Kjersti Arefjord

Myocardial infarction—emotional consequences for the wife

Abstract In this paper, anxiety and depression in 37 wives of myocardial infarction (MI) patients were assessed by interviews one week after the hospital admission, three months and 10 years after the index MI. The findings indicate high prevalence of anxiety during both the acute phase and after three months. However, during the long-term follow-up their anxiety decreased. The proportion of women with severe depression was relatively stable during the whole course. A K-mean cluster analysis identified four subgroups with different patterns of anxiety and depression. The findings indicate that pre-MI use of health services, quality of marital relationship, perceived social support and coping styles during the acute illness phase are significant predictors of emotional reactions in the sample.

Psychometric properties of the Norwegian version of the Childhood Trauma Questionnaire in high-risk groups

The Childhood Trauma Questionnaire--Short Form (CTQ-SF) is widely used to measure childhood abuse of all types. In the present study, we examined the psychometric properties of the Norwegian version of the instrument. The participants constituted four subsamples (n = 517): substance abusers (n = 126), psychiatric patients (n = 210), prisoners (n = 109) and adolescents in out-of-home placements (n = 72). Confirmatory factor analysis revealed a reasonable fit of the data to the original five-factor structure of the CTQ-SF. Measurement invariance was found across gender and the four subsamples. It was concluded that the Norwegian version of the CTQ-SF has acceptable psychometric properties, with good reliability and satisfactory accuracy, to assess different dimensions of childhood trauma.

Traumatic Events and Posttraumatic Reactions among Children and Adolescents in Out-of-Home Placement: A 25-Year Systematic Literature Review

The present study aims to review empirical research focusing on traumatic events and posttraumatic stress among children and adolescents in out-of-home placement and identify future directions for research. A search in PsychInfo, ISI, and PubMed for the period 1985–2010 and use of citation alerts from 2006 to 2010 yielded 27 studies meeting our inclusion criteria. The included studies applied a diversity of assessment instruments and methods. Only six studies reported when the traumatic event(s) had occurred and/or time of assessment posttrauma. The studies comprised two main categories of traumatic events: war related trauma and sexual/physical abuse. There was a male majority exposed to studies focusing on war-related trauma, and studies on sexual trauma had a female majority. Studies on war-related trauma included foster children from Africa and Asia, whereas studies on abuse trauma included mainly North American samples. The review reflects a scarcity of empirical studies with a trauma perspective in this vulnerable population.

Childhood trauma in schizophrenia spectrum disorder as compared to other mental health disorders

Abstract Background: Childhood trauma (CT) is a potential risk factor in psychosis, and the prevalence of CT may be higher in patients with psychosis compared to other mental health disorders. The aim of the study was to investigate the potential specificity of CT in psychosis. Methods: The sample consisted of 52 patients with schizophrenia spectrum disorders and 52 matched patients with other mental health disorders. CT was measured by the CTQ-SF. The groups were compared on CTQ-SF sum and subscale scores indicating rates of CT, in addition to rates of none/low vs. moderate/severe levels of CT. Results: The psychosis group had significantly higher CTQ-SF sum scores, and reported significantly higher levels of, and more severe, physical and sexual abuse and physical neglect. Also, 67.3% of the psychosis group reported ≥ 1 CT above the cut-off, compared to 38.5% in the non-psychosis group. No patients in the non-psychosis group reported ≥ 4 CT, compared to 9.6% in the psychosis group. Conclusions: Patients with psychosis reported more severe and frequent CT compared to non-psychotic patients. Our results may indicate some specificity for moderate and severe levels of physical and sexual abuse, and physical neglect, in schizophrenia spectrum disorders.

Childhood maltreatment and adult mental health

Background: The relationship between reported childhood maltreatment and general psychological and post-traumatic distress was examined in a sample of 551 adults from different risk samples. Aims: Exposure to childhood maltreatment was assessed using the Childhood Trauma Questionnaire Short Form, which detects physical, emotional and sexual abuse and past physical and emotional neglect. Methods: The participants’ current levels of post-traumatic stress symptoms and general psychological stress symptoms were measured with the Impact of Event Scale – Revised and the Symptom Checklist 90 – Revised, respectively. Results: The results reveal a high prevalence of reported childhood maltreatment in both men and women, and the severity levels of the five types of childhood maltreatment showed significant associations with the extent of current post-traumatic and general psychological distress. Conclusion: The findings emphasize the need for appropriate procedures for identifying childhood maltreatment.

Childhood trauma in schizophrenia spectrum disorders as compared to substance abuse disorders

The prevalence of childhood trauma (CT) in schizophrenia spectrum disorders (SSDs) and substance abuse disorders (SUDs) is high. Direct comparisons of CT in these disorders are lacking, and it is not known whether there are differences in self-reported CT in SSDs as compared to SUDs. We aimed to compare the frequency, severity and types of CT in SDDs and SUDs. Patients with SSDs (n = 57) and SUDs (n = 57) were matched for age and gender. Overall levels of CT and CT subtypes were measured retrospectively by the Childhood Trauma Questionnaire Short-Form (CTQ-SF), and grouped into none/low and moderate/severe levels of CT. Group differences in CTQ-SF sum score and subscale scores, as well as differences in the severity of overall CT and CT subtypes were all non-significant. In both groups, 64.9% reported ≥ 1 subtypes of CT above cut-off. Of those who reported CT above the cut-off, 13.5% in the psychosis group reported ≥ 4 subtypes, as compared to 2.7% in the substance abuse group. We did not find statistically significant differences between SSDs and SUDs in terms of exposure to CT frequency or severity, all effect sizes were small (r < 0.15).

Childhood maltreatment trauma: a comparison between patients in treatment for substance use disorders and patients in mental health treatment

ABSTRACT Background: While previous research has found strong associations between childhood maltreatment trauma and substance use disorders (SUDs), the role of possible moderating effects of gender and mediating effects of psychopathology and SUD is unclear. Objective: The objective of this study was to investigate differences in self-reported childhood maltreatment trauma, general psychological distress, and post-traumatic stress symptoms between 112 patients in treatment for substance use disorders (SUD group) and 112 matched controls with mild to moderate mental health disorders (comparison group). Methods: Childhood maltreatment trauma was measured by the Childhood Trauma Questionnaire – Short Form (CTQ-SF). General psychological distress was measured by the Symptom Checklist-90 – Revised (SCL-90-R), and post-traumatic stress symptoms were measured by the Impact of Event Scale – Revised (IES-R). Results: The SUD group reported more severe childhood maltreatment trauma than the comparison group. Females in the SUD group reported more severe and various forms of trauma compared to males. The SUD group reported higher mean scores on the SCL-90-R, but the proportions of people with caseness scores on the IES-R and the SCL-90-R were similar in the two samples. The SUD group reported more avoidance symptoms than the comparison group. Conclusion: This study adds further evidence to the repeatedly found strong associations between childhood maltreatment trauma and SUD, implying that the prevention of childhood maltreatment trauma may reduce the occurrence of SUD. Furthermore, patients with SUD should be screened for childhood maltreatment trauma, and the results should be applied in trauma-informed as well as trauma-focused interventions aimed to help this population. The association appears to be particularly strong for female substance users.