Relationship of childhood trauma to depression and smoking outcomes in pregnant smokers.

Abstract

Objective We evaluated whether childhood trauma moderated the treatment effect on depression and smoking outcomes in pregnant smokers. Method The sample included pregnant smokers participating in a randomized trial evaluating the efficacy of a 10-session interpersonally focused therapy—cognitive behavioral analysis system of psychotherapy (CBASP), versus a time-matched health and wellness control (HW) for smoking cessation and depression reduction. Women (N = 248) who completed the Childhood Trauma Questionnaire (CTQ) were included. On average, women were 25 years old (SD = 5.91) and smoked 10 (SD = 6.9) cigarettes per day. Depressive symptoms were assessed with the Center for Epidemiological Studies-Depression Scale (CES-D) and women had an average score of 21 (SD = 11.03). Seventy-six percent of women had experienced some form of moderate to severe childhood trauma as assessed by the CTQ. Results In women with a history of moderate to severe childhood trauma, there was a dose-response association of treatment on depression outcome through 6 months postpartum; those with increasing amounts of childhood trauma benefitted more from CBASP, while those in the HW condition did not. Childhood trauma did not moderate the treatment effect on abstinence, although increasing amounts of trauma were associated with reduced likelihood of abstinence at 6 months post treatment. Conclusions An interpersonally-focused therapy may be beneficial for the treatment of depression during the prenatal period in pregnant smokers with childhood trauma histories and such treatment becomes increasingly more important with cumulative trauma experience. Childhood trauma increases risk for cessation failure in pregnant smokers.

The impact of childhood maltreatment on the differential efficacy of CBASP versus escitalopram in patients with chronic depression: A secondary analysis

“…This can be associated with a temporary worsening of depressive symptoms (Brakemeier et al ., ). However, Blalock et al () found a significant positive time × treatment × trauma interaction in favor of CBASP compared to a health and wellness control condition over a short treatment duration of 10 sessions in pregnant women with depression. The short acute treatment phase of 8 weeks and the subsequent lower frequency of CBASP sessions during extended treatment may therefore have dampened outcomes for psychotherapy, especially for patients with CM (Cuijpers, Huibers, Ebert, Koole, & Andersson, ; Wiersma et al ., ).…”

High early life stress and aberrant amygdala activity: risk factors for elevated neuropsychiatric symptoms in HIV+ adults

“…At present, empirically supported interventions for HIV+ adults with high ELS exposure are scarce (Seedat 2012). Studies conducted in non-HIV samples indicate that psychotherapy is a critical component of successful symptom reduction for high ELS adults diagnosed with depression, even more so than pharmacotherapy alone (Blalock et al 2013; Nemeroff et al 2003; Zobel et al 2011). Hence, treatment approaches that involve a psychotherapeutic component might be particularly effective for HIV+ High-ELS patients and thus warrant further examination.…”

The Incentives to Quit tobacco in Pregnancy (IQuiP) protocol: piloting a financial incentive-based smoking treatment for women attending substance use in pregnancy antenatal services

“…Internationally, similar prevalence rates have been reported in opioid-dependent pregnant women treated with methadone or buprenorphine 14 15. In addition to problems caused by substance use, this population is often characterised by socioeconomic disadvantage,10 concurrent mental health problems,16 a history of trauma17 and social challenges including intimate partner violence, unstable housing, child protection issues, legal problems and poverty 18…”