Difficulty identifying feelings predicts the persistence of trauma symptoms in a sample of veterans who experienced military sexual trauma

The current study examined the prospective association between alexithymia and the persistence of trauma symptoms in a clinical sample of 175 male and female veterans who experienced sexual trauma during military service (military sexual trauma; MST). Trauma symptoms decreased significantly over the course of a specialized residential treatment program. Difficulty identifying feelings was related to persistence of the following trauma symptoms: overall symptoms, sexual abuse trauma symptoms, dissociative symptoms, and anxiety. Men exhibited more persistent symptoms overall, more persistent sexual problems, and more sexual abuse trauma symptoms compared with women (over and above controlling for symptoms at intake). The results speak to the significant role that difficulty identifying feelings has in the treatment of PTSD. In addition, the results suggest that MST has different implications for men compared with women. Specifically, men who were sexually abused in the military experienced greater persistence of symptoms compared with women, especially in the areas of sexual functioning.     

The role of romantic attachment security and dating identity exploration in understanding adolescents' sexual attitudes and cumulative sexual risk-taking

This study addressed how two normative developmental factors, attachment and identity, are associated with adolescents' sexual attitudes and sexual risk-taking behavior. The sample consisted of 2029 adolescents (mean age = 16.2 years) living in the Southeast United States. Path analysis was used to test the hypotheses. Higher levels of attachment anxiety predicted more dating identity exploration and less healthy sexual attitudes. Higher levels of attachment avoidance predicted less dating identity exploration and indirectly predicted less healthy sexual attitudes through dating identity exploration. Females with dating or sexual experience showed the weakest associations between the attachment dimensions and dating identity exploration. More dating identity exploration predicted healthier sexual attitudes; this association was strongest for non-virgins. Finally, higher levels of attachment avoidance were associated with higher cumulative sexual risk scores, but only among non-virgin males. Results are interpreted in light of theory and research on attachment, identity exploration, and adolescent sexual relationships.     

The role of melanocortin receptors in sexual behavior in female rats

Earlier data have indicated that alpha-MSH may play a role for sexual behavior in rats. In this study we investigated the effects of MSH peptides on sexual receptivity in ovariectomized-adrenalectomized female rats, pre-treated with benzoate of estradiol, in presence of vigorous male rats. The results show that alpha-MSH significantly increases lordosis behavior in female rats after injections into the ventromedial nucleus. Interestingly, we have for the first time shown that gamma-MSH also causes significant increase in lordosis in female rats. Furthermore, we show that HS014, an antagonist for the central MC receptors, in dose dependent manner blocks the effect of alpha-MSH on lordosis. The results indicate that the effects of MSH peptides on female sexual behaviour are mediated through a specific MC receptor, which could be the MC3 receptor.     

Mental health effects of adolescent trauma exposure in a female college sample: exploring differential outcomes based on experiences of unique trauma types and dimensions

Most studies on the psychological impact of trauma exposure focus on the response to a single type of trauma, with little or no attention paid to the contribution of prior traumatic experiences. The goal of this study was to disentangle some of the confounding effects of multiple trauma exposures by exploring the unique contribution to mental health outcomes made by specific types and dimensions of trauma. This report compares the psychological outcomes of college women who experienced different types of trauma during adolescence, including traumatic bereavement, sexual assault, and physical assault. Young women who had experienced a single event of one of these types were compared with peers who had experienced multiple single events, ongoing sexual and/or physical abuse, as well as those who had experienced no trauma. Results, based on structured clinical interviews, and self-report measures showed that there were some significant differences in mental health outcomes based on trauma type. However, trauma exposure versus no exposure and the cumulative effects of exposure versus one-time experiences played the key roles in differentiating the groups.     

Contrasting mental health correlates of physical and sexual abuse-related shame

Objective: This study represents an initial attempt to contrast behavioural and mental health correlates of shame as a result of physical abuse (PA) and sexual abuse (SA). Because they are distinctive forms of injury, it is possible that corollary shame from these injuries follows unique trajectories and ultimately results in different health challenges.

Method: Self-report data from a survey on the health of youth receiving protective services for reasons of PA and SA was used. It included standardised measures, such as the Childhood Trauma Questionnaire, Trauma Symptoms Checklist for Children, the Brief Symptoms Inventory, the Rutgers Alcohol Problem Index, and the South Oaks Gambling Screen. New measures of abuse-related shame, maltreatment, and substance use were also employed. Linear regression analyses were performed to determine whether level of shame was linked to mental health and behaviour issues, after controlling for level of abuse.

Results: Results were similar for shame as a result of PA and SA victimisation. After accounting for shared variance with abuse severity, both measures were linked to a full spectrum of mental health issues, such as depression (SA r² = 0.30, PA r² = 0.28), anxiety (SA r² = 0.27, PA r² = 0.20), post-traumatic stress (SA r² = 0.26, PA r² = 0.19), interpersonal sensitivity (SA r² = 0.17, PA r² = 0.22), and psychoticism (SA r² = 0.19, PA r² = 0.20), but not to gambling or substance use problems. PA-related shame was associated with suicidality (r² = 0.05).

Conclusions: Keeping in mind that this was largely a cross-sectional study and that causality cannot be inferred, the results seem to indicate that youth suffering from abuse-related shame are particularly vulnerable to mental health problems, but not to efforts to numb their problematic thoughts and feelings through gambling and substance use. Shame could serve as an early indicator of which child protection recipients are most in need of preventive efforts.     

The mental and physical health of female sex workers: a comparative study

OBJECTIVES: The objective of this study was to compare the mental and physical health, adult abuse experiences and social networks of female sex workers with data previously collected from two large community samples of age-matched women. METHOD: A convenience sample of sex workers were interviewed and completed two well-established questionnaires, the General Health Questionnaire (GHQ-28) and the Intimate Bond Measure (IBM). Sex workers were invited to reflect on their experiences of their work. RESULTS: There were no differences in mental health on the GHQ-28 or in self-esteem (measured by an item on the Present State Examination) between the two groups. Neither were there any differences in their assessment of their physical health or the quality of their social networks. Sex workers were less likely to be married and had been exposed to more adult physical and sexual abuse than the comparison group. They were more likely to smoke and to drink heavily when they drank. One-third said that their general practitioner was not aware of their work. A subgroup not working with regular clients or in a massage parlour had higher GHQ-28 scores and may be an at-risk group. Narrative information about the work, particularly its intermittent nature, is presented. CONCLUSIONS: No evidence was found that sex work and increased adult psychiatric morbidity are inevitably associated, although there may be subgroups of workers with particular problems. The illegal and stigmatized nature of sex work are likely to make usual public health strategies more difficult to apply, considerations which should give concern from a preventive health standpoint.     

The psychological impact of sexual assault: A study of female attenders of a sexual health psychology service

Genitourinary clinics are often used as an early point of contact for individuals attending for medical screening following sexual assault. This paper describes the psychological impact of sexual assault in 32 women referred over a one year period to clinical psychology in an East London Genitourinary medicine (GUM) clinic. Women presented with complex histories of sexual abuse and assault and multiple psychological problems. Medical services need to be prepared to deal with the immediate and long-term effects of sexual assault and have access to professional psychological support.     

The role of adherence in mediating the relationship between depression and health outcomes

Depression has been linked to poor health outcome in a number of studies; however, the mechanism underlying this relationship has received little attention. This paper explores the possibility that adherence mediates the relationship between depression and outcome. Principal findings regarding the relationship between depression, adherence, and outcome are reviewed. The data suggest that depression is related, at least moderately, to poorer adherence to a variety of treatment components. The relationship between adherence and outcome is more difficult to establish. In addition, current data, albeit limited, do not support the hypothesis that adherence mediates the relationship between depression and outcome. An alternative model in which adherence precedes and influences both mood state and health outcome is discussed. Finally, possible explanations for these relationships are explored and suggestions for future research provided.     

The role of coping humor in the physical and mental health of older adults

Objectives: This study examined the associations among coping humor, other personal/social factors and the health status of community-dwelling older adults.

Method: Survey questionnaires were completed with 73 community-dwelling older adults. Included were measures of coping humor, spirituality, self-efficacy, social support and physical and mental health status.

Results: Correlations across all variables showed coping humor to be significantly associated with social support, self-efficacy, depression and anxiety. Forward stepwise regression analyses showed that coping humor and self-efficacy contributed to outcome variance in measures of mental health status. Contrary to expectation, neither social support nor spirituality contributed to the total outcome variance on any of the dependant measures.

Conclusion: The importance of social support, self-efficacy and spirituality in determining the quality of life of older adults is well supported in the literature. Coping humor as a mechanism for managing the inevitable health stresses of aging has received less attention. This study shows that coping humor and self efficacy are important factors for explaining health status in older adults. Correlations among coping humor, self efficacy and social support suggest that a sense of humor may play an important role in reinforcing self-efficacious approaches to the management of health issues.     

Effects of trauma on bipolar disorder: the mediational role of interpersonal difficulties and alcohol dependence

OBJECTIVES: This study examined: (i) the prevalence of trauma in a bipolar disorder (BD) sample, and (ii) how trauma histories mediated by interpersonal difficulties and alcohol dependence impact on the severity of BD. The prevalence of posttraumatic stress disorder (PTSD) and its relationship to outcomes in BD were also examined. METHODS: Sixty participants were recruited from a geographically well-defined mental health service in Northern Ireland. Self-reported trauma histories, PTSD, interpersonal difficulties and alcohol dependence and were examined in relation to illness severity. RESULTS: A high prevalence of trauma was found. Trauma predicted the frequency of hospital admissions (R(2) = 0.08), quality of life (R(2) = 0.23) and inter-episode depressive symptoms (R(2) = 0.13). Interpersonal difficulties, but not alcohol dependence, appeared to play an important role in mediating these adverse effects. While only 8% of the sample met criteria for active PTSD, this comorbid disorder was associated with BD severity. CONCLUSIONS: This study indicates that awareness of trauma is important in understanding individual differences in bipolar presentations. The theoretical and clinical implications of evidence that trauma is related to more adverse outcomes in BD are discussed. The finding that interpersonal difficulties mediate the relationship between trauma and BD severity is novel. The need for adjunctive evidence-based treatments targeting interpersonal difficulties is considered.     

Mental,physical and sexual health in sexual minority third-level students: Findings from My World Survey 2

Aims

Sexual minority youth experience health disparities across mental, physical and sexual domains. However, little is known about the extent to which mental health overlaps with sexual and physical health to compound health problems among sexual minority youth. This study examined risky health behaviours, adverse health outcomes, and their overlap across mental, physical and sexual domains, in lesbian, gay, bisexual, questioning (LGBQ) and heterosexual third-level students in Ireland.

Method

Cross-sectional data from the My World Survey 2-Post Second Level (MWS2-PSL) were used. Analyses were conducted on data from N = 7950 18–25-year-old students, of which 6204 (78%) identified as heterosexual, 910 (11.4%) bisexual, 412 (5.2%) lesbian/gay and 424 (5.3%) questioning. Risky health behaviours (e.g., self-harm), adverse outcomes (e.g., mental health difficulties, physical health conditions) and their overlap across mental, physical and sexual domains were compared across heterosexual and LGBQ students using Chi-square tests. Clustering of health behaviours/outcomes within and between domains were examined.

Results

LGBQ students were more likely to exhibit a greater number of risky mental and sexual health behaviours and outcomes. Sexual, physical and mental health behaviours and outcomes overlapped to a greater extent in LGBQ versus heterosexual students. Distinct health outcomes were observed across sexual minority subgroups (e.g., bisexual women reported greater mental health difficulties).

Conclusion

Findings demonstrate health inequalities experienced by LGBQ students, particularly across mental and sexual domains. Holistic integrated approaches that consider multiple health domains simultaneously and the distinct health needs of sexual minority subgroups are needed to promote greater health equity.     

Trauma-related sleep disturbance and self-reported physical health symptoms in treatment-seeking female rape victims

The purpose of the study was to assess the relationship between trauma-related sleep disturbance and physical health symptoms in treatment-seeking female rape victims. A total of 167 participants were assessed for PTSD symptoms, depression, sleep disturbance, and frequency of self-reported health symptoms. Results demonstrated that trauma-related sleep disturbance predicted unique variance in physical health symptoms after other PTSD and depression symptoms were controlled. The findings suggest that trauma-related sleep disturbance is one potential factor contributing to physical health symptoms in rape victims with PTSD.     

Stressful childhood experiences and health outcomes in sexual minority populations: a systematic review

Purpose

Stressful childhood experiences (SCE) are associated with many different health outcomes, such as psychiatric symptoms, physical illnesses, alcohol and drug abuse, and victimization experiences. Lesbian, gay, bisexual, and transgender (LGBT) people are at risk to be victims of SCE and show higher prevalence of SCE when compared with heterosexual controls.

Methods

This review analyzed systematically 73 articles that addressed different types of SCE in sexual minority populations and included items of household dysfunction. The samples included adults who identified either their sexual orientation as non-heterosexual or their gender identity as transgender.

Results

The studies reported childhood sexual abuse (CSA), childhood physical abuse (CPA), childhood emotional abuse (CEA), childhood physical neglect, and childhood emotional neglect. Items of household dysfunction were substance abuse of caregiver, parental separation, family history of mental illness, incarceration of caregiver, and witnessing violence. Prevalence of CSA showed a median of 33.5 % for studies using non-probability sampling and 20.7 % for those with probability sampling, the rates for CPA were 23.5 % (non-probability sampling) and 28.7 % (probability sampling). For CEA, the rates were 48.5 %, non-probability sampling, and 47.5 %, probability sampling. Outcomes related to SCE in LGBT populations included psychiatric symptoms, substance abuse, revictimization, dysfunctional behavioral adjustments, and others.

Conclusions

LGBT populations showed high prevalence of SCE. Outcomes related to SCE ranged from psychiatric symptoms and disorders to physical ailments. Most studies were based in the USA. Future research should aim to target culturally different LGBT population in the rest of the world.     

The adaptive and maladaptive faces of dependency in later life: Links to physical and psychological health outcomes

Objectives: Negotiating the balance between reliance on others and desires for autonomy is a fundamental task of successful aging. The purpose of the present study was to replicate and extend a three-factor model of interpersonal dependency in a sample of older adults, and to examine the physical and psychological health correlates of this multifaceted construct.

Methods: Data come from the third wave of a population-based study of older Americans (n = 166; mean age 80 years). We conducted an exploratory factor analysis of selected dependency items from two scales, and then conducted logistic and hierarchical linear regressions to analyze the association of dependency factors with self-reported health, use of hypertension medication, depressed affect and positive affect.

Results: We found three factors closely paralleling those of Bornstein and Languirand's (Psychological Bulletin, 112(1), 3–23, 2004) measure: destructive overdependence, healthy dependency and dysfunctional detachment, as well as a fourth factor we labeled ‘healthy independence’. Healthy dependency was associated with better self-reported health. Dysfunctional detachment was related to a greater likelihood and healthy independence a lesser likelihood of taking hypertension medication. Whereas both healthy independence and healthy dependency were positively related to positive affect and negatively related to depressed affect, destructive overdependence was positively related to depressed affect.

Conclusion: Understanding the complex nature of interpersonal dependency and autonomy in old age, as well as their implications for health and wellbeing, may enable practitioners to assist older adults in negotiating the task of balancing these needs.     

The relationship between self-monitoring,outcome expectancies,difficulties with eating and exercise,and physical activity and weight loss treatment outcomes

Background/Purpose: During a behavioral weight loss program (BWLP), weight loss and exercise can vary considerably from week to week. Weekly fluctuations in outcome expectancies and perceived difficulties with eating and exercise may be associated with weekly variability in weight loss and exercise. Also, inconsistent self-monitoring of exercise may be associated with poor weight loss and physical activity treatment outcomes.Methods:Forty obese, sedentary participants completed a 6-month BWLP. Body weight, outcome expectancies, and difficulties with eating and exercise were assessed weekly. Weekly self-monitoring of exercise was computed from physical activity diaries. Physical activity, VO₂ max, and caloric intake were assessed pre-and posttreatment.Results:Within-subjects analyses indicated that participants exercised less during weeks that participants reported greater difficulties with exercise, relative to weeks participants reported fewer difficulties. Participants lost significantly more weight during weeks that participants reported more positive outcome expectancies and greater difficulties with exercise, compared to weeks participants reported less positive outcome expectancies and fewer difficulties with exercise. Consistent self-monitoring of exercise was associated with fewer difficulties with exercise and greater exercise and weight loss.Conclusions:Interventions that are targeted to increase self-monitoring and to improve transient difficulties with exercise and diminished outcome expectancies may improve BWLP treatment outcomes.     

The role of vertebrate models in understanding craniosynostosis

BACKGROUND: Craniosynostosis (CS), the premature fusion of cranial sutures, is a relatively common pediatric anomaly, occurring in isolation or as part of a syndrome. A growing number of genes with pathologic mutations have been identified for syndromic and nonsyndromic CS. The study of human sutural material obtained post-operatively is not sufficient to understand the etiology of CS, for which animal models are indispensable. DISCUSSION: The similarity of the human and murine calvarial structure, our knowledge of mouse genetics and biology, and ability to manipulate the mouse genome make the mouse the most valuable model organism for CS research. A variety of mouse mutants are available that model specific human CS mutations or have CS phenotypes. These allow characterization of the biochemical and morphological events, often embryonic, which precede suture fusion. Other vertebrate organisms have less functional genetic utility than mice, but the rat, rabbit, chick, zebrafish, and frog provide alternative systems in which to validate or contrast molecular functions relevant to CS.