Search

This study aimed to (a) identify posttraumatic stress disorder (PTSD) trajectories in a sample of Danish treatment-seeking childhood sexual abuse (CSA) survivors and (b) examine the roles of social support, coping style, and individual PTSD symptom clusters (avoidance, reexperiencing, and hyperarousal) as predictors of the identified trajectories. We utilized a convenience sample of 439 CSA survivors attending personalized psychotherapy treatment in Denmark. Four assessments were conducted on a six monthly basis over a period of 18 months. We used latent class growth analysis (LCGA) to test solutions with one to six classes. Following this, a logistic regression was conducted to examine predictors of the identified trajectories. Results revealed four distinct trajectories which were labeled high PTSD gradual response, high PTSD treatment resistant, moderate PTSD rapid response, and moderate PTSD gradual response. Emotional and detached coping and more severe pretreatment avoidance and reexperiencing symptoms were associated with more severe and treatment resistant PTSD. High social support and a longer length of time since the abuse were associated with less severe PTSD which improved over time. The findings suggested that treatment response of PTSD in CSA survivors is characterized by distinct patterns with varying levels and rates of PTSD symptom improvement. Results revealed that social support is protective and that emotional and detached coping and high pretreatment levels of avoidance and reexperiencing symptoms are risk factors in relation to PTSD severity and course. These factors could potentially identify patients who are at risk of not responding to treatment. Furthermore, these factors could be specifically addressed to increase positive outcomes for treatment-seeking CSA survivors. [ABSTRACT FROM AUTHOR]

This study aimed to examine the effects of different types of maltreatment on psychiatric outcomes. The second aim was to examine patterns of comorbidity among different types of child maltreatment. Participants were randomly selected from the total birth cohort of all children born in Denmark in 1984. Data were then linked to information drawn from the Danish health and social registries. Four distinct subgroups of child maltreatment were used: no abuse; sexual abuse; emotional abuse; and co‐occurring abuse. Multivariate analysis demonstrated that all types of maltreatment were associated with psychiatric outcomes independent of other forms of adversity and parental history of psychiatric conditions. The strength of these associations was consistent for some, but not all conditions. Findings are consistent with emerging transdiagnostic models of psychopathology, which demonstrate that the risk for psychopathology appears to operate at the broad dimension level, rather than the level of specific diagnoses. Key Practitioner Messages: This study found that maltreatment in childhood was associated with a number of psychiatric conditions and high levels of comorbidity independent of other forms of adversity and parental history of psychiatric conditions.Findings point to the importance of early intervention for maltreated children using an individual and developmentally appropriate approach that may offset the risk trajectory for co‐occurring psychiatric conditions.Interventions targeting difficulties in attachment, emotional regulation and promoting adaptive coping strategies have been useful in treating a range of conditions. [ABSTRACT FROM AUTHOR]

The association between exposure to childhood maltreatment and subsequent intimate partner violence (IPV) has been well documented. Recently, there has been increased attention to IPV in adolescence and young adulthood, with studies demonstrating that IPV peaks in young adulthood. Data were collected from a Danish national study conducted by The Danish National Centre for Social Research in 2008 and 2009. A sample of 4,718 young adults (aged 24) was randomly selected using the total birth cohort of children born in 1984. Structured interviews were conducted with 2,980 participants equating to a response rate of 63%. Childhood maltreatment including emotional, sexual, and multiple abuse experiences and being female and a young parent were used to test the association with experiencing IPV victimization. Bivariate associations showed that all variables were significantly associated with experiencing IPV. When the variables were entered into a multivariate binary logistic regression analysis, being female indicated the strongest association (odds ratio [OR] = 13.96), followed by experiencing childhood sexual abuse (OR = 10.90) and experiencing multiple types of abuse (OR = 6.49). Results suggest that among the child maltreatment typologies, sexual abuse is the dominant factor associated with IPV. The current study extends the literature conducted on a young adult population by demonstrating that early adverse experiences and being female and a parent are associated with IPV in young adulthood. These findings suggest prevention programs should be targeted in early adolescence to support young people to establish and maintain positive and healthy relationships that promote safe conflict resolution strategies. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify significant predictors of length of time spent in treatment. In a convenience sample of 439 Danish survivors of child sexual abuse, predictors of time spent in treatment were examined. Assessments were conducted on a 6-month basis over a period of 18 months. A multinomial logistic regression analysis revealed that the experience of neglect in childhood and having experienced rape at any life stage were associated with less time in treatment. Higher educational attainment and being male were associated with staying in treatment for longer periods of time. These factors may be important for identifying those at risk of terminating treatment prematurely. It is hoped that a better understanding of the factors that predict time spent in treatment will help to improve treatment outcomes for individuals who are at risk of dropping out of treatment at an early stage. [ABSTRACT FROM PUBLISHER]

Purpose: The World Health Organization's 11th revision to the International Classification of Diseases manual (ICD-11) will differentiate between two stress-related disorders: PTSD and Complex PTSD (CPTSD). ICD-11 proposals suggest that trauma exposure which is prolonged and/or repeated, or consists of multiple forms, that also occurs under circumstances where escape from the trauma is difficult or impossible (e.g., childhood abuse) will confer greater risk for CPTSD as compared to PTSD. The primary objective of the current study was to provide an empirical assessment of this proposal.Methods: A stratified, random probability sample of a Danish birth cohort (aged 24) was interviewed by the Danish National Centre for Social Research (N = 2980) in 2008-2009. Data from this interview were used to generate an ICD-11 symptom-based classification of PTSD and CPTSD.Results: The majority of the sample (87.1%) experienced at least one of eight traumatic events spanning childhood and early adulthood. There was some indication that being female increased the risk for both PTSD and CPTSD classification. Multinomial logistic regression results found that childhood sexual abuse (OR = 4.98) and unemployment status (OR = 4.20) significantly increased risk of CPTSD classification as compared to PTSD. A dose-response relationship was observed between exposure to multiple forms of childhood interpersonal trauma and risk of CPTSD classification, as compared to PTSD.Conclusions: Results provide empirical support for the ICD-11 proposals that childhood interpersonal traumatic exposure increases risk of CPTSD symptom development. [ABSTRACT FROM AUTHOR]

Background: Loneliness is a prevalent and urgent public health issue. Optimal planning of community approaches to loneliness requires a differentiated understanding of loneliness across the life span. We identified groups at high risk of loneliness by exploring the relationship between loneliness and socio-demographic and health-related factors across multiple age groups.Methods: This was a combined population-based questionnaire survey and register data study based on a representative sample, including 33,285 Danish individuals aged 16-102 years. Loneliness was measured using the Three-Item Loneliness Scale.Results: The relation between loneliness and age took a shallow U-shaped distribution. Ethnic minority status, receiving disability pensions or being unemployed, living alone, prolonged mental disorder, and psychiatric treatment were strongly associated with severe loneliness. Socio-demographic and health-related factors were associated with an increased risk of severe loneliness in specific age groups. Being female, having a low educational level and living in a deprived area were only associated with loneliness in adolescence/emerging adulthood. Receiving disability pensions and living alone (i.e., divorced), on the other hand, were strongly associated with loneliness in early and middle adulthood and young-old age.Conclusion: Ethnic minority status, living alone, and prolonged mental disorder may well be key factors in determining the generic level of loneliness in a given population. Other conditions are associated with an increased risk of severe loneliness in specific age groups and may moderate the age-loneliness relation. These findings may help to identify populations within communities at risk of loneliness and thereby support the implementation of policies and public health interventions across the life span. [ABSTRACT FROM AUTHOR]

Purpose: A number of social, familial, and psychological factors have been identified to explain the onset of mood and anxiety disorders among adolescent and young adult populations. The purpose of this study is to identify the shared and unique predictors of anxiety and mood disorders by simultaneously testing a range of established psychosocial risk factors.Method: A national birth cohort of the Danish population born in 1984 and tracked over the course of the first 21 years of their life was used in the current study (n = 54,458). Psychosocial risk factors including paternal and maternal history of any anxiety and mood disorder, parental history of self-harming behaviour, advanced paternal age, gender, urban dwelling, economic deprivation, family dissolution, and childhood adversity were used to predict diagnosis of both anxiety and mood disorders from ages 10 to 21 years.Results: Binary logistic regression analysis showed that being female and a parental history of a mood or anxiety disorder are the strongest predictors of both disorders. Economic deprivation, and family dissolution also increase likelihood of both disorders. Urban dwelling and childhood adversity are predictors of anxiety disorders but not mood disorders.Conclusion: Between the ages of 10 and 21 years, anxiety and mood disorders share many common risk factors. However, urban dwelling and childhood adversity appear to be unique predictors of anxiety disorders. Results suggest there is no dominant factor in the prediction of either disorder, rather the accumulation of different risk factors is most deleterious. [ABSTRACT FROM AUTHOR]

Lambek, R. & Shevlin, M. (2011). Working memory and response inhibition in children and adolescents: Age and organization issues. Scandinavian Journal of Psychology 52, 427-432. The aim of the present study was to examine the role of age in the organization of verbal working memory, visuospatial working memory and inhibition; specifically whether these constructs could be considered unitary or separate in children aged 7 to 12 years ( n = 164) and in adolescents aged 13 to 16 years ( n = 75) using a multi-group confirmatory factor analysis. Results suggested that verbal working memory, visuospatial working memory and inhibition improved from childhood to adolescence. However, improvement was not followed by a change in the organization of these components. Verbal working memory, visuospatial working memory and inhibition constituted separable but associated constructs in children and in adolescents. [ABSTRACT FROM AUTHOR]

Primary objective: To study (a) the associations between attachment styles, worry, and care utilisation in third trimester of first pregnancy (n = 567) and (b) the associations between third trimester attachment style and one year postpartum relationship satisfaction and parenting stress (n = 1069). Based on Bowlby’s attachment theory, we expected attachment anxiety and attachment avoidance to differ with regard to short-term appraisal of threat and interpersonal neediness, while the dimensions were expected to have similar deteriorating effect on longer-term outcomes in relationship functioning. Research design: A cross-sectional study nested within a randomised controlled trial. Methods and procedures: An assessment battery consisting of three scales at T1 and T2. Main outcome and results: Results confirmed that attachment anxiety was significantly associated with high pregnancy worry compared to attachment avoidance. None of the dimensions were associated with health care utility. Both attachment anxiety and attachment avoidance were associated with high parenting stress at one year postpartum, while only attachment anxiety was associated with low relationship satisfaction. Conclusion: These findings partly confirm conceptual distinctions between the two attachment dimensions, and point to adult attachment as an important factor in understanding the ways women cope with the challenges during the transition to motherhood. [ABSTRACT FROM PUBLISHER]

This study estimated the risk of sexual victimization associated with different family structures. Based on the Danish Civil Registration System, all female visitors to the Centre for Rape Victims (CRV) at the University Hospital in Aarhus, during a two-year period (January 2005 to December 2006) were identified ( N = 214) along with a control group ( N = 4,343) that was matched by age and residential location. The family structure in the preceding year was used as a predictor variable in a logistic regression model. Results indicted that, compared to those who were married with children at home, being single with children at home significantly increased the likelihood of having visited the CRV. This is consistent with the research literature that has shown that single women with children are at risk for disadvantage on a range of socioeconomic and psychological factors as well as at risk for interpersonal violence. [ABSTRACT FROM AUTHOR]

There is a growing research literature that indicates that sexual victimization results in increased physical health problems and health service utilization. This study aimed to examine the relationship between attendance at a center for rape victims and frequency of contact with general practitioners. The study used matched case-control design, and information about general practitioner use over a 7-year period was drawn from the Danish Civil Registration System. There was a sustained increase in health care use for those who had used the center for rape victims compared to the control group. [ABSTRACT FROM AUTHOR]

This study aimed to test the dimensional structure of acute stress disorder (ASD). Latent profile analysis was conducted on scores from the Acute Stress Disorder Scale (Bryant, Moulds, & Guthrie, 2000) using a large sample of female victims of sexual trauma. Four distinct classes were found. Two of the classes represented high and low levels of ASD, and the high ASD class was associated with a high probability of subsequent posttraumatic stress disorder (PTSD). There were 2 intermediate classes that were differentiated by the number of arousal symptoms, and the class with high levels of arousal symptoms had a higher risk of PTSD. The results suggested that ASD is best described by qualitatively and quantitatively differing subgroups in this sample, whereas previous research has assumed ASD to be dimensional. This may explain the limited success of using ASD to predict subsequent PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved)., ((c) 2014 APA, all rights reserved.)

The present study modeled the direct relationship between child sexual abuse (CSA) and adolescent peer-to-peer sexual victimization (APSV) and the mediated effect via variables representing the number of sexual partners, sexual risk behavior, and signaling sexual boundaries. A cross-sectional study on the effect of CSA on APSV was conducted, utilizing a multiple mediator model. Mediated and direct effects in the model were estimated employing Mplus using bootstrapped percentile based confidence intervals to test for significance of mediated effects. The study employed 327 Danish female adolescents with a mean age of 14.9 years (SD = 0.5). The estimates from the mediational model indicated full mediation of the effect of CSA on APSV via number of sexual partners and sexual risk behavior. The current study suggests that the link between CSA and APSV was mediated by sexual behaviors specifically pertaining to situations of social peer interaction, rather than directly on prior experiences of sexual victimization. The present study identifies a modifiable target area for intervention to reduce adolescent sexual revictimization., (© 2013 American Orthopsychiatric Association.)

Objective: An increasing research literature has identified a statistical association between trauma exposure and psychosis. Methodological limitations, primarily relating to failures to establish the temporal ordering of events and relying on retrospective self-reports, have made the argument for a causal association difficult to establish., Method: A case-control study was conducted based on data from the Danish Civil Registration System and the Danish Psychiatric Central Register. All female visitors to a rape center during the index year (2003) were matched with controls based on age and area of residence. Information on previous and subsequent diagnoses of psychosis was extracted from the registers for cases and controls., Results: A hierarchical binary logistic regression was used with demographic variables, preindex psychosis, and rape center attendance as predictor variables, and the dependent variable was a postindex year diagnosis of psychosis. The OR associated with sexual victimization (OR = 10.04; 95% CI 2.50-40.33) indicted an increased likelihood of psychosis while controlling for the other predictors in the model., Conclusions: This study found that sexual victimization significantly increased the likelihood of a diagnosis of psychosis and therefore suggests that there may be a role for traumatic experiences in the etiology of psychosis.

The aim of this study was to determine if there are meaningful clusters of individuals with similar experiences of adverse life events in a nationally representative sample of Danish adolescents. Latent class analysis (LCA) was used to identify such clusters or latent classes. In addition, the relationships between the latent classes and living arrangements and diagnosis of post-traumatic stress disorder (PTSD) were estimated. A four-class solution was found to be the best description of multiple adverse life events, and the classes were labelled "Low Risk", "Intermediate Risk", "Pregnancy" and "High Risk". Compared with the Low Risk class, the other classes were found to be significantly more likely to have a diagnosis PTSD and live with only one parent. This paper demonstrated how trauma research can focus on the individual as the unit of analysis rather than traumatic events.

The factor structure of the World Assumptions Scale (WAS) was assessed by means of confirmatory factor analysis. The sample was comprised of 1,710 participants who had been exposed to trauma that resulted in whiplash. Four alternative models were specified and estimated using LISREL 8.72. A correlated 8-factor solution was the best explanation of the sample data. The estimates of reliability of eight subscales of the WAS ranged from .48 to .82. Scores from five subscales correlated significantly with trauma severity as measured by the Harvard Trauma Questionnaire, although the magnitude of the correlations was low to modest, ranging from .08 to -.43. It is suggested that the WAS has adequate psychometric properties for use in both clinical and research settings.