACEs, neurodevelopmental diagnoses, and foster or residential care placement available. </span><b><span style="font-family:Verdana;">Results:</span> </b><span style="font-family:Verdana;">Relative risk for FASD was increased in patients with increased ACE scores (RR = 5.08), increased numbers of neurodevelopmental diagnoses (RR = 2.36), and patients who have been in foster or residential care (RR = 9.53). FASD risk increased as ACE scores or the number of neurodevelopmental diagnoses increased. Patients with any ACEs were 3.96 times more likely to have FASD, and those with eight or more ACEs were 6.31 times more likely to have FASD than those with no ACEs. Patients with three or more neurodevelopmental diagnoses were 6.55 times more likely to have FASD than those with two or fewer diagnoses. Nine or more diagnoses increased the risk for FASD ten-fold (RR = 10.91). Conversely, patients diagnosed with FASD were more likely to have at least three ACEs (RR = 3.71), at least five neurodevelopmental diagnoses (RR = 1.61), and high rates of previous foster or residential care placement (RR = 5.39). </span><b><span style="font-family:Verdana;">Conclusion:</span> </b><span style="font-family:Verdana;">This study demonstrates that all children being considered for placement in foster care or residential should be screened for FASD.</span></span>展开更多
Suicidality is a complex phenomenon influenced by genetic,environmental,and epigenetic factors.Current tools to estimate suicide risk are insufficient,and there is an increasing need for reliable biomarkers to complem...Suicidality is a complex phenomenon influenced by genetic,environmental,and epigenetic factors.Current tools to estimate suicide risk are insufficient,and there is an increasing need for reliable biomarkers to complement clinical approaches.Growing evidence suggests that immune system dysregulation contributes to the pathophysiology of psychiatric disorders and suicidal behavior.Epigenetic mechanisms,including DNA methylation,histone modifications,and non-coding RNAs,regulate gene expression and may act as a bridge between environmental stressors and(neuro)inflammatory responses.In this review,we examine the evidence of peripheral and central inflammation in suicide completers and individuals with suicidal behavior.Next,we review current knowledge from various studies on suicide-associated epigenetic alterations.Furthermore,we evaluate the mechanisms by which early life adversity and chronic stress contribute to suicide diathesis,focusing on their association with epigenetic modifications and inflammatory pathways.We also examine future prospects and limitations of immunology-related biomarkers and the possibilities of therapeutic interventions targeting the immune system and epigenetic regulation.While challenging,research on epigenetic and immune alterations in suicidality shows promise for identifying suicide risk subtypes and advancing personalized psychiatry.展开更多
Background Globally,suicide is the third leading cause of death among girls aged 15-19 years.However,there is a growing concern that suicide research has paid lttle attention to pregnant adolescent girls,particularly ...Background Globally,suicide is the third leading cause of death among girls aged 15-19 years.However,there is a growing concern that suicide research has paid lttle attention to pregnant adolescent girls,particularly in lowincome and middle-income countries,including Ghana,where nearly one in seven adolescents experiences(unwanted)pregnancy.Aims To assess the prevalence and correlates of suicidal ideation and suicide attempt and the self-reported reasons for attempted suicide among pregnant adolescent girls in Ghana.Methods We collected cross-sectional data(between August 2022 and December 2023)using structured anonymous questionnaires from a sample of 449 pregnant adolescent girls(aged 14-19 years)drawn from the three geographical zones of Ghana.We applied bivariable and multivariable analysis techniques to the data.Results Overall,28.51%(95%confidence interval(Cl)24.37%to 32.93%)reported suicidal ideation,and 18.04%(95%Cl 14.59%to 21.91%)reported suicide attempt during the current pregnancy.Participants who reported attempted suicide endorsed more interpersonal reasons(eg,to communicate distress,to seek help or to influence others)than intrapersonal reasons for their attempted suicide.In the final adjusted logistic regression models,food insecurity(adjusted odds ratio(aOR)=2.69;95%Cl 1.34 to 5.41;p=0.005)was uniquely associated with increased odds of suicidal ideation.Adverse childhood experiences(a0R=3.04;95%CI 1.33 to 6.97;p=0.008),history of attempted suicide before current pregnancy(a0R=3.47;95%CI 1.27 to 9.47;p=0.015)and depression(measured by the 5-item World Health Organization Well-Being Index;aOR=0.31;95%CI 0.12 to 0.77;p=0.012)were uniquely associated with increased odds of suicide attempt.Five variables were commonly associated with increased odds of both suicidal ideation and suicide attempt:conflict with parents,alcohol use,pregnancy-related anxiety,history of attempted suicide and intimate partner violence.While being in junior high school was uniquely associated with reduced odds of suicidal ideation,intimate partner's acceptance of paternity was commonly associated with reduced odds of both suicidal ideation and suicide attempt.Conclusions Although the prevalence estimates of suicidal ideation and suicide attempt in this study are comparable with known rates among non-pregnant adolescent girls in Ghana,additional research is needed to nuance our understanding of the correlates identified in this study.The evidence aiso highlights a need for both routine antepartum primary care mental health screening for suicidality and related risks and targeted prevention and intervention programmes.展开更多
Background Non-suicidal self-injury(NSSI)is a significant health concern among adolescents and young adults,often resulting from adverse childhood experiences(ACEs).Dissociation,post-traumatic symptoms and attachment ...Background Non-suicidal self-injury(NSSI)is a significant health concern among adolescents and young adults,often resulting from adverse childhood experiences(ACEs).Dissociation,post-traumatic symptoms and attachment style may have a role in shaping such associations.Aims This study aims to provide a unified model of the impact of ACEs on NSSI,exploring complex post-traumatic stress disorder(cPTSD)symptoms and dissociation as potential mediators and the role of the predominant attachment style in affecting such associations.Methods 1010 young individuals attending the last year of high school participated in this cross-sectional study.ACEs,cPTSD,dissociation and NSSI were evaluated using self-report questionnaires.We fitted a path model of NSSI,with ACEs as exogenous variables and cPTSD and dissociation as sequential mediators.Secure,fearful and preoccupied attachment styles were modelled as grouping variables.Results Our findings showed that dissociation mediated the impact of ACEs on NSSI in subjects with a fearful attachment style,as opposed to those with a preoccupied attachment for whom cPTSD symptoms mediated the ACEs-NSSI association.Conclusions Attachment styles moderate the relationship between ACEs and NSSI,with either dissociation or post-traumatic symptomatology mediating the impact of ACEs on NSSI,depending on the predominant attachment style.Our results highlight the importance of attachment as a pathway modifier in the relationships between different psychopathology dimensions,providing a useful framework to better conceptualise the ACEs-NSSI association.展开更多
ObjectiveTo present an approach to phenotyping ACEs and explore the association between ACEs and adolescent health risky behaviors based on the social context of China.Methods Totally,5,726 adolescents aged 12-18 year...ObjectiveTo present an approach to phenotyping ACEs and explore the association between ACEs and adolescent health risky behaviors based on the social context of China.Methods Totally,5,726 adolescents aged 12-18 years were investigated about their ACEs in the family,peer,school,and personal domains and the occurrence of six types of risky health behaviors(i.e.,smoking,drinking,sexual intercourse,self-harm,and suicidal ideation and attempts).Latent class analysis(LCA)was used to explore the ACE patterns.Results Six latent classes of ACEs were identified,including low adversity,school adversity,school adversity and peer victimization,peer victimization,maltreatment and peer victimization,and high adversity,and associated with risky health behaviors in adolescents.Being physically punished by a teacher,experiencing sexual abuse,and experiencing family trauma most strongly differentiated from the six AcE classes and were correlated with an increased risk for risky adolescent health behaviors.ConclusionThis study supports a positive association between ACEs and risky adolescent health behaviors.Peer victimization,school adversity and associated contexts need to be considered in future ACEstudies.展开更多
As a behavioural consultant, one of the most common phrases used in referral information is that the individual is engaging in a series of behaviors “just to get attention”. Attention has been postulated as a motiva...As a behavioural consultant, one of the most common phrases used in referral information is that the individual is engaging in a series of behaviors “just to get attention”. Attention has been postulated as a motivation for behavior by the most widely used behavioral assessments such as the Motivation Assessment Scale, the Functional Assessment Screening Tool and others. This article will present the concept that people do not want attention, rather they want the things attention brings, such as safety, affection, acceptance and other needs. In a sense, attention is the means to an end, and not the end itself. A conceptualization for identifying the reinforcers sought by people using behavior to get the attention of others is presented within the context of a single case study.展开更多
The documentation of psychological trauma is obviously a challenge to clinicians while they are diving deep into remote events related to their clients or patients.The potential role of psychological trauma in the ear...The documentation of psychological trauma is obviously a challenge to clinicians while they are diving deep into remote events related to their clients or patients.The potential role of psychological trauma in the early developmental stages,and even the existence of adverse childhood experiences,is important to prove,yet it is difficult to do so.A diverse range of methods have been applied,all of which presumably benchmark a big therapeutic step;however,these enthusiastic methods frequently do not last for long.While hypnosis supporters,Freudian and Neo-Freudian disciples can be acute enough to enhance and uncover suppressed memories,modern psychiatry relies mostly on diversely structured interviews.Functional magnetic resonance and its related subtleties might help,but the questions that remain unanswered are numerous and confusing.Connecting early experiences with long-term memory while identifying psychological trauma its importance for the individual’s growth trajectory;thus,it remains an intriguing issue.展开更多
文摘Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent and cumulative effects of ACEs exposure on the likelihood of Posttraumatic Stress Disorder (PTSD) and a Complex PTSD (CPSTD) diagnosis in Indian adolescents. Methods: A sample of 411 schoolchildren participated in the study. It was collected data on exposure to ACEs, PTSD, CPTSD, and attachment styles. Results: It was found that exposure to bullying and threats of violence was significantly associated with PTSD and CPTSD diagnosis, and exposure to physical violence and serious illness was associated with CPTSD diagnosis. Exposure to one ACE and exposure to 2 - 3 ACEs were associated with PTSD and CPTSD diagnosis, while exposure to 4 - 5 ACEs was associated with CPTSD diagnosis. Preoccupied and fearful attachment styles were significantly associated with PTSD and CPTSD diagnosis. Conclusion: The results of the study suggest that biological, psychological, and social factors interact and contribute to the differential prevalence of ACE, attachment styles, and PTSD/CPTSD. This study emphasizes the need of addressing childhood trauma as a public health priority in India.
基金supported by the STI 2030-Major Projects(2021ZD0200500).
文摘Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to examine the association between ACEs and a range of HRBs,including substance use,sexual risk behavior,suicidal ideation,physical inactivity,and violence.Methods:This cross-sectional study used self-administered questionnaire and cluster sampling in seven junior high schools in Samarinda,Indonesia,with a sample size of 534 students.Data analysis using descriptive statistics,the Chi-square test,the independent t-test,ANOVA,binary logistic regression,and mediation analysis with macro-PROCESS.Results:The most common ACEs were community violence(68.0%),physical neglect(52.8%),psychological/emotional abuse(52.6%),physical abuse(50.4%),and peer bullying(45.9%).Adolescents with more than five ACEs showed significantly higher involvement in smoking/vaping(67.9%),suicidal ideation(75.2%),sexual risk behavior(57.7%),bullying(64.3%),and physical fighting(59.7%)(p<0.001).ACEs were significantly correlated with EF deficits(r=0.471,p<0.01)and HRB(r=0.578,p<0.01).Regression analysis confirmed that ACEs predicted EF deficits(β=0.466,p<0.001)and HRB(β=0.469,p<0.001),with EF deficits partially mediating this relationship(β=0.107,95%CI[0.045,0.094]).In addition,two subdomains of EF deficits,self-motivation(β=0.042)and self-regulation of emotion(β=0.032),significantlymediated the relationship between ACEs and HRBs.Conclusion:These findings suggest an important role for EF deficits in linking childhood adversity to engagement in risky behaviors.Addressing ACEs and EF deficits(self-motivation and self-regulation of emotion)through early intervention may be important in reducing long-term health risks among Indonesian adolescents.
基金supported by Hainan special fund project for science and technology(KJHZ2015-20)
文摘Early rearing experiences are important in one＇s whole life, whereas early adverse rearing experience（EARE） is usually related to various physical and mental disorders in later life. Although there were many studies on human and animals, regarding the effect of EARE on brain development, neuroendocrine systems, as well as the consequential mental disorders and behavioral abnormalities, the underlying mechanisms remain unclear. Due to the close genetic relationship and similarity in social organizations with humans, non-human primate（NHP） studies were performed for over 60 years. Various EARE models were developed to disrupt the early normal interactions between infants and mothers or peers. Those studies provided important insights of EARE induced effects on the physiological and behavioral systems of NHPs across life span, such as social behaviors（including disturbance behavior, social deficiency, sexual behavior, etc）, learning and memory ability, brain structural and functional developments（including influences on neurons and glia cells, neuroendocrine systems, e.g., hypothalamic-pituitary-adrenal（HPA） axis, etc）. In this review, the effects of EARE and the underlying epigenetic mechanisms were comprehensively summarized and the possibility of rehabilitation was discussed.
基金funded by the Guangdong Provincial Philosophy and Social Science Planning Project(GD22XJY25).
文摘Adverse childhood experiences(ACEs)can negatively affect mental health,whereas character strengths seem to be positively correlated with mental health.Detailed information on the history of ACEs among university students in China and the extent which mental health is associated with ACEs and character strengths can contribute to the needed empirical evidence for relevant stakeholders.Objectives of this study are 1)to estimate the prevalence of ACEs among undergraduate students in Southern China;and 2)to assess the extent which mental health outcomes(positive growth,well-being,and depression)are associated with ACEs and character strengths among undergraduate students in Southern China.We conducted a self-administered survey amongfirst and second-year students at a university in Southern China and analyzed data using descriptive statistics and linear regression analyses.Among the 779 students who completed the questionnaire,283 were males,439 were females,and 57 did not indicate their gender.The prevalence of ACEs among the participants was 32.1%.History of ACEs was associated with lower positive growth score(Adjusted Beta=-0.20;95%CI=-0.37,-0.02;p=0.030)and lower well-being score(Adjusted Beta=-1.13;95%CI=-2.04,-0.23;p=0.014).Vitality domain of character strength was associated with all three mental health outcomes after adjusting for covariables(all p-values<0.001).Our studyfindings provide empirical evidence for stakeholders in university mental health.However,caveats regarding lack of temporality,selection bias,social desirability bias,and lack of generalizability should be considered in the interpretation of the studyfindings.
文摘<strong>Objectiv</strong><strong>e</strong><strong>:</strong><span style="font-family:""><span style="font-family:Verdana;"> Children with fetal alcohol spectrum disorder (FASD) are overrepresented in early intervention programs, foster care, special education, juvenile corrections, and mental health services. In this study, we examine relationships between FASD and non-FASD controls for adverse childhood experiences (ACEs), and neurodevelopmental disorders. </span><b><span style="font-family:Verdana;">Methods:</span> </b><span style="font-family:Verdana;">A chart review was conducted among patients seen at our clinic from 2010-2017 with data on FASD, ACEs, neurodevelopmental diagnoses, and foster or residential care placement available. </span><b><span style="font-family:Verdana;">Results:</span> </b><span style="font-family:Verdana;">Relative risk for FASD was increased in patients with increased ACE scores (RR = 5.08), increased numbers of neurodevelopmental diagnoses (RR = 2.36), and patients who have been in foster or residential care (RR = 9.53). FASD risk increased as ACE scores or the number of neurodevelopmental diagnoses increased. Patients with any ACEs were 3.96 times more likely to have FASD, and those with eight or more ACEs were 6.31 times more likely to have FASD than those with no ACEs. Patients with three or more neurodevelopmental diagnoses were 6.55 times more likely to have FASD than those with two or fewer diagnoses. Nine or more diagnoses increased the risk for FASD ten-fold (RR = 10.91). Conversely, patients diagnosed with FASD were more likely to have at least three ACEs (RR = 3.71), at least five neurodevelopmental diagnoses (RR = 1.61), and high rates of previous foster or residential care placement (RR = 5.39). </span><b><span style="font-family:Verdana;">Conclusion:</span> </b><span style="font-family:Verdana;">This study demonstrates that all children being considered for placement in foster care or residential should be screened for FASD.</span></span>
基金Supported by Slovenian Research and Innovation Agency Program,No.P1-0390 and No.N3-0349Slovenian Research and Innovation Agency Program,Young Researcher Grant(toŠmon J).
文摘Suicidality is a complex phenomenon influenced by genetic,environmental,and epigenetic factors.Current tools to estimate suicide risk are insufficient,and there is an increasing need for reliable biomarkers to complement clinical approaches.Growing evidence suggests that immune system dysregulation contributes to the pathophysiology of psychiatric disorders and suicidal behavior.Epigenetic mechanisms,including DNA methylation,histone modifications,and non-coding RNAs,regulate gene expression and may act as a bridge between environmental stressors and(neuro)inflammatory responses.In this review,we examine the evidence of peripheral and central inflammation in suicide completers and individuals with suicidal behavior.Next,we review current knowledge from various studies on suicide-associated epigenetic alterations.Furthermore,we evaluate the mechanisms by which early life adversity and chronic stress contribute to suicide diathesis,focusing on their association with epigenetic modifications and inflammatory pathways.We also examine future prospects and limitations of immunology-related biomarkers and the possibilities of therapeutic interventions targeting the immune system and epigenetic regulation.While challenging,research on epigenetic and immune alterations in suicidality shows promise for identifying suicide risk subtypes and advancing personalized psychiatry.
基金the Global WACh Rising Star Seed Award by the Department of Global Health,University of Washington,Seattle,USA(Grant No:UW/GWACh/RSA/2023-01)。
文摘Background Globally,suicide is the third leading cause of death among girls aged 15-19 years.However,there is a growing concern that suicide research has paid lttle attention to pregnant adolescent girls,particularly in lowincome and middle-income countries,including Ghana,where nearly one in seven adolescents experiences(unwanted)pregnancy.Aims To assess the prevalence and correlates of suicidal ideation and suicide attempt and the self-reported reasons for attempted suicide among pregnant adolescent girls in Ghana.Methods We collected cross-sectional data(between August 2022 and December 2023)using structured anonymous questionnaires from a sample of 449 pregnant adolescent girls(aged 14-19 years)drawn from the three geographical zones of Ghana.We applied bivariable and multivariable analysis techniques to the data.Results Overall,28.51%(95%confidence interval(Cl)24.37%to 32.93%)reported suicidal ideation,and 18.04%(95%Cl 14.59%to 21.91%)reported suicide attempt during the current pregnancy.Participants who reported attempted suicide endorsed more interpersonal reasons(eg,to communicate distress,to seek help or to influence others)than intrapersonal reasons for their attempted suicide.In the final adjusted logistic regression models,food insecurity(adjusted odds ratio(aOR)=2.69;95%Cl 1.34 to 5.41;p=0.005)was uniquely associated with increased odds of suicidal ideation.Adverse childhood experiences(a0R=3.04;95%CI 1.33 to 6.97;p=0.008),history of attempted suicide before current pregnancy(a0R=3.47;95%CI 1.27 to 9.47;p=0.015)and depression(measured by the 5-item World Health Organization Well-Being Index;aOR=0.31;95%CI 0.12 to 0.77;p=0.012)were uniquely associated with increased odds of suicide attempt.Five variables were commonly associated with increased odds of both suicidal ideation and suicide attempt:conflict with parents,alcohol use,pregnancy-related anxiety,history of attempted suicide and intimate partner violence.While being in junior high school was uniquely associated with reduced odds of suicidal ideation,intimate partner's acceptance of paternity was commonly associated with reduced odds of both suicidal ideation and suicide attempt.Conclusions Although the prevalence estimates of suicidal ideation and suicide attempt in this study are comparable with known rates among non-pregnant adolescent girls in Ghana,additional research is needed to nuance our understanding of the correlates identified in this study.The evidence aiso highlights a need for both routine antepartum primary care mental health screening for suicidality and related risks and targeted prevention and intervention programmes.
基金supported by #NEXTGENERATIONEU(NGEU)and funded by the Ministry of University and Research(MUR),National Recovery and Resilience Plan(NRRP),project MNESYS(PE0000006)-(DN.155311.10.2022)supported by Sapienza Grant 2021(RM12117A60BDF685).
文摘Background Non-suicidal self-injury(NSSI)is a significant health concern among adolescents and young adults,often resulting from adverse childhood experiences(ACEs).Dissociation,post-traumatic symptoms and attachment style may have a role in shaping such associations.Aims This study aims to provide a unified model of the impact of ACEs on NSSI,exploring complex post-traumatic stress disorder(cPTSD)symptoms and dissociation as potential mediators and the role of the predominant attachment style in affecting such associations.Methods 1010 young individuals attending the last year of high school participated in this cross-sectional study.ACEs,cPTSD,dissociation and NSSI were evaluated using self-report questionnaires.We fitted a path model of NSSI,with ACEs as exogenous variables and cPTSD and dissociation as sequential mediators.Secure,fearful and preoccupied attachment styles were modelled as grouping variables.Results Our findings showed that dissociation mediated the impact of ACEs on NSSI in subjects with a fearful attachment style,as opposed to those with a preoccupied attachment for whom cPTSD symptoms mediated the ACEs-NSSI association.Conclusions Attachment styles moderate the relationship between ACEs and NSSI,with either dissociation or post-traumatic symptomatology mediating the impact of ACEs on NSSI,depending on the predominant attachment style.Our results highlight the importance of attachment as a pathway modifier in the relationships between different psychopathology dimensions,providing a useful framework to better conceptualise the ACEs-NSSI association.
基金This study has been supported by grants from the National Natural Science Foundation of China[Grant number 81874268].
文摘ObjectiveTo present an approach to phenotyping ACEs and explore the association between ACEs and adolescent health risky behaviors based on the social context of China.Methods Totally,5,726 adolescents aged 12-18 years were investigated about their ACEs in the family,peer,school,and personal domains and the occurrence of six types of risky health behaviors(i.e.,smoking,drinking,sexual intercourse,self-harm,and suicidal ideation and attempts).Latent class analysis(LCA)was used to explore the ACE patterns.Results Six latent classes of ACEs were identified,including low adversity,school adversity,school adversity and peer victimization,peer victimization,maltreatment and peer victimization,and high adversity,and associated with risky health behaviors in adolescents.Being physically punished by a teacher,experiencing sexual abuse,and experiencing family trauma most strongly differentiated from the six AcE classes and were correlated with an increased risk for risky adolescent health behaviors.ConclusionThis study supports a positive association between ACEs and risky adolescent health behaviors.Peer victimization,school adversity and associated contexts need to be considered in future ACEstudies.
文摘As a behavioural consultant, one of the most common phrases used in referral information is that the individual is engaging in a series of behaviors “just to get attention”. Attention has been postulated as a motivation for behavior by the most widely used behavioral assessments such as the Motivation Assessment Scale, the Functional Assessment Screening Tool and others. This article will present the concept that people do not want attention, rather they want the things attention brings, such as safety, affection, acceptance and other needs. In a sense, attention is the means to an end, and not the end itself. A conceptualization for identifying the reinforcers sought by people using behavior to get the attention of others is presented within the context of a single case study.
文摘The documentation of psychological trauma is obviously a challenge to clinicians while they are diving deep into remote events related to their clients or patients.The potential role of psychological trauma in the early developmental stages,and even the existence of adverse childhood experiences,is important to prove,yet it is difficult to do so.A diverse range of methods have been applied,all of which presumably benchmark a big therapeutic step;however,these enthusiastic methods frequently do not last for long.While hypnosis supporters,Freudian and Neo-Freudian disciples can be acute enough to enhance and uncover suppressed memories,modern psychiatry relies mostly on diversely structured interviews.Functional magnetic resonance and its related subtleties might help,but the questions that remain unanswered are numerous and confusing.Connecting early experiences with long-term memory while identifying psychological trauma its importance for the individual’s growth trajectory;thus,it remains an intriguing issue.
