Empirical research suggests a link between childhood abuse and adult onset of depression, anxiety, personality disorders, and psychosis. Research also suggests a positive relationship between childhood abuse and both self-harm behaviors and suicide. However, important relationships between these variables remain unclear, nor have they been studied within the context of significant comorbidity. The current study looks at the relationship between multiple occurrences of childhood abuse and self-harm behaviors and suicide attempts, within the context of depression, anxiety, borderline personality disorder, and psychosis. We hypothesize that these diagnoses mediate relationships between recurring childhood abuse and selfharm behaviors and suicide attempts. A sample of 494 psychiatric inpatients were used for analysis (54.7% Caucasian, 41.7% African American, 1.6% Hispanic, .5% Asian, .6% Native American, .6% Mixed, and .4% other/unknown). Over half of the patients presented with a mood disorder (55.9%) and/or a psychotic spectrum disorder (61.5%). The study found a positive and significant correlation between abuse history and the presence of self-harm (r=.241, p<.001) as well as number of suicide attempts (r=.176, p<.001). These results were expected and are consistent with the current empirical literature. The significant relationship between abuse and self-harm was mediated by depression (rpartial=.229), anxiety, (rpartial=.234), and borderline personality disorder (rpartial=.211). Similarly, the relationship between abuse and suicide attempts was significantly mediated by depression (rpartial=.166), anxiety (rpartial=.155), and borderline personality disorder (rpartial=.157). This suggests a strong relationship between abuse and self-harm behaviors as well as suicide attempts that is impacted be various psychiatric diagnoses. Depression, anxiety, and borderline personality disorder serve as significant mediators while psychosis showed no significant influence. These effects are interesting because psychosis is most impacted by biological factors where as depression, anxiety, and borderline personality disorder are influenced greatly by experience. These findings allow us to better understand the nature of suicide and self-harm behavior within the context of abuse and psychiatric comorbidity in order to help in treatment planning for such individuals.

This study examined the relationship between self-reported childhood physical and sexual abuse, relationship quality, possible gender differences, and clinical implications. Three hundred thirty eight women and 296 men who sought services at a university mental health clinic in the northeast region of the United States completed a 30-minute self-report assessment questionnaire before their first therapy session. Among the items in the questionnaire were measures of childhood physical abuse and sexual abuse, relationship stability, problems areas in the relationship, and other demographic information. Results from structural equation modeling indicated that childhood physical abuse influenced relationship quality for both men and women while childhood sexual abuse did not have a significant impact on relationship quality for either gender. The results of the study indicate that there may be more gender similarities than differences in experiences of childhood abuse and relationship quality than previous research suggests. Clinical implications and directions for future research are discussed.

Evidence of Lives is a novel that deals with themes of childhood abuse, mental illness, and alienated families. The book opens with the main character, forty-two-year-old Mark Barr, who has returned home from New York to West Virginia after eleven years for his older brother Steve’s funeral. Steve, having died of a heart attack at forty-six, was mentally ill most of his adult life, though Mark has always questioned what was “mentally ill” and what was the result of their father’s verbal and physical abuse during their childhood. When Mark discovers that there is to be no funeral, but a cremation without service, he calls his girlfriend, an attorney back in New York, who tells him he has a “legal responsibility” to voice his brother’s oral will. Just nights before his death, Steve called Mark and conveyed his last wishes to be buried, not cremated. The book unfolds into an odyssey for Mark to discover love for his brother posthumously in a loveless family. Evidence of Lives is a portrait of an oldest brother’s supposed mental illness and unfulfilled life, as well as a redeeming tale of a youngest brother’s alienation from his family and his guilt for abandoning them.

The literature review revealed co-morbidity between adverse childhood experiences, adult psychopathology and alcohol dependence, although causality was questionable due to multiple variables. The current study used 54 clients at the acute end of the spectrum of severe alcohol dependence from a specialist tertiary substance misuse service (clients) and a control group of 54 non-problematic drinkers from an NHS working population (controls) to examine possible differences in security of attachment and maladaptive schemas and investigated how early relational experiences influenced core beliefs regarding self, others and intimate relationships and therapeutic implications for severely alcohol dependent clients’ engagement in specialist services. The study was divided into two sections: (1) quantitative analysis using Feeney, Noller and Hanrahan’s (1994) Attachment Style Questionnaire to measure attachment style and Young’s Schema Questionnaire (Young & Brown, 2001) to measure maladaptive schemas in the domain of disconnection and rejection and (2) qualitative analysis, using Interpretational Phenomenological Analysis (IPA) to explore eight severely alcohol dependent clients’ subjective experiences of intimate relationships. Clients scored significantly lower in secure attachment style and significantly higher in both avoidant and ambivalent attachment style than controls and suggested overlapping between the two dimensions, known as ‘fearful avoidant’ attachment. Clients scored significantly higher than controls in all five sub-categories of maladaptive schemas in the domain of disconnection and rejection, namely mistrust/abuse, emotional deprivation, abandonment, social isolation/alienation and defectiveness/shame. IPA revealed common themes of negative parent-child interaction: physical and psychological abuse, neglect and explicit maternal rejection and emotional deprivation and hostile and abusive parent-parent interaction. These aetiological factors influenced fearful avoidant attachment and maladaptive core beliefs. Negation of children’s needs implicated an immaturely developed diffuseness of identity and defective self that inhibited formation of intimate adult relationships. A bio-psychosocial explanation suggested alcohol ameliorated hyper-vigilant anxiety and depression from adverse childhood experiences within a threatening family environment that implicated insecure attachment, maladaptive core beliefs and negative self-identity, inhibiting emotional intimacy. It advocated screening procedures and an integrated CBT and schema-based therapeutic approach for those at the more severe end of the spectrum of alcohol dependence deemed at risk of not engaging or disengaging prematurely from services.

Female survivors of multiple forms of trauma are increasingly found to be a significant portion of the university population (Briere, Kaltman, & Green 2008). While there is a strong literature base for understanding the effects of individual trauma on psychological functioning (e.g., Briere, 1992; Kaltman, Krumnick, Stockton, Hooper, & Green, 2005), little is known about specific symptom constellations for those who have experienced multiple traumas (Rich, Gingerich, & Roseìn, 1997). Using a clinical population of 500 female university students, this study explored the rates of multiple interpersonal traumatic experiences, the connection between multiple traumas and symptom severity, and the association of specific constellations of multiple types of traumas with specific constellations of trauma symptoms. The Trauma Symptom Inventory-Alternate (Briere, 1995) and self-report measures of demographic data and abuse histories were used to collect data, which was analyzed with frequencies, Multivariate Analysis of Variance, and a Canonical Correlation to explore the interrelationships of abuse and trauma symptoms. Multiple abuse was common, with 81% of participants experiencing two or more types of abuse. Multiple trauma generally predicted more severe trauma-related symptoms than those with no trauma or single traumas. A Canonical Correlation revealed a moderately significant relationship between participants with aggressive types of abuse (e.g., childhood physical, adult physical, and adult sexual abuse) with higher symptoms of intrusive experiences, defensive-avoidance, and dissociation. These findings suggest a differential model of trauma effects, particularly for trauma types characterized by aggression. Implications for future research and clinical practice are addressed.

abstract: The current study examined the unique influence of emotional childhood abuse on positive and negative aspects of different types of social relationships (e.g., family, spouse/partner, and friends) in midlife and whether genetic variations of the oxytocin receptor gene (OXTR) moderated these associations. Genetic variations in OXTR are measured by single-nucleotide polymorphisms (SNPs), which have been the most substantially studied prospects for explaining individual differences in socio-behavioral phenotypes. Specifically, an SNP, rs53576, involving a guanine (G) to adenine (A) substitution located in the third intron of the OXTR has been associated with fundamental aspects of social processes and behaviors. Compared to A carriers, individuals homozygous for the G allele have enhanced social competencies and tend to elicit more positive responses from social partners, consequently increasing the overall quality of social relationships across the lifespan. However, the G allele of the OXTR has also been associated with greater social sensitivity. In the current study, conducted among a sample of 614 adults in midlife, it was shown that emotional childhood abuse was significantly associated with having less supportive and more strained relationships in midlife. Regarding supportive family relationships, the effect of emotional childhood abuse was moderated by the OXTR rs53576 polymorphism. Specifically, under conditions of more emotional abuse in childhood, individuals homozygous for the G allele had more supportive family relationships in midlife compared to A carriers. Overall, the findings suggest that genetic variations of OXTR rs53576 may be an important candidate in understanding the development of social relationship functioning within the context of negative early life experiences. / Dissertation/Thesis / Masters Thesis Psychology 2018

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The aims of this study were to explore professionals’ and clients’ experiences of diagnosis and treatment of auditory verbal hallucinations with a view to identifying important clinical issues for counselling psychologists. Six professionals, three psychologists and three psychiatrists, who had worked with people who hear voices, alongside four clients who hear voices, volunteered and participated in a semi-structured interview. These interviews were transcribed and analysed using Interpretative Phenomenological Analysis (IPA) as described by Smith, Flowers and Larkin (2009). A table of super-ordinate and sub-ordinate themes was created as a result of this analysis. A number of themes arose from both groups of participants’ experiences. The main themes that arose for the professionals was: professional ambivalence; varying theories on causes of voices; perspectives on diagnosis and formulation; perspectives on medication; thoughts on working therapeutically; and, thinking on recovery. The themes that arose from the clients’ experiences were feelings about diagnosis and experiences of treatment. This research concludes that there is professional ambivalence in working with people who hear voices that is caused by a lack of certainty about the causes of the phenomenon alongside a lack of training in working with clients who have symptoms of psychosis. This impacts clients in several ways. The clients in this study were not offered the option to have any involvement in their own care and none of them were offered therapy as a treatment option. The study also concludes that psychiatric diagnosis does not consider all pertinent information related to clients’ issues which can lead to inconsistency in the diagnosis of clients who hear voices.

Previous research indicates that those with a history of abuse have an increased risk to experience subsequent traumatic events. This study utilized a convenience sample of undergraduate students to examine the reaction of those with a history of abuse to subsequent traumatic experiences. In addition, the study assessed the level of posttraumatic growth an individual experiences following childhood abuse. The level of posttraumatic growth was examined to determine if the growth allowed for participants to better handle successive traumas. Those with a history of abuse experienced higher levels of symptomology following a successive traumatic event. Results did not support the hypothesis that among those with a history of abuse, lower levels of posttraumatic growth would predict higher levels of symptoms following a later trauma. Implications and limitations of the study, as well as directions for future research are discussed.

Estimates on the prevalence of childhood sexual abuse on boys vary from 8% to 35% globally. These figures are known to be well below the actual numbers that are believed to be much higher than those found in official data. Most cases of childhood sexual abuse are never reported, boys are less likely to report sexual abuse and if they ever do, they do so up to 10-20 years later than girls with similar experiences. This metasynthesis adds to the scarce qualitative literature on coping of male victims. It brings together the types of coping strategies men with histories of childhood sexual abuse use and allows for deeper understanding on how men cope with childhood sexual abuse. Aim: To explore coping strategies used by men who have been affected by childhood sexual abuse  Method: A qualitative metasynthesis Findings: Men affected by childhood sexual abuse reported the use of several coping strategies throughout their lives. These coping strategies were adapted to changes in their social environment. Meaningful inter-personal relationships were found to influence which coping strategies victims would resort to. Not all men felt affected by their experiences of childhood sexual abuse and some reject to be labelled as victims, while others felt empowered by the recognition of their victimhood. Conclusion: Men reported using similar coping strategies in different settings, but with different outcomes. Social support and social awareness about male victimisation were found to affect coping strategies used by men who have been affected by childhood sexual abuse.