Objectives: This thesis aimed to investigate whether a history of childhood trauma was indirectly associated with eating psychopathology through mediation by dissociation and/or emotion dysregulation. Method: Firstly, a systematic review was conducted to appraise the current level of evidence within the literature that supported dissociation as a potential mediator. To this end, studies that assessed the variables of childhood trauma, dissociation and eating psychopathology within a single study were identified and systematically reviewed. Secondly, an empirical cross-sectional study was undertaken to investigate a multiple mediation model of the association between childhood trauma and eating psychopathology which included dissociation and emotion dysregulation as potential mediators. 165 undergraduate Psychology students took part in this study. Participants completed measures of childhood trauma, eating psychopathology, dissociation and emotion dysregulation. Experiences of multiple forms of childhood trauma were assessed, including emotional abuse (CEA), physical abuse (CPA), sexual abuse (CSA), emotional neglect (CEN) and physical neglect (CPN). Results: The results of the systematic review were inconclusive regarding the potential role of dissociation as a mediator in the relationships between childhood trauma and eating psychopathology. Findings within the reviewed studies generally offered more support for associations between childhood trauma and dissociation and dissociation and eating psychopathology. Studies reported more inconsistent findings regarding the association between childhood trauma and eating psychopathology. The results from the empirical study indicated that CEA and CEN were both significantly associated with increased eating psychopathology within the whole sample. These relationships were significantly mediated by both dissociation and emotion dysregulation. A separate analysis with female participants only, indicated that CPA and CPN in addition to CEA and CEN were significantly associated with increased eating psychopathology. The associations between CEA, CEN, CPN and eating psychopathology were all significantly mediated by both dissociation and emotion dysregulation. Dissociation and emotion dysregulation did not mediate the association between CPA and eating psychopathology. Conclusions: The studies included within the systematic review offered tentative support for an indirect relationship between childhood trauma and eating psychopathology through dissociation. Firm conclusions were limited, however, due to a number of methodological shortcomings identified within the included studies. The main methodological shortcomings concerned the definition and measurement of childhood trauma and the failure of a number of studies to address theoretical models within their research design. Addressing both of these methodological limitations, the results of the empirical study provided support for the growing consensus that emotional maltreatment may be an important risk factor for the development of eating psychopathology. Further, the results of this study indicate that childhood trauma impacts indirectly on eating psychopathology through an enduring effect on both dissociative and emotion regulation processes.

The purpose of this study was to investigate the influence of childhood sexual, physical and emotional abuse and childhood emotional and physical neglect on eating disorder symptoms and general psychopathology. This study utilized a cross-sectional research design incorporating a combination of self-report measures and clinical interviews. Seventy participants were recruited from two eating disorder treatment centres. A series of univariate tests revealed no significant differences between individuals who reported a mild level of trauma and those who reported a severe level of trauma on all clinical measures. Logistic regression analyses revealed associations between impulsivity and childhood physical abuse and between psychiatric comorbidity and childhood physical neglect. Few associations were found and the observed effect sizes were generally small suggesting that the null findings were not due to inadequate power. It may be that the study sample differed from those used in previous investigations in which significant associations have been documented.

The purpose of this study was to investigate the influence of childhood sexual, physical and emotional abuse and childhood emotional and physical neglect on eating disorder symptoms and general psychopathology. This study utilized a cross-sectional research design incorporating a combination of self-report measures and clinical interviews. Seventy participants were recruited from two eating disorder treatment centres. A series of univariate tests revealed no significant differences between individuals who reported a mild level of trauma and those who reported a severe level of trauma on all clinical measures. Logistic regression analyses revealed associations between impulsivity and childhood physical abuse and between psychiatric comorbidity and childhood physical neglect. Few associations were found and the observed effect sizes were generally small suggesting that the null findings were not due to inadequate power. It may be that the study sample differed from those used in previous investigations in which significant associations have been documented.

Autoimmunity is a modern age medical dilemma which is inextricably linked with emotional stress. Based on semi-structured interviews and participant Adverse Childhood Experiences (ACE) survey results, this study confirms that the autoimmune process may be initiated via psychosocial factors like emotional stress and childhood trauma. Ninety-three percent of participants experienced adversity or trauma in childhood, and 50% of participants talked about a period of prolonged stress that preceded the onset of their condition. This study also confirms the intimate and satisfactory relationship developed between patients and complementary and alternative (CAM) practitioners, who invite patients to be co-producers of health and holistically address patients' minds, bodies, and souls. Finally, this study demonstrates the incredible resiliency of people diagnosed with autoimmune conditions and how they find healing and meaning post-diagnosis.

Presentation in J. Cohen's Successful Strategies for Treating Traumatized Children in Challenging Circumstances.

This work contains a series of essays examining childhood trauma through the lens and experience of the author.

Thesis advisor: Matthew Monnig / Thesis (STL) — Boston College, 2023. / Submitted to: Boston College. School of Theology and Ministry. / Discipline: Sacred Theology.

Trata-se de uma revisão integrativa da literatura com o objetivo de identificar, sistematizar e analisar as evidências científicas que corroborem que ter sofrido Estresse Precoce, mensurado pelo instrumento Childhood Trauma Questionnaire (CTQ), é um fator determinante no uso e abuso de substâncias psicoativas na adolescência e vida adulta. A busca foi realizada em agosto de 2014 nas bases de dados: PubMed, Web of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Psycinfo, e utilizou-se o limite dos estudos indexados nos últimos 10 anos. Para as buscas nas bases de dados eletrônicas foram utilizadas combinações entre descritores controlados e palavras chaves relacionadas ao uso de substâncias psicoativas, estresse precoce e CTQ adaptadas para cada base de dados, as quais resultaram em 1114 estudos. Com a utilização dos filtros de idiomas Inglês, Espanhol e Português, somente artigos originais e publicações a partir do ano de 2003 até 18 de Agosto de 2014 o número de referências totais foram de 439. Após retirar os artigos duplicados em mais de uma base de dados, o número total de referências elegíveis para este estudo foi de 359. Após leitura de títulos e resumos foram selecionados para leitura na íntegra 157 estudos. Após leitura na íntegra foram excluídos aqueles textos que não respondiam a questão de pesquisa, sendo eleitos para esta revisão 08 artigos. Para extração dos dados foi utilizado um instrumento validado (URSI). A análise da descrição dos estudos foi realizada com base no instrumento STROBE, metodologia e delineamento das pesquisas foram analisadas com assessoria estatística. A análise dos dados foi descritiva e dividida em subcategorias: Estresse Precoce e Uso de Substâncias Psicoativas na Adolescência; Estresse Precoce e a Diferença Entre os Gêneros; Estresse Precoce e a Relação com Estresse e Depressão na Vida Adulta; Estresse Precoce e as Estratégias de Enfrentamento (Coping) na Vida Adulta; Estresse Precoce e o Álcool: a droga mais utilizada e porta de entrada para outras substâncias psicoativas. A partir dos estudos incluídos nessa revisão, foi possível identificar fatores que evidenciam que ter sofrido Estresse Precoce tem como um desfecho o uso abusivo de álcool e outras substâncias psicoativas na adolescência e vida adulta, em combinação com outros fatores ambientais e genéticos que influenciam o início do uso e posterior abuso das mesmas / This is an integrative literature review in order to identify, classify and analyze the scientific evidence supporting that have suffered Early Life Stress, measured by the Childhood Trauma Questionnaire (CTQ), is a determining factor in the use and abuse of psychoactive substances in adolescence and adulthood. The search was conducted in August 2014 in the databases: PubMed, Web of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Psycinfo, and used the limit of the indexed studies in the last 10 years. For searches of electronic databases were used combinations of controlled descriptors and keywords related to substance abuse, early life stress and CTQ, adapted to each database, resulting in 1114 studies. With the use of the filters: English, Spanish and Portuguese language, only original articles and publications from the year 2003 until August 18, 2014, the total number of references were 439. After removing duplicate items in more than one database, the total number of references eligible for this study was 359. After reading titles and abstracts, were selected for full reading 157 studies. In the full texts, were excluded those who did not respond to the research question, being elected to this review 08 articles. For data extraction was used a validated instrument (URSI). The analysis of the description of the studies was based on the STROBE instrument. The methodology and design of the researches were analyzed with statistical advice. Data analysis was descriptive and divided into subcategories: Early Life Stress and Psychoactive Substance Use in Adolescence; Early Life Stress and the Difference Between the Genders; Early Life Stress and the Relationship with Stress and Depression in Adulthood; Early Life Stress and Coping Strategies in Adulthood; Early Life Stress and Alcohol: the most widely used drug and gateway to other psychoactive substances. From the studies included in this review, it was possible to identify factors that Early Life Stress is an outcome of the alcohol and other psychoactive abuse in adolescence and adulthood, in combination with other environmental and genetic factors, that influence the beginning of use and later abuse of them

Trata-se de uma revisão integrativa da literatura com o objetivo de identificar, sistematizar e analisar as evidências científicas que corroborem que ter sofrido Estresse Precoce, mensurado pelo instrumento Childhood Trauma Questionnaire (CTQ), é um fator determinante no uso e abuso de substâncias psicoativas na adolescência e vida adulta. A busca foi realizada em agosto de 2014 nas bases de dados: PubMed, Web of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Psycinfo, e utilizou-se o limite dos estudos indexados nos últimos 10 anos. Para as buscas nas bases de dados eletrônicas foram utilizadas combinações entre descritores controlados e palavras chaves relacionadas ao uso de substâncias psicoativas, estresse precoce e CTQ adaptadas para cada base de dados, as quais resultaram em 1114 estudos. Com a utilização dos filtros de idiomas Inglês, Espanhol e Português, somente artigos originais e publicações a partir do ano de 2003 até 18 de Agosto de 2014 o número de referências totais foram de 439. Após retirar os artigos duplicados em mais de uma base de dados, o número total de referências elegíveis para este estudo foi de 359. Após leitura de títulos e resumos foram selecionados para leitura na íntegra 157 estudos. Após leitura na íntegra foram excluídos aqueles textos que não respondiam a questão de pesquisa, sendo eleitos para esta revisão 08 artigos. Para extração dos dados foi utilizado um instrumento validado (URSI). A análise da descrição dos estudos foi realizada com base no instrumento STROBE, metodologia e delineamento das pesquisas foram analisadas com assessoria estatística. A análise dos dados foi descritiva e dividida em subcategorias: Estresse Precoce e Uso de Substâncias Psicoativas na Adolescência; Estresse Precoce e a Diferença Entre os Gêneros; Estresse Precoce e a Relação com Estresse e Depressão na Vida Adulta; Estresse Precoce e as Estratégias de Enfrentamento (Coping) na Vida Adulta; Estresse Precoce e o Álcool: a droga mais utilizada e porta de entrada para outras substâncias psicoativas. A partir dos estudos incluídos nessa revisão, foi possível identificar fatores que evidenciam que ter sofrido Estresse Precoce tem como um desfecho o uso abusivo de álcool e outras substâncias psicoativas na adolescência e vida adulta, em combinação com outros fatores ambientais e genéticos que influenciam o início do uso e posterior abuso das mesmas / This is an integrative literature review in order to identify, classify and analyze the scientific evidence supporting that have suffered Early Life Stress, measured by the Childhood Trauma Questionnaire (CTQ), is a determining factor in the use and abuse of psychoactive substances in adolescence and adulthood. The search was conducted in August 2014 in the databases: PubMed, Web of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Psycinfo, and used the limit of the indexed studies in the last 10 years. For searches of electronic databases were used combinations of controlled descriptors and keywords related to substance abuse, early life stress and CTQ, adapted to each database, resulting in 1114 studies. With the use of the filters: English, Spanish and Portuguese language, only original articles and publications from the year 2003 until August 18, 2014, the total number of references were 439. After removing duplicate items in more than one database, the total number of references eligible for this study was 359. After reading titles and abstracts, were selected for full reading 157 studies. In the full texts, were excluded those who did not respond to the research question, being elected to this review 08 articles. For data extraction was used a validated instrument (URSI). The analysis of the description of the studies was based on the STROBE instrument. The methodology and design of the researches were analyzed with statistical advice. Data analysis was descriptive and divided into subcategories: Early Life Stress and Psychoactive Substance Use in Adolescence; Early Life Stress and the Difference Between the Genders; Early Life Stress and the Relationship with Stress and Depression in Adulthood; Early Life Stress and Coping Strategies in Adulthood; Early Life Stress and Alcohol: the most widely used drug and gateway to other psychoactive substances. From the studies included in this review, it was possible to identify factors that Early Life Stress is an outcome of the alcohol and other psychoactive abuse in adolescence and adulthood, in combination with other environmental and genetic factors, that influence the beginning of use and later abuse of them

INTRODUCTION: Approximately two-thirds of the U.S. population have had at least one adverse childhood experience (CDC-Kaiser Permanente Adverse Childhood Experiences [ACE] Study, 2009). Some consequences of ACEs are manifested as the child grows into late teenage years and young adulthood. Research suggests that children exposed to traumatic events during childhood subsequently experience negative health outcomes like substance abuse, engagement in risky and harmful sexual behavior, and STD occurrence. AIM: In this thesis I explore the associations of 18 year olds’ described use of alcohol, risky sexual behavior and sexually transmitted diseases (STDs) with childhood exposure to caregiver substance abuse, violence and family circumstances METHODS: Data were obtained from the Longitudinal Studies of Childhood Abuse and Neglect (LONGSCAN) Assessments 0 - 18 from the National Data Archive on Child Abuse and Neglect (NDACAN). Variables on adverse childhood experiences, sex behaviors, STDs and substance use were observed in SAS. Multiple logistic regression models were used to identify odds ratios and strength of associations. RESULTS: Results suggests significant associations among participants who were exposed to parent/caregiver use of illicit drugs during participant’s childhood and subsequent self-reported heavy alcohol use 1.60 (95% CI: 1.18, 2.22), having early sexual initiation (at age 13 or younger) 1.60 (95% CI: 1.18, 2.22), having 6 or more sexual partners 1.36 (95% CI: 1.09, 1.68) and having STDs 1.83 (95% CI: 1.36, 2.46). Eighteen year olds with who were African American, were at a greater odds of having greater than 6 sexual partners, having sexual intercourse at or before age 13 and having (an) STD(s). No significant associations were found between having a parent/caregiver or member of household who was incarcerated, being exposed to violence, being exposed to yelling often or parental often use of alcohol and subsequent alcohol abuse, having greater than 6 sexual partners, having sexual intercourse at or before age 13 and having (an) STD(s) . DISCUSSION: Based on the findings of these analyses, programs for adolescents should focus time and resources on young children who may be currently experiencing, or at risk for experiencing, parental/ caregiver illicit drug use in the home.