Cumulative childhood maltreatment and its dose-response relation with adult symptomatology: Findings in a sample of adult survivors of sexual abuse

Steine, Iris Mulders; Winje, Dagfinn; Krystal, John H.; Bjorvatn, Bjørn; Milde, Anne Marita; Grønli, Janne; Nordhus, Inger Hilde; Pallesen, Ståle

doi:10.1016/j.chiabu.2017.01.008

Cited by 119 publications

(87 citation statements)

References 76 publications

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“…The long‐term effects of childhood abuse involve the development of both specific ED symptoms (e.g., body image disturbance; Caslini et al, ) and psychopathological conditions such as emotional dysregulation, identity issues, and poor self‐esteem, typically accounting for the comorbid psychiatric disorders (Brewerton, ; Cutajar et al, ; Devries et al, ; Guillaume et al, ; Vanderlinden, Van Dyck, Vandereycken, & Vertommen, ). In line with these observations, some authors (Caslini et al, ; Cloitre et al, ; Guillaume et al, ; Steine et al, ) have suggested that the effects of cumulative childhood adversities are associated with an increase in symptom complexity. In this regard, it is feasible to hypothesize that a history of childhood abuse might represent a condition predisposing ED patients to report a different outcome and response to treatment (Strangio et al, ), in terms of symptom reduction, as well as compliance with the standard therapies.…”

Section: Introductionmentioning

confidence: 76%

“…The present study was mainly aimed at identifying a subpopulation of patients with EDs, in which the reduction of general psychopathology does not follow the resolution of ED symptoms. In particular, some of the main environmental factors associated with the onset and maintenance of EDs such as childhood abuse (Guillaume et al, ; Jacobi, Hayward, de Zwaan, Kraemer, & Agras, ; Steine et al, ) have received scarce attention as putative moderators of the long‐term outcome (Castellini et al, ; Micali et al, ; Strangio et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Different outcomes, psychopathological features, and comorbidities in patients with eating disorders reporting childhood abuse: A 3‐year follow‐up study

Castellini

Lelli

Cassioli

et al. 2018

Euro Eating Disorders Rev

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The aim of this study was to evaluate the role of childhood adversities in long-term outcomes in eating disorders (EDs). One hundred thirty-three eating disorder patients were studied by means of the Structured Clinical Interview for DSM-IV and psychometric tests, at baseline, at the end of individual cognitive behavioural therapy, and at 3-year follow-up. As compared with the other patients, those reporting childhood abuse (overall: 24.8%; physical abuse: 20.3%; sexual abuse: 13.6%) showed higher impulsivity, psychiatric comorbidity, lower full recovery at follow-up (12.1% vs. 31%), and higher diagnostic crossover (39.4% vs. 13.0%). The different rates of recovery were mostly due to a higher persistence of depression in abused patients (77.8% vs. 26.7%). Patients with both abuse and neglect had a higher probability of dropout. Eating disorder patients with childhood abuse represent a group of persons with more complex psychopathological features and a worse long-term outcome, thus requiring specific treatment strategies.

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Section: Introductionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Different outcomes, psychopathological features, and comorbidities in patients with eating disorders reporting childhood abuse: A 3‐year follow‐up study

Castellini

Lelli

Cassioli

et al. 2018

Euro Eating Disorders Rev

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“…Direct and indirect human and animal stress research supports the important supraordinate role of CS on stress system and GCs, linking circadian misalignment in ELS/CT-related pathophysiology and potentially resulting in the extensive comorbidities of ELS/CT through an impaired homeostatic balance. Some animal (332), but-most importantly-numerous human studies including large cohorts, have repeatedly confirmed that ELS/CT is independently associated with enduring adult sleep disruption including global sleep pathology (i.e., insomnia), as well as specific types of sleep problems, such as shortened total sleep time, prolonged sleep onset latency, decreased sleep efficiency, increased number of awakenings, nightmare related distress, sleep apnea and higher nocturnal activity in a probably dose-response manner (333)(334)(335)(336)(337)(338)(339)(340)(341)(342)(343)(344).…”

Section: Sleep and Circadian Systemmentioning

confidence: 97%

Developmental Trajectories of Early Life Stress and Trauma: A Narrative Review on Neurobiological Aspects Beyond Stress System Dysregulation

et al. 2019

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Early life stressors display a high universal prevalence and constitute a major public health problem. Prolonged psychoneurobiological alterations as sequelae of early life stress (ELS) could represent a developmental risk factor and mediate risk for disease, leading to higher physical and mental morbidity rates in later life. ELS could exert a programming effect on sensitive neuronal brain networks related to the stress response during critical periods of development and thus lead to enduring hyper- or hypo-activation of the stress system and altered glucocorticoid signaling. In addition, alterations in emotional and autonomic reactivity, circadian rhythm disruption, functional and structural changes in the brain, as well as immune and metabolic dysregulation have been lately identified as important risk factors for a chronically impaired homeostatic balance after ELS. Furthermore, human genetic background and epigenetic modifications through stress-related gene expression could interact with these alterations and explain inter-individual variation in vulnerability or resilience to stress. This narrative review presents relevant evidence from mainly human research on the ten most acknowledged neurobiological allostatic pathways exerting enduring adverse effects of ELS even decades later (hypothalamic-pituitary-adrenal axis, autonomic nervous system, immune system and inflammation, oxidative stress, cardiovascular system, gut microbiome, sleep and circadian system, genetics, epigenetics, structural, and functional brain correlates). Although most findings back a causal relation between ELS and psychobiological maladjustment in later life, the precise developmental trajectories and their temporal coincidence has not been elucidated as yet. Future studies should prospectively investigate putative mediators and their temporal sequence, while considering the potentially delayed time-frame for their phenotypical expression. Better screening strategies for ELS are needed for a better individual prevention and treatment.

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“…Furthermore, they found that 23% of people who were sexually abused, 19% of those physically abused and 17% of those who had been emotionally neglected before the age of 12 had PTSD at the age of 29 years. A meta-analysis of children who have been sexually abused suggests a dose–response effect, with higher risks associated with penetrative sexual abuse than with contact or non-contact abuse (Steine et al, 2017). …”

Section: Introductionmentioning

confidence: 99%

How do men with severe sexual and physical childhood traumatization experience trauma-stabilizing group treatment? A qualitative study

Røberg

Nilsen

Røssberg

2018

European Journal of Psychotraumatology

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Background: Exposure to potentially traumatizing events, defined as events involving actual or threatened death or serious injury, is associated with an elevated risk of developing enduring physical, psychological and social problems. Complex post-traumatic stress disorder (PTSD) is a disorder that can occur after prolonged and repeated trauma. At least 30% of the sexually abused population is male, but in spite of this fact, treatment research focusing on male victims is virtually non-existent in comparison to research on female victims.Objective: Trauma-stabilizing group treatment is an increasingly used treatment method for patients with complex PTSD. The aim of the present study was to explore how men participating in a gender-specific trauma-stabilizing intervention experience this treatment approach.Methods: Five men who participated in a trauma-stabilizing group treatment were interviewed with a semi-structured qualitative interview. The data were analysed using interpretative phenomenological analysis.Results: The analysis revealed five main themes. The themes highlight the experiences of the participants and describe positive and negative experiences: (1) Group atmosphere, comprising safety, community, emotional openness, anxiety and pressure; (2) Learning, categorized into knowledge and self-understanding; (3) Motivation, which describes both inner and outer motivation; (4) Structure, comprising structure of the meetings, group size and duration of the meetings; and (5) Gender, defined as the experiences of being in an all-male group with female group leaders.Conclusions: There seem to be a lot of advantages to inviting men to attend gender-specific groups for trauma-stabilizing treatment. The men emphasized the support they received and that participating in a mixed-gender group would have been more difficult. In the future, it may be important to arrange all-male stabilization groups with more focus on male-specific topics.

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Cumulative childhood maltreatment and its dose-response relation with adult symptomatology: Findings in a sample of adult survivors of sexual abuse

Cited by 119 publications

References 76 publications

Different outcomes, psychopathological features, and comorbidities in patients with eating disorders reporting childhood abuse: A 3‐year follow‐up study

Different outcomes, psychopathological features, and comorbidities in patients with eating disorders reporting childhood abuse: A 3‐year follow‐up study

Developmental Trajectories of Early Life Stress and Trauma: A Narrative Review on Neurobiological Aspects Beyond Stress System Dysregulation

How do men with severe sexual and physical childhood traumatization experience trauma-stabilizing group treatment? A qualitative study

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