Childhood trauma and depression in alcoholics: relationship to hostility

OBJECTIVE: To examine for a relationship between childhood trauma and depression in alcoholics. METHODS: Euthymic depressed alcoholics (N = 23) were compared with never depressed alcoholics (N = 20) for their scores on the Childhood Trauma Questionnaire (CTQ). Subjects also completed the Hostility and Direction of Hostility Questionnaire (HDHQ). RESULTS: Euthymic depressed alcoholics had significantly higher scores on the CTQ for childhood emotional abuse, physical abuse, sexual abuse, and emotional neglect. They also had significantly higher hostility scores on the HDHQ. There were significant correlations between adult hostility scores and CTQ scores for childhood emotional neglect, physical neglect, sexual abuse and total childhood trauma. CONCLUSION: A history of childhood trauma was correlated with adult depression in male alcoholics: a hostile personality dimension might be a mediating variable. LIMITATION: Subjects were queried on their memories of childhood traumas. Prospective studies are needed.     

The relationship of sociotropy and autonomy to posttraumatic cognitions and PTSD symptomatology in trauma survivors

The current study examined relationships between sociotropic and autonomous personality styles and posttraumatic stress disorder (PTSD) symptomatology following trauma as well as specific posttraumatic cognitions that have been shown to characterize individuals with PTSD. Self-report data were collected in a sample of 156 college students indicating a history of traumatic experience. Significant relationships were found between symptoms of PTSD and depression and measures of sociotropy, autonomy, and negative posttraumatic beliefs about self and world. Additionally, measures of autonomy and negative posttraumatic thoughts improved prediction of PTSD symptom level after controlling for depressive symptoms.     

Childhood parental loss and risk for first-onset of major depression and alcohol dependence: the time-decay of risk and sex differences

BACKGROUND: Whereas a number of studies have suggested that parental loss is associated with increased risk for major depression (MD), much less is known about possible gender differences, diagnostic specificity and the time course of the impact of loss. METHOD: First-onsets for MD and alcohol dependence (AD) were assessed at personal interviews in 5070 twins from same-sex (SS) and 2118 from opposite-sex (OS) twin pairs ascertained from a population-based registry. Cox Proportional Hazard (PH) and Non-Proportional Hazard (NPH) models, examining first onsets of MD and AD, were used with twins from SS pairs and conditional logistic regression for OS pairs. Parent-child separations prior to age 17 were divided into death and separation from other causes. RESULTS: The PH assumptions of constant increased risk were rejected for the impact of loss on risk for MD but not for AD. NPH models found significantly increased risk for MD after both death and separation with the risk lasting much longer for separations. For AD, the PH model found significantly increased risk after parental separation but not death. In both SS and OS twin pairs, no sex differences were seen in the impact of parental loss on risk for MD whereas the association between separation and risk for AD was significantly stronger in females than in males. CONCLUSION: Consistent sex differences in the association with parental loss were seen for AD but not MD. The analysis of the time-course of increased risk after loss suggests three different patterns which may reflect different relationships: parental death and MD (return to baseline within approximately 12 years), separation and MD (return to baseline within approximately 30 years) and separation and AD (no change in risk over time).     

Childhood trauma and psychosis: evidence, pathways, and implications

There is currently a growing body of research examining environmental factors in the etiology of psychosis. Much recent interest has focused on the relationship between childhood trauma and the risk of developing psychotic experiences later in life. Numerous studies of psychiatric patients where the majority are diagnosed psychotic indicate that the prevalence of traumatic experiences in this group is high. This body of research now includes many large-scale population-based studies controlling for possible mediating variables, which together provide persuasive evidence of a dose-response association and are indicative of a causal relationship. Several psychological and biological models have been proposed which offer credible accounts of the processes by which trauma may increase risk of psychotic experience. Clinically it is imperative to routinely inquire about traumatic experiences, to respond appropriately and to offer psychosocial treatments to those who report traumatic life events in the context of psychotic experiences.     

Combat guilt and its relationship to PTSD symptoms

Guilt regarding combat experiences is often considered an associated symptom of PTSD in military veterans. Little is known, however, about the role combat guilt plays in the development and maintenance of PTSD. Inadequate measurement of combat-related guilt may be one reason for this deficiency in the literature. In the present study, 40 veterans with PTSD completed a novel measure of combat guilt. Items on the scale assessed various types of guilt and shame concerning combat experiences (i.e., survival guilt, guilt over acts of omission and acts of commission, guilt about thoughts/feelings). Guilt was quite prevalent within this sample, and severity of guilt regarding combat was positively correlated with the reexperiencing and avoidance symptoms of PTSD and a general measure of PTSD severity. Implications of these findings and recommendations for the development of measures for combat-related guilt are discussed. © 1997 John Wiley & Sons, Inc. J Clin Psychol 53: 801–808, 1997     

Risk and preventive factors of post-traumatic stress disorder (PTSD): alcohol consumption and intoxication prior to a traumatic event diminishes the relative risk to develop PTSD in response to that trauma

BACKGROUND: Previous reports examined the effects of selected pre- (e.g. female gender, previous trauma), peri- (e.g. the horror of the trauma, threatened death) or post-exposure (e.g. the physical injury caused by the trauma) risk factors on the development of post-traumatic stress disorder (PTSD), an anxiety disorder associated with a traumatic event outside the range of usual human experience. We hypothesized that alcohol consumption prior to traumatic events may reduce the incidence rate of PTSD. The aim of this study was to examine the effects of the above risk factors and preventive factors, such as alcohol consumption, on the development of PTSD. METHODS: An epidemiological cohort study was carried out on 127 victims trapped in a ballroom fire. Data were collected, 7-9 months after the traumatic event, by means of the Composite International Diagnostic Interview (CIDI) and structured interviews, aimed to assess the above pre-, peri- and post-exposure factors. Logistic regression analysis was used to examine the association of PTSD with the etiologic factors and to delineate those risk factors which contribute most to the development of PTSD. RESULTS: Female gender, the number of previous trauma, a past history of simple phobia, threatened death, trauma exposure, hospitalization for trauma-induced injuries and the presence of burns increased the odds of PTSD, whereas a sense of control during the trauma, and alcohol consumption and intoxication decreased the odds of PTSD. Six factors made independent contributions to the prediction of PTSD, i.e. the number of previous trauma, a past history of simple phobia, loss of control (increase the odds), a sense of control, alcohol consumption and alcohol intoxication (decrease the odds). CONCLUSIONS: The results of this study show that the development of PTSD is determined by the effects of pre-, peri- and post-exposure risk factors and may be prevented by the effects of peri-traumatic factors, such as sense of control, alcohol consumption and intoxication.     

The relationship of lifetime polysubstance dependence to trauma exposure, symptomatology, and psychosocial functioning in incarcerated women with comorbid PTSD and substance use disorder.

There is a dearth of literature examining the relationship between trauma-related experiences, PTSD, and lifetime polysubstance dependence among incarcerated women. A sample of 69 treatment-seeking incarcerated women with current PTSD and comorbid substance use disorder (PTSD-SUD) were recruited from a northeastern state medium-security prison. Women with lifetime polysubstance dependence (PTSD-SUD/LPD; n = 33) were compared to women with no lifetime polysubstance dependence (PTSD-SUD only; n = 36) across a range of features; trauma characteristics (e.g., number of traumas, type of trauma), associated symptoms (e.g., dissociation, anxiety), severity of substance use and psychosocial functioning. Women with PTSD and lifetime polysubstance dependence reported greater severity of drug and alcohol use, increased exposure to traumatic events (i.e., general disasters, crime-related events), and increased prevalence of PTSDrelated symptoms (i.e., derealization, survivor guilt). Trends also suggest that PTSD-SUD/LPD women are more likely to experience dissociation, anxiety, and sexual problems than PTSD-SUD respondents. Treatment-related implications are discussed.     

Perceived parental reactions to coming out, attachment, and romantic relationship views

Coming out as lesbian, gay, or bisexual (LGB) to one's parents can be a challenging experience and may lead to acceptance or rejection. Attachment theory can help predict parents' reactions to coming out and consequences for romantic attachment. In a cross-sectional study of 309 LGB individuals, we found that those who perceived their mother as accepting in childhood were more likely to have come out to her. Moreover, parents perceived as accepting and independence-encouraging in childhood were reported to react more positively to their child's sexual orientation. Mothers' positive reactions were associated with lower romantic attachment anxiety for men. The links between parent-child relationship quality and optimism and trust in romantic relationships were mediated by romantic attachment patterns. Findings support the contention that LGB pair bonds are attachment relationships, and underline the importance of prior parent-child relationships for predicting LGB individuals' experience of coming out and romantic relationships.     

Perceived parental reactions to coming out,attachment, and romantic relationship views

Coming out as lesbian, gay, or bisexual (LGB) to one's parents can be a challenging experience and may lead to acceptance or rejection. Attachment theory can help predict parents' reactions to coming out and consequences for romantic attachment. In a cross-sectional study of 309 LGB individuals, we found that those who perceived their mother as accepting in childhood were more likely to have come out to her. Moreover, parents perceived as accepting and independence-encouraging in childhood were reported to react more positively to their child's sexual orientation. Mothers' positive reactions were associated with lower romantic attachment anxiety for men. The links between parent–child relationship quality and optimism and trust in romantic relationships were mediated by romantic attachment patterns. Findings support the contention that LGB pair bonds are attachment relationships, and underline the importance of prior parent–child relationships for predicting LGB individuals' experience of coming out and romantic relationships.     

Attachment styles,traumatic events,and PTSD: a cross-sectional investigation of adult attachment and trauma

The aim of the present study was to examine the association between post-traumatic stress disorder (PTSD) and adult attachment in a young adult population. A sample of 328 Danish students (mean age 29.2 years) from four different schools of intermediate education level were studied by the Harvard Trauma Questionnaire (HTQ), the Revised Adult Attachment Scale (RAAS), the Trauma Symptom Checklist (TSC), the Crisis Support Scale (CSS), the Coping Style Questionnaire (CSQ), and the World Assumption Scale (WAS). Attachment styles were associated with number of PTSD symptoms, negative affectivity, somatization, emotional coping, attributions, and social support. The distribution of attachment styles in relation to PTSD symptoms could be conceived as uni-dimensional.     

Attachment styles, traumatic events, and PTSD: a cross-sectional investigation of adult attachment and trauma

The aim of the present study was to examine the association between post-traumatic stress disorder (PTSD) and adult attachment in a young adult population. A sample of 328 Danish students (mean age 29.2 years) from four different schools of intermediate education level were studied by the Harvard Trauma Questionnaire (HTQ), the Revised Adult Attachment Scale (RAAS), the Trauma Symptom Checklist (TSC), the Crisis Support Scale (CSS), the Coping Style Questionnaire (CSQ), and the World Assumption Scale (WAS). Attachment styles were associated with number of PTSD symptoms, negative affectivity, somatization, emotional coping, attributions, and social support. The distribution of attachment styles in relation to PTSD symptoms could be conceived as uni-dimensional.     

Bridging past and present: Embodied intergenerational trauma and the implications for dance/movement therapy

This paper explores the role of the body in intergenerational transmission of trauma using examples of wartime sexual violence (WSV) during World War II in Germany. It is argued that traumatic memory held in the body is transmitted between generations in a similar fashion to how implicit body memory is passed on from body to body. In relationship, the body shapes subjectivity and intersubjectivity and therefore represents a vessel for transmission of trauma on a familial and cultural level. Silence and culture as source of perpetuation of trauma are taken into account. Furthermore, the severe long-term effects of rape, underlying body defences and relational consequences are outlined. Somatic implications for descendents of WSV survivors are unknown and require research. Dance/movement therapy is offered as a body-focused modality to help transform intergenerational trauma caused by WSV. Implications for further research in body-to-body transmission of trauma are highlighted.     

Childhood sexual abuse, relationship satisfaction, and sexual risk taking in a community sample of women

Childhood sexual abuse (CSA) has been proposed to influence both women's adult sexual risk behaviors and the quality of their intimate relationships. Among a household sample of women (n = 732), good fit was obtained for a model in which CSA predicted Wave 1 male partner sexual risk and aggression characteristics, resulting in lower relationship satisfaction, and ultimately in higher numbers of Wave 2 sexual partners. The model was generally replicated among women who entered new relationships at Waves 2 and 3. Partner sexual risk characteristics also were associated with women's risk of sexually transmitted infection from current partner. Elevated sexual risk behaviors among CSA survivors reflect difficulty in establishing stable and safe relationships and may be reduced by interventions aimed at improving intimate relationships.     

Stress-related changes in financial risk taking: Considering joint effects of cortisol and affect

Many decisions under risk and uncertainty are made under physical or emotional stress. A recent meta-analysis suggested that stress reliably influences risk taking but did not find a relation between single measures of stress such as cortisol and risk taking. One reason for the conflicting findings could be that the influence of stress on risk taking depends not only on physiological but also on psychological stress responses, in particular affective valence. We tested this hypothesis in an exploratory empirical study: Seventy participants worked on a financial risk-taking task. In half of the participants acute stress was induced with a cold pressor task. For all participants we measured cortisol and α-amylase levels, blood pressure, subjective arousal, and affective valence before and after the task. The stress induction increased participants' levels of cortisol, subjective arousal, and systolic blood pressure but did not directly influence negative affect or risky decision making. Examining the interplay between physiological and psychological stress responses, a moderation analysis revealed an interaction between stress induction and affect valence: Negative affect predicted an increase in risk-seeking decision making in the stress condition, but not in the control group. A similar moderation was found with cortisol reactivity, that is, negative affect predicted an increase in risk-seeking decision making in participants with high cortisol reactivity but not in participants with low cortisol reactivity. These results suggest that the effect of stress on risky decision making depends on the interplay of affective valence and cortisol reactivity.     

Integrated genetic,epigenetic, and gene set enrichment analyses identify NOTCH as a potential mediator for PTSD risk after trauma: Results from two independent African cohorts

The risk of developing posttraumatic stress disorder (PTSD) increases with the number of traumatic event types experienced (trauma load) in interaction with other psychobiological risk factors. The NOTCH (neurogenic locus notch homolog proteins) signaling pathway, consisting of four different trans-membrane receptor proteins (NOTCH1–4), constitutes an evolutionarily well-conserved intercellular communication pathway (involved, e.g., in cell–cell interaction, inflammatory signaling, and learning processes). Its association with fear memory consolidation makes it an interesting candidate for PTSD research. We tested for significant associations of common genetic variants of NOTCH1–4 (investigated by microarray) and genomic methylation of saliva-derived DNA with lifetime PTSD risk in independent cohorts from Northern Uganda (N₁ = 924) and Rwanda (N₂ = 371), and investigated whether NOTCH-related gene sets were enriched for associations with lifetime PTSD risk. We found associations of lifetime PTSD risk with single nucleotide polymorphism (SNP) rs2074621 (NOTCH3) (p_uncorrected = 0.04) in both cohorts, and with methylation of CpG site cg17519949 (NOTCH3) (p_uncorrected = 0.05) in Rwandans. Yet, none of the (epi-)genetic associations survived multiple testing correction. Gene set enrichment analyses revealed enrichment for associations of two NOTCH pathways with lifetime PTSD risk in Ugandans: NOTCH binding (p_corrected = 0.003) and NOTCH receptor processing (p_corrected = 0.01). The environmental factor trauma load was significant in all analyses (all p < 0.001). Our integrated methodological approach suggests NOTCH as a possible mediator of PTSD risk after trauma. The results require replication, and the precise underlying pathophysiological mechanisms should be illuminated in future studies.     

Childhood loss of parent, lack of adequate parental care and adult depression: a replication

A study of women living in Islington has confirmed earlier findings that the loss of a mother before the age of 17 (by death or separation) is associated with an increase in clinical depression in adulthood. Lack of adequate parental care following the loss accounted for the increase in disorder and there was some evidence that it acted as a 'vulnerability factor' increasing risk of onset of depression during a 1-year follow-up period, in the presence of a severe life event or major difficulty. Premarital pregnancy, marital separation/divorce and negative evaluation of self were identified as factors intervening between childhood lack of care and adult depression.