The mediating role of post-traumatic stress disorder symptoms in the relationship between childhood adversities and depressive symptoms in two samples

Lam

Chien

et al. 2022

Aust N Z J Psychiatry

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Objective: Childhood trauma is associated with adulthood depressive symptoms, but very few studies explored potential social and interpersonal mediators behind this association. This study made the first attempt to test the potential mediating effects of interpersonal stress in the associations between childhood betrayal and non-betrayal trauma and depressive symptoms. Method: We analyzed data in a sample of English-speaking adults from diverse backgrounds (from 19 different countries, mainly from Western countries) ( N = 468). We then replicated and compared the results with those in another convenience sample of Chinese-speaking younger adults with different cultural backgrounds and mental health status ( N = 205). Results: The results in both samples indicated that (1) childhood betrayal trauma had a stronger relationship with depressive symptoms than childhood non-betrayal trauma and that (2) interpersonal stress was a significant mediator in the relationship between childhood betrayal trauma and depressive symptoms, even when childhood non-betrayal trauma was included as a covariate. The indirect effect of childhood non-betrayal trauma on depressive symptoms through interpersonal stress was not consistent in two samples. Conclusions: Our findings point to the importance of taking social and interpersonal contexts into account when investigating, preventing and managing depression in trauma-exposed populations. Early social interventions such as family interventions, interpersonal skills training and building social resources may have the potential to change the trajectory of the development of mental health problems in trauma survivors.

Section: Discussionmentioning

confidence: 99%

“…Since this project focused on ‘youth’, participants had to (1) be aged between 18 and 24 years, (2) be able to read Chinese and (3) agree to give informed consent. The methodology and sample have been reported elsewhere (Fung et al, 2022c).…”

Section: Methodsmentioning

confidence: 99%

Interpersonal stress mediates the relationship between childhood trauma and depressive symptoms: Findings from two culturally different samples

Lam

Chien

et al. 2022

Aust N Z J Psychiatry

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“…Third, most participants were female. The reasons behind the gender differences are unknown, but many previous studies have also shown that females were more likely to participate in health surveys (Fung, Chien, Ling et al, 2022; Glass et al, 2015). Therefore, our sample was not a representative sample.…”

Section: Discussionmentioning

confidence: 99%

“…The Chinese version of the BBTS had been used in previous studies (e.g. Chiu et al, 2010) and was found to have acceptable test-retest reliability with an average agreement of 90.7% between two tests (Fung, Chien, Ling et al, 2022). In this study, we focused on the number of betrayal and non-betrayal traumatic events (possible range: 0-10).…”

Section: The Brief Betrayal Trauma Survey (Bbts)mentioning

confidence: 99%

Prevalence and sociocultural correlates of post-traumatic stress disorder and complex PTSD among Chinese community health service users in Hong Kong

Wong

Lam

et al. 2022

Int J Soc Psychiatry

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Objectives: Complex post-traumatic stress disorder (CPTSD) is a newly recognized trauma disorder in ICD-11. Little is known about the prevalence and correlates of CPTSD in primary care settings. Its cultural aspects also remained minimally explored. This study investigated the prevalence and sociocultural correlates of PTSD and complex PTSD among Chinese community health service users in Hong Kong. Methods: This study investigated ICD-11 PTSD and CPTSD in a sample of adults ( N = 376) who had recently received services from Registered Chinese Medicine Practitioners in Hong Kong. Traditional Chinese medicine service is part of primary care services in Chinese societies. Participants completed self-report measures of CPTSD, trauma exposure, perceived family support, perceived caregiver’s Chinese traditionality/modernity, participation (social activities and occupational productivity), depression and pain. Results: The past-month prevalence of ICD-11 PTSD and CPTSD was 5.6% and 18.4%, respectively, in our sample. Chi-square tests and one-way ANOVAs revealed that participants with CPTSD were younger and reported more trauma, lower family support, lower levels of social participation and productivity, more depressive symptoms and pain, and more social welfare and mental health service usages than those without PTSD. We found that perceived caregiver’s Chinese modernity (e.g. egalitarianism) was negatively correlated with CPTSD symptoms. Apart from age, non-betrayal trauma had the strongest association with classical PTSD symptoms, while betrayal trauma and perceived family support had the strongest association with disturbances in self-organization symptoms. Conclusion: This study provides the first data regarding the prevalence and correlates of ICD-11 PTSD and CPTSD among community health service users in Hong Kong. PTSD and CPTSD are common but often unrecognized mental health problems which are associated with more impairments and more service needs.

“…The Chinese version of the BBTS has been used in several studies (e.g. Fung et al, 2021 ) and it had an acceptable test-retest reliability with an average agreement of 90.7% (SD = 4.98) (Cohen’s kappa = .299 to .769, p < = .001) for 21 out of 24 items in a Chinese sample of young adults ( N = 116) (Fung et al, 2022 ). Dissociative Experiences Scale-Taxon (DES-T).…”

Section: Methodsmentioning

confidence: 99%

Trauma and dissociation among inpatients diagnosed with schizophrenia spectrum disorders in Taiwan

European Journal of Psychotraumatology

Chien

et al. 2022

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Background: The overlapping symptoms of schizophrenia and dissociation have been increasingly recognized. This paper explains why it is reasonable to expect that there would be a substantial subgroup of patients diagnosed with schizophrenia spectrum disorders (SSDs) who suffer from pathological dissociation. Objective: As little is known about the prevalence of dissociative disorders and symptoms among patients with SSDs, we investigated the prevalence of dissociative disorders and symptoms among patients with SSDs. Method: We used both self-report measures and structured interviews to examine dissociative disorders and symptoms in a randomly recruited sample of inpatients with a clinical diagnosis of SSDs in Taiwan ( N = 100). Results: Over 60% of participants exhibited pathological dissociation, and 54% had a dissociative disorder according to structured interview data; three participants met the DSM-5 diagnostic criteria for dissociative identity disorder. The concurrent validity of pathological dissociation in this sample was similar to that of depression among patients with schizophrenia reported in the literature. Participants with a dissociative disorder were more likely to report high-betrayal traumas and meet DSM-5 criteria for post-traumatic stress disorder; they also reported more psychotic symptoms than those without a dissociative disorder. Conclusions: This was one of very few studies that used structured interviews to examine pathological dissociation in patients with SSDs. The results indicate that pathological dissociation in SSDs is not uncommon. Clinical assessment should include measures of dissociation to facilitate early identification.