BackgroundAdverse childhood experiences (ACEs) and psychiatric disorders are common in juvenile detainees. Emotional dysregulation resulting from cumulated ACEs may be characterized by symptoms of irritability. The present study examined whether the accumulation of ACEs, irritability, or both predicted mental disorders in incarcerated adolescents with and without controlling for one another and for socio-demographic factors.MethodsOne hundred thirty male detained juvenile offenders (aged 13.8–19.5 years) were assessed by structured clinical interviews and a self-reporting scale for irritability. Univariate and multivariate regression models were used to examine the shared and distinct associations of ACEs and irritability with psychiatric diagnoses.ResultsA total of 75 % of the participants reported more than one ACE. The ACE total score was positively related to self-reported irritability. The ACE total score predicted depressive disorders, suicidality, post-traumatic stress disorder (PTSD), and anxiety disorders. Irritability was positively related to depressive disorders, suicidality, disruptive behavior disorder (DBD), substance use disorder (SUD), and attention deficit hyperactivity disorder (ADHD). These associations remained significant in multivariate models.ConclusionsThis study provides evidence for the predictive impact of self-reported ACEs and irritability with regard to adolescent psychiatric disorders in young male inmates. Both variables differed in their predictive power for PTSD, internalizing, and externalizing disorders indicating the need for specific therapeutic interventions. Taking a close look at their trauma history seems to be of special importance for juveniles suffering from PTSD and anxiety disorders. For delinquent adolescents with DBD, ADHD and SUD, the training of emotion regulation techniques appears most promising. Approaches focusing on both, ACEs and emotion-focused contents may be implemented in the treatment of depressive disorders and suicidality.
Objective: Adverse childhood experiences, such as maltreatment, and affective disorders are associated with a proinflammatory state and/or variably compromised counts in lymphocyte subsets in adults. Animal models of social stress indicate that recent thymic emigrant cells (RTE), which maintain the T-cell compartment, are affected. Methods: In this study, we examined the association between lymphocyte subsets, and depression and posttraumatic stress disorder (PTSD) among 16 maltreated children (aged 6-17 years) 1-3 years after the intervention by the Child Protection Team and among 14 healthy age-matched controls. The participants completed psychological assessment and had blood drawn for fluorescent-activated cell sorting analysis. Results: Among maltreated children and adolescents, depression was associated with lower counts of RTEs and T-helper cells after controlling for age. We found additional trends and large effect sizes with regard to the percentages of these cells, as well as for related lymphocyte subsets. Similar effects were found for PTSD, i.e. lower counts of naïve T cells, which was also supported by a trend for their percentage. Compared to controls, maltreated participants with a clinical level of depression had decreased percentages of RTEs, with a similar trend for PTSD. Conclusion: Limited by the nature of a pilot study and the small sample size, these preliminary findings of a compromised T-cell compartment related to psychiatric symptoms in maltreated children and adolescents need to be further studied; particularly the role of RTEs needs further evaluation.
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