Search Results (45)

Serum S100B has been proposed as a peripheral biomarker associated with neuroinflammatory and astroglial stress-related processes in major depressive disorder (MDD). This study aimed to evaluate serum S100B levels in patients with MDD and suicidal ideation and to investigate whether childhood trauma mediates the relationship between suicide probability and S100B levels. This study included patients with MDD and suicidal ideation (n = 29), patients with MDD without suicidal ideation (n = 30), and healthy controls (n = 29). Serum S100B levels were measured before and after treatment in patients with suicidal ideation. Suicide Probability Scale (SPS), Childhood Trauma Questionnaire (CTQ), and Rosenberg Self-Esteem Scale (RSES) scores were assessed. Group comparisons were performed using Mann–Whitney U and Kruskal–Wallis tests with Dunn–Bonferroni post hoc analysis. Logistic regression and mediation analyses were conducted to examine the relationships among suicide probability, childhood trauma, and S100B levels. Pre-treatment serum S100B levels were significantly higher in patients with MDD and suicidal ideation compared with healthy controls (median 10.95 vs. 8.97 pg/mL, p = 0.001), whereas post-treatment levels did not differ between groups (median 7.84 vs. 8.97 pg/mL, p = 0.323). Within-group analysis demonstrated a significant reduction in S100B levels after treatment (Z = −3.359, p < 0.001). Additional three-group comparison revealed a significant overall difference in S100B levels among the study groups (H = 8.17, p = 0.017). Logistic regression analysis showed that serum S100B levels were independently associated with suicidal ideation (OR = 1.14, 95% CI 1.02–1.27, p = 0.021). Mediation analyses demonstrated a significant indirect effect of suicide probability on S100B levels through childhood trauma (Sobel Z = −2.45, p = 0.014). Serum S100B levels were elevated during the acute phase of MDD with suicidal ideation and decreased following treatment; however, the specificity of this longitudinal change to suicidality could not be determined within the present study design. The relationship between suicide probability and S100B levels appears to be mediated by childhood trauma, suggesting that S100B may reflect trauma-related neurobiological vulnerability rather than a disease-specific biomarker of suicidality. These findings support a potential association between peripheral glial-related biomarkers and stress-responsive neurobiological processes underlying suicidality. Full article

Background: Major depressive disorder (MDD) is a common mental disorder characterized by a wide range of symptoms and a substantial contribution to global disease burden. Our study aimed to examine the relationships between childhood trauma, sleep quality, dissociative symptoms, posttraumatic growth, and suicidality in patients diagnosed with MDD. Methods: Our sample consisted of 115 patients with MDD and 84 healthy controls. Participants were administered the Hamilton Depression Rating Scale (HDRS), Beck Scale for Suicidal Ideation (BSSI), Pittsburgh Sleep Quality Index (PSQI), Childhood Trauma Questionnaire (CTQ-33), Dissociative Experiences Scale (DES), and Posttraumatic Growth Inventory (PTGI). Group differences were analyzed, and associations among variables within the MDD group were examined using correlation and mediation analyses. Results: Compared to healthy controls, patients with MDD had significantly higher scores on all scales except the PTGI (p < 0.001 for each). Within the MDD group, individuals with a history of suicide attempts had significantly higher CTQ total scores, physical and sexual abuse subscale scores, and DES scores than those without previous attempts. Additionally, dissociative experiences had a partial mediating role in the relationship between depression severity and suicidal ideation, as well as in the relationship between childhood traumas and sleep quality. Conclusions: The findings highlight the clinical relevance of dissociative experiences and sleep disturbances in the heterogeneous presentation of MDD and their association with illness severity and suicidality. In the follow-up and treatment process of patients with MDD, risk and protective factors should be evaluated together, and individualized treatment programs should be targeted. Full article

Background/Objectives: Transgender and gender-diverse (TGD) individuals experience disproportionately high rates of childhood trauma and depression; however, the mechanisms linking gender identity and depressive symptoms remain insufficiently understood. This study examines differences in depressive symptoms and childhood trauma between cisgender (CG) and TGD adults. It investigates whether specific subtypes of childhood maltreatment mediate the association between gender identity and depression. Methods: The cross-sectional online study included 249 participants aged 18–72 years (M = 30.85, SD = 12.72), including 144 CG (75 women and 69 men) and 105 TGD individuals (44 transgender and 61 gender diverse individuals). Depression symptoms were assessed using the nine-item Patient Health Questionnaire (PHQ-9), while childhood trauma experiences were measured using the Childhood Trauma Questionnaire–Short Form (CTQ-SF). Results: The independent-sample Student’s t-test showed that TGD participants reported significantly higher levels of depressive symptoms and all forms of childhood trauma than cisgender individuals. Mediation analyses indicated that overall childhood trauma partially mediated the association between gender identity and depression. In parallel mediation models, emotional abuse emerged as the primary statistical mediator, with sexual abuse showing a smaller indirect effect. Conclusions: The findings extend prior prevalence-focused research by identifying specific childhood trauma pathways associated with depressive symptoms in TGD adults. Experiencing traumatic events during childhood may be a key factor contributing to an increased risk of depression in adulthood, particularly among the TGD population. Therefore, intervention and prevention programs should target TGD individuals and their families to minimize the risk of adverse childhood experiences and mental health disorders. The results underscore the importance of trauma-informed and gender-affirming mental health care and highlight emotional abuse as a particularly salient correlate of depression in this population. Full article

Background/Objectives: Suicide is a leading cause of death among adolescents. Emotion dysregulation, impulsivity, and childhood trauma are key factors underlying Self-Injurious Thoughts and Behaviors (SITB), yet reliable short-term predictors are limited, especially in at-risk clinical populations. This study prospectively examined the association between SITB and clinical (psychological pain, impulsivity, childhood trauma) and cognitive measures (Implicit Association Tests, IATs). Methods: A prospective, observational study was conducted in adolescents (12–17) admitted to a university hospital psychiatry unit following recent SITB. Participants completed the Death/Suicide IAT (D/S-IAT), Self-Injury IAT (SI-IAT), and standardized instruments including the Columbia Suicide Severity Rating Scale (C-SSRS), Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsiveness Scale (BIS-11), and Childhood Trauma Questionnaire (CTQ-SF). SITB recurrence was assessed at six months. Results: Within six months, 28.9% of 38 participants reported suicidal thoughts, 15.8% engaged in self-injury, and 2.6% attempted suicide. The SI-IAT showed a small but significant correlation with C-SSRS, whereas D/S-IAT showed none. Neither IAT predicted SITB recurrence. Higher levels of emotion dysregulation and impulsivity were significantly associated with SITB. Specific DERS dimensions—emotional rejection, interference, and confusion—predicted future SITB, highlighting emotional dysregulation as a vulnerability factor. Conclusions: In high-risk adolescents, psychological pain and impulsivity predicted SITB more reliably than IATs. Unlike adult populations, explicit measures outperform implicit ones in suicide risk prediction. These findings emphasize emotion dysregulation as a key clinical construct that may intensify psychological pain and contribute to suicidal vulnerability. Full article

Background/Objectives: Childhood trauma is a well-established risk factor for adult psychopathology, yet the underlying neuropsychiatric mechanisms remain unclear. Therefore, this study examined whether resilience mediates the relationship between childhood trauma and depressive and anxiety symptoms, and whether this pathway is moderated by harm avoidance (HA). Methods: A total of 218 Korean adults (aged 19–50 years; 79 men and 139 women) completed validated measures of childhood trauma (Childhood Trauma Questionnaire (CTQ)-Short Form), harm avoidance (Temperament and Character Inventory–Harm Avoidance subscale), resilience (Brief Resilience Scale), depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder-7). Mediation and moderated mediation models were tested using structural equation modeling, and indirect effects were estimated via bootstrapping with 5000 resamples. Results: Childhood trauma was associated with lower resilience, an effect moderated by HA. Resilience was strongly inversely associated with depression and anxiety. Indirect effects of trauma through resilience were significant for both outcomes, with stronger effects at higher HA. Conclusions: The associations between childhood trauma and both depression and anxiety were mediated by resilience, and this indirect pathway was amplified by HA. These findings suggest a neuropsychiatric mechanism whereby early-life stress and temperament jointly shape effective neural vulnerability, leading to depression- and anxiety-associated outcomes. Full article

Background/Objectives: Suicide is the leading cause of death among South Korean military soldiers, accounting for more than 70% of all deaths. This issue is particularly relevant in the military context due to the nature of living in groups in a controlled environment. This study was conducted active-duty south Korean male soldiers aged 18 to 28 who were performing mandatory military service for one year and six months. Additionally, it compares and analyzes the differences in suicidal ideation and risk factors between military soldiers and a comparison group consisting of males in their 20s without military experience. Methods: This study included 248 Korean soldiers and 292 general controls, totaling 540 participants. The research instruments used for evaluation included the Beck Scale of Suicide Ideation (BSI), the Childhood Trauma Questionnaire (CTQ-SF), the Perceived Stress Scale (PSS), the Difficulties in Emotion Regulation Scale (DERS-16), the Barratt Impulsiveness Scale Version 11 (BIS-11), the Rosenberg Self-Esteem Scale (RSES), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder 7-item scale (GAD-7), the UCLA Loneliness Scale (UCLAS), and the State-Beck Hopelessness Scale (S-BHS). Results: The results of this study showed that suicidal ideation, depression, anxiety, impulsivity, and self-esteem were significantly higher in the military group compared to the comparison group. Conversely, emotional dysregulation was considerably lower in the soldiers than in the comparison group. No significant differences were found in childhood trauma, stress, loneliness, and hopelessness between the two groups. Multiple regression analysis within the military group revealed that childhood trauma, hopelessness, and depression were major factors influencing suicidal ideation. Conclusions: These findings will help identify risk factors for suicide among soldiers and develop effective intervention strategies to prevent it. Full article

Background/Objectives: Borderline Personality Disorder (BPD) frequently overlaps with trauma-related conditions, particularly PTSD and Complex PTSD (cPTSD). Adverse Childhood Experiences (ACEs)—especially emotional and sexual abuse—are considered key factors in the development of emotion dysregulation and dissociation. This study investigates the impact of different ACE dimensions on borderline symptomatology, emotion dysregulation, and dissociative symptoms. Methods: Eighty-three BPD patients were assessed using standardized self-report questionnaires: CTQ-SF (ACEs), DERS (emotion dysregulation), DES (dissociation), BSL-23 (borderline symptoms), and PDS-3 (post-traumatic symptoms). Analyses included bivariate correlations, Structural Equation Modeling (SEM), and Exploratory Graph Analysis (EGA). Results: Emotional abuse significantly predicted borderline symptoms, while sexual abuse predicted dissociation. Emotion dysregulation was strongly associated with both borderline and dissociative symptoms, emerging as a central node in the symptom network. EGA confirmed the clustering of dissociative symptoms with sexual abuse and the centrality of emotion dysregulation across domains. Conclusions: Findings support the role of specific ACEs in shaping the clinical expression of BPD. Emotion dysregulation acts as a key transdiagnostic factor linking trauma history to borderline and dissociative features. These results underscore the importance of trauma-informed assessments and interventions, such as DBT and DBT-PTSD, tailored to individual ACE profiles. Full article

Childhood trauma has been associated with criminal behaviour and a variety of psychopathologies. Furthermore, it is known that emotional dysregulation (ED) predicts anxiety and depression and can be a product of traumatic experiences. In order to develop effective interventions for offenders’ rehabilitation and prevent recidivism, it is essential to fully understand their mental health and its relation with previous child trauma experiences and ED. This study involved a sample of 100 male inmates incarcerated in seven different prisons in the northern region of Portugal. The following measures were used: the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the International Trauma Questionnaire (ITQ), the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire (PHQ-9), and the Difficulties in Emotional Regulation Scale (DERS). Our findings suggest that individuals who experienced physical and sexual abuse are more likely to perpetrate violent crimes and that ED increases anxiety and depressive symptoms in individuals with traumatic symptoms. In conclusion, it is imperative to provide psychological support to this population, and interventions need to be adapted according to trauma exposure. Full article

Background: Patients with obesity seeking bariatric surgery often display high rates of depressive symptoms, which are linked to worse clinical and surgical outcomes. A comprehensive evaluation of depression-related features in this population is lacking. Therefore, this study investigated clinical and psychopathological factors associated with depressive symptoms’ severity in 946 outpatients with obesity undergoing pre-surgical evaluation. Methods: The sample (45.1 ± 12 years) was subdivided according to Patient Health Questionnaire-9 (PHQ-9) into ‘absent’, ‘mild’, and ‘moderate-to-severe depression’ groups, which were compared for sociodemographic characteristics, childhood trauma, and emotional dysregulation. Assessments included the Childhood Trauma Questionnaire-Short-Form (CTQ-SF) and Difficulties in Emotion Regulation Scales (DERS). Inflammatory levels were evaluated through the Systemic Immune-inflammatory Index (SII). Multinomial logistic regression and correlations were performed to evaluate predictors of depression severity and their interrelationship. Results: Beyond sociodemographic and clinical differences, patients with moderate-to-severe depression displayed higher childhood trauma, emotional dysregulation, and inflammatory levels. Logistic regression with 95% confidence intervals showed that higher CTQ-SF scores were significantly associated with moderate-to-severe vs. absent depression (p = 0.005, 95% CI: 1.02–1.09), while elevated DERS scores were a risk factor for both moderate-to-severe vs. mild (p < 0.001, 95% CI: 1.04–1.11) and vs. absent depression (p < 0.001, 95% CI: 1.11–1.18). Additionally, PHQ-9 was significantly correlated with CTQ-SF, DERS, and SII. Conclusions: A worse clinical picture was observed in patients with moderate-to-severe depression, and significant interactions were found between psychopathology and inflammatory indexes. Emotional dysregulation was primarily associated with depression severity. These preliminary results support the implementation of rigorous pre-operative screening to identify and deliver targeted psychotherapeutic/pharmacological interventions aimed at improving clinical and post-surgical outcomes. Full article

Background and Objectives: We investigated whether early psychological trauma can contribute to the development of dysfunctional personality traits and emotional dysregulation. Personality disorders (PDs) are often characterized by using immature defense mechanisms and maladaptive coping strategies. Materials and Methods: We evaluated the relationship between early traumatic experiences, PDs, defense mechanisms, and coping strategies. A total of 90 patients aged between 18 and 70 with PDs were studied to detect different subtypes of early trauma, along with the defensive mechanisms and the prevailing coping strategies. Correlation and regression analyses aimed at establishing if specific trauma subtypes were associated with specific defense mechanisms and coping strategies. The Childhood Trauma Questionnaire—Short Form (CTQ-SF), the Defense Style Questionnaire 40 (DSQ-40), and the Coping Orientation to Problem Experienced (COPE) were used as psychodiagnostic tools. Results: Our findings determine emotional abuse, emotional neglect, and physical neglect as the most represented subtypes of trauma and underline the use of immature defense mechanisms in PD patients, while adaptive coping strategies, such as social support and positive aptitude were used. Conclusions: Early trauma, such as abuse and neglect, can be associated with dysfunctional defense mechanisms and coping strategies. This may have significant implications for managing not only pathological areas of the patient but also the functional ones. Moreover, being aware of these aspects can be useful for psychotherapy, reinforcing therapeutic alliance and reducing symptoms. Full article

This study aimed to examine the role of childhood sexual abuse in attachment styles and involvement in BDSM (bondage, discipline, dominance, submission, and sadomasochism) practices in adult intimate relationships. A model was built to test the predictive value of factors for involvement in BDSM practices. This study included 318 participants. Demographic data were collected and three questionnaires were used: the Childhood Trauma Questionnaire (CTQ) identified past sexual abuse, the Adult Attachment Scale (RSQ) assessed attachment style in adulthood, and the Sadomasochism Checklist (SMCL) assessed interest in masochistic practices. The results show that childhood sexual abuse is associated with practicing and enjoying BDSM, positively with submissiveness, negatively with dominance, and positively with a composite score measuring both submissiveness and dominance. It is also linked to fearful and preoccupied attachment styles in adulthood, but not dismissive attachment. Men exhibit higher levels of submissiveness and dominance in BDSM compared to women. Older individuals are more inclined to engage in BDSM. Urban residents show higher involvement in BDSM compared to those in other environments. Homosexual or bisexual individuals in open relationships are more frequently involved in BDSM. These findings highlight the complexity of connections between past experiences, sexual preferences in BDSM, and secure attachment in intimate relationships. Full article

Objective: The present investigation sought to examine the interrelationships between early-life adverse experiences, dissociative symptoms, suicidal ideation, and depressive manifestations among metropolitan firefighters screened with post-traumatic stress disorder (PTSD), and to elucidate the potential mediating effects of these psychological variables on both the presence and severity of PTSD symptomatology in this high-risk occupational cohort. Methods: A cross-sectional investigation was performed to assess psychological conditions among 760 metropolitan male firefighters, employing conditional process analysis with multiple mediation modeling (PROCESS macro Model 6). The investigative protocol employed validated psychometric instruments including the PTSD Checklist (PCL-5); the Childhood Trauma Questionnaire (CTQ-33); the Dissociative Experiences Scale (DES); the Suicidal Behaviors Questionnaire (SBQ-4); and the Patient Health Questionnaire (PHQ-9). Bootstrap resampling (n = 5000) generated bias-corrected 95% confidence intervals, enabling interrogation of complex trauma response mechanisms. Results: Conditional process analysis demonstrated that childhood trauma functions as a significant mediator (indirect effect = 0.142, 95% CI [0.086, 0.198]), with emotional abuse pathways revealing significant mediational effects (β = 0.285, p < 0.001). Stratifying participants using a PCL-5 ≥ 33 threshold (non-PTSD: n = 543, 71.5%, median PCL-5: 22; PTSD: n = 217, 28.5%, median PCL-5: 39), the investigation elucidated serial mediation mechanisms, particularly through childhood trauma to dissociative experiences (serial indirect effect = 0.168, 95% CI [0.092, 0.244]), collectively explaining nearly half of PTSD variance through complex psychological interaction pathways. Conclusions: Conditional process analysis revealed childhood trauma as a pivotal mediator, with emotional abuse pathways demonstrating significant mediational effects, while dissociative experiences emerged as a significant secondary mechanism, collectively explaining a substantial portion of PTSD variance through interactions between occupational trauma exposure and intrinsic psychological vulnerabilities. Full article

Objective: The literature concerning the association between coronary slow flow (CSF) and anxiety and depression is controversial. Furthermore; there is no existing data in the literature on the potential association between CSF and adverse childhood experiences or alexithymia. Methods: The participants underwent coronary angiography through femoral access. Coronary artery blood flow rate was evaluated quantitatively for each coronary artery according to the Thrombolysis in Myocardial Infarction frame count (TFC) method. CSF was diagnosed as a corrected TFC value >27 in at least one coronary artery during the imaging. Symptoms of anxiety and depression were assessed through the Hospital Anxiety and Depression Scale (HADS). Alexithymia and ACE were evaluated by the Twenty-item Toronto Alexithymia Scale (TAS-20) and the Childhood Trauma Questionnaire (CTQ). Results: The study participants were categorized into two groups: normal coronary flow (n = 58) and CSF (n = 18). Total HADS score; HADS anxiety subscale (HADS-A) score; and HADS depression subscale (HADS-D) score were determined as significant factors associated with CSF in univariate logistic regression analysis. However; the TAS-20 and CTQ scores showed no significant association with CSF. Multivariate regression analysis performed in separate models demonstrated that total HADS score (OR: 1.27; 95 CI%: 1.08–1.50; p = 0.003); HADS-A score (OR: 1.25; 95 CI%: 1.03–1.51; p = 0.019); and HADS-D score (OR: 1.36; 95 CI%: 1.06–1.74; p = 0.014) were independently associated with CSF in multivariate logistic regression analysis. Conclusions: Neither alexithymia nor ACE was associated with CSF. On the other hand; measures of both anxiety and depression assessed through HADS were independently associated with CSF. Future studies should address the major limitations of this study; such as the limited sample size; lack of structured diagnostic interview by a psychiatrist; and the lack of establishment of causality Full article

Background: This research aimed to investigate the mediating and moderating effects of psychological resilience (PR) on the association between childhood trauma (CT) and the development of depression. Methods: This study included 94 cases who consecutively applied to the outpatient psychiatry clinic of Rize Recep Tayyip Erdoğan University Training and Research Hospital in Turkey between 1 June 2023 and 1 December 2023 and were diagnosed with Major Depressive Disorder (MDD). In addition, 83 healthy individuals (control group) were also included. Participants administered the Hamilton Depression Rating Scale (HDRS), the Resilience Scale for Adults (RSA), and the Childhood Trauma Questionnaire (CTQ). Results: In the context of this research, the mediating effect of PR between CT and depression development was investigated. When examining the mediating role of PR on the association between CT and depression, it was found that CT statistically significantly influenced disease severity directly (B = 0.158, SE = 0.0398, z = 3.98, p < 0.001, 95% CI [0.0759, 0.232]), while it also influenced disease severity indirectly through PR (B = 0.193, SE = 0.028, z = 6.88, p < 0.001, 95% CI [0.1343, 0.244]). It was revealed that PR mediated the association between CT and depressive symptoms partially. Conclusions: This study demonstrates that PR has a mediating effect on the relationship between CT and MDD. These results provide new contributions to the existing literature. Interventions that increase psychological resilience may positively contribute to the treatment of patients with MDD who have suffered from CT. Full article

In recent years, self-injury attempts have accounted for 46.2% of emergency room visits by teenagers and young adults. This study aimed to explore the prevalence of non-suicidal self-injury (NSSI) among Korean college students, compare the mean number of NSSI risk factors between those with a history of NSSI and a control group with no history of thoughts or experiences of self-injury, and identify which factors have a greater influence on NSSI. The participants consisted of 403 Korean college students aged 18–29 who were divided into a subject group with a history of NSSI (n = 198) and a comparison group (n = 205) with no history of NSSI. The Functional Assessment of Self-Mutilation (FASM), Childhood Trauma Questionnaire (CTQ-SF), Social Experience Questionnaire (SEQ), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item scale (GAD-7), Difficulties in Emotion Regulation Scale—16 item version (DERS-16), Experiences in Close Relationship Questionnaire-Revised (ECR-R), Rosenberg Self-Esteem Scale (RSES), Parents as Social Context Questionnaire-Kids (PSCQ-KA), and Barratt Impulsiveness Scale-11-Revised (BIS-11). The collected data were analyzed using SPSS 25.0. Before a regression analysis, a MANOVA was performed to examine the mean difference between groups of each dependent variable, and a multiple regression analysis was performed to confirm the influence. The mean difference in all risk factors in the subject group compared with the comparison group was found to be statistically significant, with an effect size of 0.8 or greater. As a result of examining the relative influence of each variable on NSSI, emotional dysregulation (t = 2.481, p = 0.014), anxiety (t = −2.109, p = 0.036), and adult attachment (t = 2.004, p = 0.046) were found to significantly influence NSSI (p = 0.05). These findings will serve as fundamental data for screening clients at risk of self-injury in counseling and treatment settings, in addition to providing preventive and therapeutic interventions. Full article