Search Results (106)

Background and Objectives: Emerging evidence indicates that individuals exposed to adverse childhood experiences (ACEs) face elevated risks for various chronic illnesses. However, the association between ACEs and osteoporosis risk remains underexplored, particularly regarding potential modifications by genetic susceptibility. This prospective cohort study aims to examine the relationship of ACEs with incident osteoporosis and investigate interactions with polygenic risk score (PRS). Materials and Methods: This study analyzed 124,789 UK Biobank participants initially free of osteoporosis. Cumulative ACE burden (emotional neglect, emotional abuse, physical neglect, physical abuse, sexual abuse) was ascertained through validated questionnaires. Multivariable-adjusted Cox proportional hazards models assessed osteoporosis risk during a median follow-up of 12.8 years. Moderation analysis examined genetic susceptibility interactions using a standardized PRS incorporating osteoporosis-related SNPs. Results: Among 2474 incident osteoporosis cases, cumulative ACEs showed dose–response associations with osteoporosis risk (adjusted hazard ratio [HR]_{per one-unit increase} = 1.07, 95% confidence interval [CI] 1.04–1.11; high ACEs [≥3 types] vs. none: HR = 1.26, 1.10–1.43). Specifically, emotional neglect (HR = 1.14, 1.04–1.25), emotional abuse (HR = 1.14, 1.03–1.27), physical abuse (HR = 1.17, 1.05–1.30), and sexual abuse (HR = 1.15, 1.01–1.31) demonstrated comparable effect sizes. Sex-stratified analysis revealed stronger associations in women. Joint exposure to high ACEs/high PRS tripled osteoporosis risk (HR = 3.04, 2.46–3.76 vs. low ACEs/low PRS) although G × E interaction was nonsignificant (P-interaction = 0.10). Conclusions: These results suggest that ACEs conferred incremental osteoporosis risk independent of genetic predisposition. These findings support the inclusion of ACE screening in osteoporosis prevention strategies and highlight the need for targeted bone health interventions for youth exposed to ACEs. 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

Background: Childhood neglect is a pervasive yet often overlooked form of maltreatment that exerts profound and lasting effects on neurodevelopment. Unlike other types of abuse, neglect is characterized by the absence of essential stimuli and caregiving, which are critical for normal brain maturation, particularly in regions involved in executive function. Objective: This narrative review aims to critically explore the neurobiological mechanisms through which early-life neglect impairs the development of executive functions. Special emphasis is placed on alterations in brain structure and function, dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, and emerging epigenetic evidence. Methods: A comprehensive literature search (170 articles) was conducted across PubMed, Scopus, Web of Science, and PsycINFO, including studies published between 1 January 2000 to 31 March 2025. Relevant empirical and review articles were selected based on methodological rigor, relevance to executive functioning, and focus on child neglect. Results: Evidence reveals that neglect disrupts key neural circuits, particularly those involving the prefrontal cortex and amygdala, leading to deficits in attention, working memory, impulse control, and cognitive flexibility. Chronic stress associated with neglect also induces HPA axis dysregulation and elevated cortisol levels, which further compromise neural plasticity. Additionally, epigenetic modifications appear to mediate long-term cognitive and emotional consequences. Conclusions: Childhood neglect represents a distinct and critical risk factor for executive dysfunction. Understanding the neurodevelopmental consequences of neglect is essential for developing targeted prevention strategies and therapeutic interventions aimed at supporting cognitive resilience in affected populations. Full article

Background: Adverse childhood experiences (ACEs) are linked to increased risk of deliberate self-harm (DSH), yet little is known about how women in forensic inpatient settings with histories of childhood abuse understand their self-harm. This study aimed to explore how such women make sense of their self-harm, including perceived contributing and protective factors. Methods: Semi-structured interviews were conducted with six female psychiatric inpatients (aged 22–38) detained in a low-secure forensic hospital in the north of England. All had a history of ACEs and DSH. Interpretative phenomenological analysis (IPA) was used to analyse the data. Results: Three overarching themes were identified: (1) Journey of self-harm, (2) reasons for self-harm, and (3) relationships and self-harm. Participants described self-harm as a method of emotional regulation, a way to regain control, or a means of feeling something. Protective factors included supportive relationships, self-awareness, and having meaningful goals. The findings reflect complex, evolving understandings of self-harm shaped by personal histories and relational dynamics. Conclusions: This study highlights the persistent and multifaceted nature of self-harm among women in forensic settings. The findings support the need for trauma-informed interventions that address emotion regulation, relational support, and personal empowerment. Implications for clinical practice and directions for future research are discussed. Full article

Background: Adverse childhood experiences (ACEs) such as abuse (defined as emotional, physical, or sexual abuse without distinguishing type or severity) have long been linked to mental health challenges in adulthood. However, less is known about how these effects differ by sex/gender in global samples, particularly using large-scale, multi-country panel data. Objectives: To examine whether the long-term association between childhood abuse and changes in depressive symptoms during adulthood differ between men and women, after adjusting for demographic and socioeconomic factors. Methods: We conducted a secondary analysis of Waves 1 and 2 of the Global Flourishing Study (GFS), a longitudinal panel study covering 22 diverse countries. The sample included adult participants with complete data on childhood abuse (yes/no); depression at baseline and follow-up; sex/gender; and relevant covariates (age; education; marital status; immigration status; smoking status; and employment). Depression was measured using a two-item scale. Multi-group structural equation models were used to test the effect of ACE on changes in depression over time where groups were defined based on sex/gender. Results: Overall, childhood abuse was associated with a statistically significant increase in depression scores between Wave 1 and Wave 2. This association was significant among women but not among men. Conclusions: Our findings suggest that the mental health consequences of childhood abuse extend into adulthood and disproportionately affect women. These sex/gender differences may reflect variations in stress processing; coping; and social roles. Interventions addressing early adversity may need to be tailored to recognize and respond to such sex/gender-specific vulnerabilities. Full article

Introduction: Childhood emotional maltreatment, which includes emotional abuse and neglect, has been identified as a significant risk factor for the development of disordered eating behaviors related to overeating and reduced dietary control. At the same time, the literature suggests that childhood emotional maltreatment appears to be linked to deficits in reflective functioning which, in turn, may increase vulnerability to dysregulated, impulsive, and addictive behaviors. However, to date, the role of a key factor, such as food addiction (FA), within this model has not yet been investigated. Therefore, the aim of this study was to test a mediation model in which emotional abuse and neglect predict overeating and reduced dietary control through deficits in reflective functioning and FA symptoms. Method: Using a cross-sectional design, a conventional non-clinical sample of 543 participants was recruited and completed a set of standardized questionnaires. A multiple mediation model with observed variables was specified (10,000 bootstrap resampling). Results: The multiple mediation model showed good results, confirming the initial hypotheses. Specifically, emotional abuse and neglect were associated with FA symptoms through deficits in reflective functioning. In turn, FA symptoms predicted overeating behaviors and poor dietary control. Discussion: These findings highlight the central role of FA in linking reflective functioning deficits to disordered eating patterns associated with excessive food consumption. This study advances our understanding of the psychological mechanisms underlying disordered eating behaviors and underscores the need for targeted interventions addressing reflective functioning deficits and food addiction in individuals with a history of childhood emotional maltreatment. 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

Background/Objectives: Early parent–child attachment interactions guided by right-to-right brain synchrony are the foundation of emotional development and the quality of attachment relationships. Interactive failures are the hallmark of not only insecurity and trauma but also the internalization of shame. The purpose of this study was to advance our understanding of the relation between attachment and shame. The study explored a range of shame experiences, from normal socialization to harsh treatment and abuse. Debilitating shame was expected for individuals who had not mourned attachment trauma. Methods: Attachment was assessed using The Adult Attachment Projective (AAP) system in a sample of 245 adults. The AAP identifies the traditional regulated attachment classifications (Secure, Dismissing, Preoccupied) and, in addition to Unresolved attachment, three forms of incomplete mourning—Failed Mourning, Preoccupied with Personal Suffering, and Traumatized Secure. The study used participants’ narratives regarding three AAP classifications when “alone” to examine individual differences in representations of the shamed self contexts portraying the self in Private, Exposed, and Threatening situations. Results: All study hypotheses were confirmed. Adults with regulated attachments (Secure, Dismissing, Preoccupied) were significantly less likely to ascribe shame to the AAP pictures than traumatized adults. The patterns of results were the same when comparing differences in shame intensity and outcomes. There were no differences in shame intensity in the regulated group. Shame intensity for the Traumatized Secures was somewhat greater. There was a significant increase observed in the traumatized groups, with the Unresolved group showing the highest ratings. Reparative outcomes were significantly related to attachment security, although not to the extent expected. Secure, regulated insecure (Dismissing, Preoccupied), and some traumatized individuals described reconciliation and functional restitution. Unresolved individuals left shame unremedied. Regression analysis demonstrated that attachment classification was a greater predictor of shame intensity than outcomes. Conculusions: Attachment and neurological development are intertwined. Childhood interactive failures are deeply traumatic. If not mourned, shame takes its place in the identity core. This study provides clinicians with an in-depth perspective on attachment and shame assessment for goal-setting in therapy, consonant with their patients’ attachment representations. Full article

Adverse childhood experiences, such as abuse, are a risk factor for mental health and poor socio-emotional development in adulthood. Assessing these experiences in specific populations allows for the identification of patterns and the implementation of preventive interventions. Objective: To evaluate the psychometric properties of the abbreviated version of the Adverse Childhood Experiences Abuse Form (ACE-ASF) in Ecuadorian youth, aiming to ensure the validity, reliability, and consistency of the instrument in accurately measuring abuse dimensions in this Ecuadorian population. Methodology: An instrumental study was conducted on the psychometric properties of the eight-item ACE-ASF, applying it to a sample of 840 university students (52.1% females and 47.9% males). The evaluation focused on analyzing the factorial structure and internal consistency of the instrument in this sample. Results: The two-factor model showed a satisfactory fit across all levels of invariance (configural, metric, scalar, and strict), with acceptable fit indices (CFI, TLI, GFI, RMSEA, and SRMR). The internal consistency was adequate, as assessed using the McDonald’s omega and Cronbach’s alpha coefficients. Convergent and discriminant validity were confirmed using the AVE and HTMT indices, ensuring proper differentiation between the dimensions assessed. Conclusion: The ACE-ASF proved to be a valid and reliable instrument for assessing abuse experiences in Ecuadorian youth. Its two-factor structure reflects distinct yet related dimensions, providing a useful tool for identifying adverse childhood experiences in this population. Full article

Introduction: Dissociative identity disorder (DID) is a condition characterized by the presence of at least two distinct identities. The experience of severe trauma, particularly in childhood and especially related to physical and emotional abuse, is considered the most common etiological source, leading to the development of dissociative mechanisms, as confirmed by both the literature and the authors’ research findings. The diagnosis of DID is complex and requires a multimodal approach. This report presents a comprehensive psychiatric and psychological assessment using an integrated diagnostic framework combining clinical observation, psychometric evaluation, and neuroimaging. Methods: A 33-year-old woman presented to the Psychiatric Clinic due to numerous amnestic episodes and recurrent identity switches, resulting in a lack of continuity in autobiographical memory and heterogeneous functioning. The patient had previously been treated at the Mental Health Outpatient Clinic with suspected schizophrenia. The patient’s history was difficult to collect and switches between identities were observed, with a marked change in behavior. The patient declared the presence of 46 different personalities. The stories she reported changed, depending on the dominant identity, each of which varied in terms of gender, name, sexual orientation, interests, or pattern of behavior. Results: The patient underwent a thorough laboratory diagnosis, including toxicologic diagnosis, neuroimaging, and psychological diagnosis. On the basis of the information collected, based on the ICD-10 Classification, the diagnosis was: F44.8—dissociative identity disorder. Discussion: The clinical entity described by the authors still poses many diagnostic and therapeutic uncertainties. In the literature, we do not find a case description that holistically encompasses DID. Therefore, the following description represents a unique bibliographic item that is useful to professionals in planning medical and therapeutic care. Full article

Background/Objectives: Pregnancy is a critical period marked by significant transformations that can trigger or exacerbate eating disorder symptoms. Childhood emotional maltreatment, including abuse and neglect, is a known risk factor for disordered eating, yet its specific impact during pregnancy remains unexplored. For this reason, this study aimed to examine the link between childhood emotional maltreatment and eating disorder symptoms in pregnant women, also focusing on the potential mediating and moderating variables involved in this association. Specifically, this study explored the mediating role of prenatal emotional distress, whereas prenatal social support was investigated as a protective factor able to moderate the effects of past trauma on disordered eating during this sensitive period. Methods: Participants were 272 Italian pregnant women (aged 18–48, M_age = 31.21, SD = 4.95) who were asked to respond to four self-report instruments: Childhood Trauma Questionnaire—Short Form; Eating Disorder Examination—Questionnaire Short; Perinatal Assessment of Maternal Affectivity; and Maternity Social Support Scale. Results and Conclusions: The results showed that prenatal emotional distress totally mediated the association between childhood emotional maltreatment and eating disorder symptoms in pregnant women (β = 0.20; SE = 0.06; 95% CI: 0.08, 0.33; p < 0.001). Moreover, moderation analysis showed that prenatal social support only moderated the direct link between childhood emotional maltreatment and disordered eating, so higher levels of childhood emotional maltreatment were predictive of higher levels of eating disorder symptoms only among pregnant women with low levels of prenatal social support (b = 0.17; SE = 0.06; t = 2.73; 95% CI: 0.05, 0.30; p < 0.01). The limitations and clinical implications are discussed. Full article

Adverse childhood experiences (ACEs) represent one of the most critical factors contributing to the manifestation of psychiatric disorders later in life. Furthermore, such experiences are often associated with deficits in interpersonal relationships, manifesting as mistrust and violent behaviors, and are indicative of a fragmented personality. This study aimed to analyze the correlative relationships between personality deficits influenced by ACEs and the expression of reactive and appetitive aggression using self-report questionnaires in 53 male forensic psychiatric patients with a drug dependency background detained under §64 of the German Criminal Code between 2019 and 2022. Instruments included the Operationalized Psychodynamic Diagnosis Structure Questionnaire (OPD-SF), the Maltreatment and Abuse Chronology of Exposure Scale–German Version (KERF), and the Appetitive and Facilitative Aggression Scale (AFAS). Specifically, the OPD-SF used the following subscales: self-perception, self-regulation, the regulation of object relations, emotional communication inward/outward, internal/external attachment, and total score. The results demonstrate a significant relationship between childhood traumatic experiences, personality structure, attachment capacity, self-perception, and regulation and the expression of both reactive and appetitive aggression. While the association with reactive aggression is intuitively plausible, the findings notably reveal that the propensity to derive pleasure from violence is also associated with personality deficits caused by adverse childhood experiences. These findings have important implications for the treatment of offenders with personality disorders and should be considered in therapeutic interventions. Full article

Background/Objectives: To effectively support children’s learning and well-being, primary educators must thoroughly understand child trauma. Being ‘trauma informed’ means recognizing the impact of trauma and responding supportively, which can help mitigate its adverse effects on learners. This study explored the understanding of childhood trauma among primary school teachers in Limpopo province, focusing on the circuits of Mvudi and Dzindi due to their high prevalence of childhood traumatic experiences. Methods: An exploratory descriptive and contextual design was used in this study. Data were collected through semi-structured interviews with 26 teachers, utilizing total population sampling for schools and purposive sampling for respondents. Results: The findings revealed that teachers typically define trauma in terms of domestic issues and abuse and identify symptoms in learners’ behavior, emotions, and academic performance. Teachers employ strategies to assist affected learners, such as building rapport and involving social workers or school authorities when needed. Conclusions: This study highlighted teachers’ critical role in identifying and assisting traumatized children and underlined the necessity for effective training programs and school-based support systems. A comprehensive strategy is necessary, including advocacy for equitable support services and standardized training on trauma-informed practices. Full article

Based on the literature indicating that emotional abuse erodes children’s secure attachment bonds, this study aimed to examine a mediation model positing that insecure attachment (anxious and/or avoidant styles) would mediate the association between childhood emotional abuse and rejection sensitivity (rejection and acceptance expectancies), which, in turn, will be associated with a fear of intimacy. One hundred and eighty members of the Israeli public aged 21–30 who were in relationships participated in the study. The results showed that avoidant and anxious attachment mediated the relationship between childhood emotional abuse and a fear of intimacy, acceptance expectancy mediated the relationship between avoidant and anxious attachment and a fear of intimacy, anxious attachment mediated the relationship between childhood emotional abuse and both rejection and acceptance expectancies, and avoidant attachment mediated the relationship between childhood emotional abuse and acceptance expectancy. These results indicated the salient role of insecure attachment styles and their associations with rejection sensitivity in forming intimate relationships due to having experienced childhood emotional abuse. Intervention promoting “earned security” was recommended. Full article

Child maltreatment is a worldwide issue with serious consequences throughout life. Maltreated children tend to be at greater risk of developing aggressive and antisocial behaviours (e.g., violent behaviour in adulthood). The present study aims to analyse how temperament mediates the relationship between childhood trauma and sexual violence perpetration in adolescence. The present cross-sectional study was conducted with 252 Portuguese adolescent students between ages 11 and 20 years (n = 126 boys), of whom 126 self-identified as perpetrators of sexual violence. Overall, the results show that temperament mediated the relationship between emotional abuse and the perpetration of sexual violence. Limitations and implications for future studies were discussed. This study will be crucial for the development of intervention programs on violence and will help to explore these practices in intimate relationships. A better understanding of violence through the identification of variables of interest will allow a better understanding of this phenomenon, deepening the relational dynamics between the different genders. Full article