Is Depression With Atypical Features Associated With Trauma History?

Withers, Amy; Tarasoff, Jenna M.; Stewart, Jonathan W.

doi:10.4088/jcp.12m07870

Cited by 40 publications

(22 citation statements)

References 48 publications

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“…Increasing stress sensitivity would lower the threshold to provoke depression and anxiety [ 56 ]. Regarding interpersonal relationship, childhood trauma can disrupt the development of attachment to others and reflective awareness of self and others [ 25 ]. It might lead to difficulty with interpersonal functioning.…”

Section: Discussionmentioning

confidence: 99%

Childhood trauma and adult interpersonal relationship problems in patients with depression and anxiety disorders

Huh

Kim²,

et al. 2014

Ann Gen Psychiatry

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IntroductionAlthough a plethora of studies have delineated the relationship between childhood trauma and onset, symptom severity, and course of depression and anxiety disorders, there has been little evidence that childhood trauma may lead to interpersonal problems among adult patients with depression and anxiety disorders. Given the lack of prior research in this area, we aimed to investigate characteristics of interpersonal problems in adult patients who had suffered various types of abuse and neglect in childhood.MethodsA total of 325 outpatients diagnosed with depression and anxiety disorders completed questionnaires on socio-demographic variables, different forms of childhood trauma, and current interpersonal problems. The Childhood Trauma Questionnaire (CTQ) was used to measure five different forms of childhood trauma (emotional abuse, emotional neglect, physical abuse, physical neglect, and sexual abuse) and the short form of the Korean-Inventory of Interpersonal Problems Circumplex Scale (KIIP-SC) was used to assess current interpersonal problems. We dichotomized patients into two groups (abused and non-abused groups) based on CTQ score and investigated the relationship of five different types of childhood trauma and interpersonal problems in adult patients with depression and anxiety disorders using multiple regression analysis.ResultDifferent types of childhood abuse and neglect appeared to have a significant influence on distinct symptom dimensions such as depression, state-trait anxiety, and anxiety sensitivity. In the final regression model, emotional abuse, emotional neglect, and sexual abuse during childhood were significantly associated with general interpersonal distress and several specific areas of interpersonal problems in adulthood. No association was found between childhood physical neglect and current general interpersonal distress.ConclusionChildhood emotional trauma has more influence on interpersonal problems in adult patients with depression and anxiety disorders than childhood physical trauma. A history of childhood physical abuse is related to dominant interpersonal patterns rather than submissive interpersonal patterns in adulthood. These findings provide preliminary evidence that childhood trauma might substantially contribute to interpersonal problems in adulthood.

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Section: Discussionmentioning

confidence: 99%

Childhood trauma and adult interpersonal relationship problems in patients with depression and anxiety disorders

Huh

Kim²,

et al. 2014

Ann Gen Psychiatry

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“…Patients with atypical depression have a significantly higher incidence of childhood and adolescent trauma than those with melancholia. 50 Rene Spitz made seminal observations regarding developmental abnormalities that befell infants placed soon after birth in understaffed orphanages, where they had little or no sustained human contact. Initially, most of the infants cried bitterly for hours until attended.…”

Section: Atypical Depressionmentioning

confidence: 99%

The organization of the stress system and its dysregulation in depressive illness

2014

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Stressors are imminent or perceived challenges to homeostasis. The stress response is an innate, stereotypic, adaptive response to stressors that has evolved in the service of restoring the nonstressed homeostatic set point. It is encoded in specific neuroanatomical sites that activate a specific repertoire of cognitive, behavioral and physiologic phenomena. Adaptive responses, though essential for survival, can become dysregulated and result in disease. A clear example is autoimmune disease. I postulate that depression, like autoimmunity, represents a dysregulated adaptive response: a stress response that has gone awry. The cardinal manifestation of the normal stress response is anxiety. Cognitive programs shift from complex associative operations to rapid retrieval of unconscious emotional memories acquired during prior threatening situations. These emerge automatically to promote survival. To prevent distraction during stressful situations, the capacity to seek and experience pleasure is reduced, food intake is diminished and sexual activity and sleep are held in abeyance. Monoamines, cytokines, glutamate, GABA and other central mediators have key roles in the normal stress response. Many central loci are involved. The subgenual prefrontal cortex restrains the amygdala, the corticotropin-releasing hormone/hypothalamic-pituitary-adrenal (CRH/HPA) axis and the sympathomedullary system. The function of the subgenual prefrontal cortex is moderately diminished during normal stress to disinhibit these loci. This disinhibition promotes anxiety and physiological hyperarousal, while diminishing appetite and sleep. The dorsolateral prefrontal cortex is downregulated, diminishing cognitive regulation of anxiety. The nucleus accumbens is also downregulated, to reduce the propensity for distraction by pleasurable stimuli or the capacity to experience pleasure. Insulin resistance, inflammation and a prothrombotic state acutely emerge. These provide increased glucose for the brain and establish premonitory, proinflammatory and prothrombotic states in anticipation of either injury or hemorrhage during a threatening situation. Essential adaptive intracellular changes include increased neurogenesis, enhancement of neuroplasticity and deployment of a successful endoplasmic reticulum stress response. In melancholic depression, the activities of the central glutamate, norepinephrine and central cytokine systems are significantly and persistently increased. The subgenual prefrontal cortex is functionally impaired, and its size is reduced by as much as 40%. This leads to sustained anxiety and activations of the amygdala, CRH/HPA axis, the sympathomedullary system and their sequella, including early morning awakening and loss of appetite. The sustained activation of the amygdala, in turn, further activates stress system neuroendocrine and autonomic functions. The activity of the nucleus accumbens is further decreased and anhedonia emerges. Concomitantly, neurogenesis and neuroplasticity fall significantly. Antidepressants ameliorate ...

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“…3 Some studies have found an association between lifetime trauma and atypical depression. 4 Others have found an association between history of physical or sexual abuse (SA) in childhood and MDD with reversed neurovegetative signs. 5,6 Physical or SA has also been linked to MDD with psychotic features (as opposed to MDD without psychotic features).…”

Section: Introductionmentioning

confidence: 99%

Childhood trauma and dimensions of depression: a specific association with the cognitive domain

Vares

Salum

Spanemberg

et al. 2015

Rev. Bras. Psiquiatr.

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Objective: To investigate associations between a history of childhood trauma and dimensions of depression in a sample of clinically depressed patients. Methods: A sample of 217 patients from a mood-disorder outpatient unit was investigated with the Beck Depression Inventory, the Hamilton Depression Rating Scale, the CORE Assessment of Psychomotor Change, and the Childhood Trauma Questionnaire. A previous latent model identifying six depressive dimensions was used for analysis. Path analysis and Multiple Indicators Multiple Causes (MIMIC) models were used to investigate associations between general childhood trauma and childhood maltreatment modalities (emotional, sexual, and physical abuse; emotional and physical neglect) with dimensions of depression (sexual, cognition, insomnia, appetite, non-interactiveness/ retardation, and agitation). Results: The overall childhood trauma index was uniquely associated with cognitive aspects of depression, but not with any other depressive dimension. An investigation of childhood maltreatment modalities revealed that emotional abuse was consistently associated with depression severity in the cognitive dimension. Conclusion: Childhood trauma, and specifically emotional abuse, could be significant risk factors for the subsequent development of cognitive symptoms of major depression. These influences might be specific to this depressive dimension and not found in any other dimension, which might have conceptual and therapeutic implications for clinicians and researchers alike.

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Is Depression With Atypical Features Associated With Trauma History?

Abstract: These results suggest that a relationship exists between atypical depression and lifetime trauma that may be more complex than the etiologic pathways outlined in prior research. Rather, trauma and atypical depression may be interrelated throughout life.

Cited by 40 publications

References 48 publications

Childhood trauma and adult interpersonal relationship problems in patients with depression and anxiety disorders

Childhood trauma and adult interpersonal relationship problems in patients with depression and anxiety disorders

The organization of the stress system and its dysregulation in depressive illness

Childhood trauma and dimensions of depression: a specific association with the cognitive domain

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