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Further evidence for the differential familial aggregation of agoraphobia and panic disorder
Abstracts / Comprehensive Psychiatry 54 (2013) E1–E14 Methods: We assessed PTSD (PCL N=50), combat intensity (34 summed, weighted items in tertiles), depression (PHQ), and alcohol misuse (TICS) in a sample of 2422 Soldiers. Family history of depression and alcohol misuse were assessed using 2 items from the Adverse Childhood Experiences Study. Results: In logistic regression models, combat intensity increases risk for PTSD (for intermediate intensity, odds ratio [OR]=2.5, 95% confidence interval [CI]=1.8–3.5; for high intensity, OR=5.2, CI=3.8,7.2; prNχ 2 for trend=0.000). Family history of depression (OR=1.4, CI=1.0–2.0), and alcohol misuse (OR=1.4, CI=1.1–1.9), and subject depression (OR=20.6, CI=15.0–28.4) and alcohol misuse (OR=1.5, CI=1.1–2.0), all increase risk for PTSD but do not confound the association of combat experiences and PTSD. No effect modification was detected. Conclusion: Family histories of depression and alcohol misuse modestly predict PTSD, but neither confound nor modify the effect of subjects' combat experience, depression, and alcohol misuse on PTSD. Intensity of exposure to warfare itself principally drives PTSD symptomatology and concomitant depression and alcohol misuse.
http://dx.doi.org/10.1016/j.comppsych.2012.07.027
The impact of paternal and maternal depression on internalizing and externalizing disorders among offspring R.H. Jacobs, V. Warner, M.M. Weissman New York, NY The negative sequelae of maternal depression on offspring have been well documented, but few studies have examined the independent impact of paternal depression. We examine rates of internalizing mental health disorders (major depressive disorder and anxiety disorders) in youth, stratified by gender of depressed parent in a longitudinal family study. We also examine differences over the course of adolescent development. Relative risk ratios and confidence intervals were calculated in predicting youth disorder (depression or anxiety) from parental depression in a sample offspring. Both maternal and paternal depression increased the likelihood of internalizing disorders among youth. Youth with depressed fathers had an increased risk of MDD (n=99; RR, 1.7; 95% CI, 1.1–2.6; P=.02) and anxiety (n=94; RR, 1.9; 95% CI, 1.2–3.2; P=.01) when compared to youth with nondepressed fathers. Analyses on age of child at onset of paternal depression implicate early adulthood as a critical period, specifically age 18 or over (RR, 2.0; 95% CI, 1.1–3.6; P=.02); whereas a differential effect by age was not detected in the case of maternal depression. Interestingly, paternal MDD did not significantly impact youth younger than 13. This research suggests that depression in fathers independently impacts disorder in their offspring, particularly later in their adolescence (i.e., after age 18). Future research can examine whether pubertal status interacts with the sex of the affected parent in predicting onset of disorder in offspring. Funded by NIMH 5R01MH036197, 5P50MH090966, and 5T32MH016434. http://dx.doi.org/10.1016/j.comppsych.2012.07.028
A prospective study to assess the relation between different traumatic events and the risk of six physical health conditions in a population-based sample K.M. Keyes a, K. McLaughlin a, R. Demmer a, M. Cerda a, K. Koenen a, M. Uddin b, S. Galea a a New York, NY b Ann Arbor, MI Introduction: Traumatic event experiences are associated with increased risk for psychiatric disorders. Although a relation between traumatic event exposure and adverse physical health has also been documented, few studies have examined the associations between a range of potentially traumatic events and physical health conditions in the same study. This research is critical to understand the role of the social environment in the production of
E5
physical health conditions, and to clarify the processes by which psychiatric and physical health disorders co-occur. Methods: Data were drawn from the Detroit Neighborhood Health Study, a community sample of predominately African Americans living in Detroit, MI interviewed in 2008–2009 (N=1547) and again prospectively in 2009– 2010 (N=1054). Kaplan Meier and Cox proportional hazards models were used to assess whether number and type of traumatic events experienced were associated with the hazard of five self-reported physical health conditions: cardiovascular disease, arthritis, diabetes, atrial fibrillation, and respiratory disease. Results: We observed a monotonic dose–response relationship between number of traumatic events experienced and arthritis risk. Compared to those who reported no lifetime traumatic events, respondents with 1–2, 3–4, 5–7, and 8+ traumatic events had 1.07, 1.12, 1.74, and 2.44 times the hazard of arthritis, controlling for socio-demographics, post-traumatic stress disorder, depressive symptoms, binge drinking, and smoking. Assaultive violence (HR=1.7, 95% CI 1.3–2.3) and other threats to physical integrity (HR=1.5, 95% CI 1.1–2.1) were particularly robust risk factors for arthritis. There was a suggestion of a relation between traumatic events and cardiovascular disease, although the association was unstable. We found no evidence for an association between traumatic events and diabetes, atrial fibrillation or respiratory disease nor with the total number of physical health conditions. Conclusion: These results provide novel evidence linking traumatic events, particularly those involving violence and threat to life, to elevated risk for arthritic conditions. This suggests that some mental and physical health conditions may share traumatic event experience as a common cause, illuminating one pathway through which adverse mental and physical health become comorbid. Identifying biologic mechanisms underlying both mental and physical health phenotypes, such as inflammatory pathways, is an important goal for future research.
http://dx.doi.org/10.1016/j.comppsych.2012.07.029
Further evidence for the differential familial aggregation of agoraphobia and panic disorder S. Knappe a, A. Nocon b, K. Beesdo-Baum a, H.U. Wittchen a,b Dresden, Germany b Munich, Germany a
Background: Over the past 30 years, Agoraphobia (AG) and Panic Disorder (PD) have been included in our diagnostic systems. The relationship between the two disorders is however controversial, particular with regard to the question of whether AG exists as a discrete diagnostic entity apart from PD. Studies on the patterns of familial aggregation of AG and PD may help to elucidate differential pathogenetic mechanisms involved in either disorder. Findings from family and genetic studies are nonetheless conflicting due to hierarchical rules of diagnostic criteria and diverging assessment strategies. Given the significance of this issue in relation to the up-coming DSM-5 revision, convincing evidence for the position of AG relative to the panic/anxiety-spectrum is needed, and therefore also other anxiety disorders should be taken into account to picture homotypic and heterotypic familial transmission pathways. Methods: Familial transmission of panic attacks (PA), PD and AG was examined in a 10-year prospective-longitudinal community study of 3021 adolescents and young adults including completed direct and indirect information on parental psychopathology. Standardized diagnostic assessments using the Munich-Composite International Diagnostic Interview allowed generating exclusive diagnostic groups irrespective of diagnostic hierarchy rules. Associations between cumulated lifetime parental and offspring psychopathology (up to age 34) were assessed with odds ratios (ORs) from logistic regressions, controlled for offspring age and gender, and for other offspring anxiety disorders. Results: Rates for parental PA, PD without AG and AG without PD were 8.8%, 4.1% and 3.9%. In offspring up to age 34, observed lifetime rates for PA, PD without AG, and AG without PD were 9.4%, 1.6% and 3.3%, respectively.
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Abstracts / Comprehensive Psychiatry 54 (2013) E1–E14
PD, but not AG aggregates in families: Parental PD without AG was associated with an increased risk for PA and PD+AG (OR range 2.7–3.9, Pb.05), but not for AG without PD or PD without AG in offspring. Parental AG without PD and parental PD+AG were not associated with the offsprings’ risk for PA, exclusive PD or AG or PD+AG. Additionally, associations between parental specific phobias and parental generalized anxiety disorder with offspring AG without PD emerged (OR range 3.1–3.5, Pb.05). All findings were largely unaffected by adjustment for other offspring anxiety disorders. Conclusions: We found no indication that AG without the involvement of PA/PD aggregates in families; moreover, etiological pathways for offspring AG are likely heterotypic and probably different from those for PA and PD — providing further evidence for the independence of AG apart from the PD-spectrum.
http://dx.doi.org/10.1016/j.comppsych.2012.07.030
Maternal depression and parenting: associations with HPA axis reactivity in early childhood K.R. Kryski, H.J. Smith, H.I. Sheikh, S.M. Singh, E.P. Hayden Western Ontario, Canada While activation of the hypothalamic–pituitary–adrenal (HPA) axis is an adaptive response to stress, HPA axis reactivity is excessive in many individuals with depressive and anxiety disorders (Gunnar & Talge, 2005; Risbrough & Stein, 2006) and is likely an important marker of childhood vulnerability to psychopathology (Belsky & Pluess, 2009). With respect to the development of HPA axis reactivity, a family history of depression may be an important marker of vulnerability to early adverse experiences (Ashman et al., 2002), which may together shape the developing HPA system. This study tested this model in 122 three-year-old children (72 girls; 58.5%) and their caregivers. Maternal depression history, obtained from structured clinical interviews, and ratings of observed parenting by the child's primary caregiver were examined as predictors of child cortisol reactivity. Cortisol samples were obtained at baseline and at 5 time points following a standardized stress task tapping responses to social evaluation. For children with maternal depression history, greater parent hostility was associated with a significantly higher baseline cortisol level, higher slope, and slower rate of quadratic curvature, suggestive of greater cortisol reactivity and a slower recovery. Low parental sensitivity was associated with higher baseline cortisol for children with a family history of maternal depression compared to children without this history. Results indicate that early parenting may exacerbate the risk associated with maternal depression history by heightening children's cortisol reactivity in early childhood. http://dx.doi.org/10.1016/j.comppsych.2012.07.031
Construct overlap between depression and frailty in later life: evidence from the health and retirement study M. Lohman, B. Mezuk Richmond, VA Background: In epidemiologic research, late-life depression and frailty are often conceptualized and modeled as independent constructs despite having shared risk factors and consequences. Ignoring the interrelationships between depression and frailty may lead to false inferences about the relative importance of these syndromes for morbidity, disability, and mortality. The goal of this study was to use confirmatory latent class analysis to examine the joint relationship between the constructs of depression and frailty among community-dwelling older adults. Method: Data come from the 2008 wave of the Health and Retirement Study, a nationally-representative sample of adults over the age of 50. Analysis is limited to participants 65 and older with complete data on depressive symptoms and frailty indicators (N=3665). Depressive symptoms were indexed by the 8-item Centers for Epidemiologic Studies
Depression (CES-D) scale, and frailty was indexed by modified Fried criteria (i.e., low weight, inactivity, slowness, exhaustion, and weakness). Latent class analysis was used to model the depression and frailty constructs, and latent Kappa coefficients were estimated from competing models to assess the chance-corrected agreement between depression and frailty. Results: Latent class analyses suggested that depression and frailty could best be modeled as distinct syndromes, each with 3 classes. In the joint modeling of depression and frailty latent constructs, 13.0% of participants were classified as high depressive symptoms, 19.0% as mild, and 68.0% as low depressive symptoms. Regarding frailty, 18.2% were classified as severely frail, 18.5%, as mild, and 63.3% with low frailty symptoms. A latent Kappa statistic representing chance-corrected agreement between depression and frailty indicated substantial construct overlap (Кl: 0.56, 95% CI: 0.53–0.59). Conclusion: Findings suggest that late-life depression and frailty, as commonly defined in epidemiologic research, are substantially interrelated constructs and identify overlapping populations of older adults. Future research should explicitly examine this relationship to better understand both late-life depression and frailty, and to identify intervention strategies to delay or prevent functional decline in later life.
http://dx.doi.org/10.1016/j.comppsych.2012.07.032
The association between parental mood/anxiety disorders and psychiatric symptoms and disorders in young adult offspring N.C.P. Low a, E. Dugas a, E. Constantin a, I. Karp a, D. Rodriguez b, J. O'Loughlin a a Montréal, Québec, Canada b Philadelphia, PA Background: Mood/anxiety disorders affect up to 15%–20% of adolescents/young adults. Parental history of the disorders is the strongest risk factor for the disorders. This study tested if maternal or paternal history of mood/anxiety disorders increases the risk of mood disorders, anxiety disorders, or symptoms of specific anxiety disorders, in offspring. Methods: Data were from the Nicotine Dependence in Teens Study, a prospective population-based cohort. Data used in this analyses were from self-reports when participants were aged 20.4 years and from parental selfreports. This analysis pertains to 565 participants with maternal and/or paternal data. The association between maternal and paternal history and each of diagnosed anxiety disorder, diagnosed mood disorder, and specific anxiety disorder symptoms in offspring was studied in multivariate logistic regression. Results: More mothers than fathers had been diagnosed with a mood/ anxiety disorder (23% versus 12%). 14% of female offspring had a diagnosed mood/anxiety disorder, compared to 6% of male offspring. The adjusted OR (95% CI) for maternal history was 2.2 (1.1, 4.5) for diagnosed mood disorders, 4.0 (2.1, 7.8) for diagnosed anxiety disorders, and 2.2 (1.2, 4.0) for social phobia symptoms. Paternal history was not associated with any of the mental health outcomes in offspring. Conclusion: Maternal disorders were associated with diagnosed psychiatric disorders, as well as symptoms of specific anxiety disorders, in offspring. Efforts to detect offspring anxiety in those with a maternal mood/anxiety disorder history should be encouraged.
http://dx.doi.org/10.1016/j.comppsych.2012.07.033
Reactions to research participation in victims of childhood sexual abuse: a comparison of court-substantiated and retrospectively self-reported cases C. Massey, C.S. Widom New York, NY Objective: To determine whether adults with a history of childhood sexual abuse (CSA) report more negative reactions to research participation,
http://dx.doi.org/10.1016/j.comppsych.2012.07.027
The impact of paternal and maternal depression on internalizing and externalizing disorders among offspring R.H. Jacobs, V. Warner, M.M. Weissman New York, NY The negative sequelae of maternal depression on offspring have been well documented, but few studies have examined the independent impact of paternal depression. We examine rates of internalizing mental health disorders (major depressive disorder and anxiety disorders) in youth, stratified by gender of depressed parent in a longitudinal family study. We also examine differences over the course of adolescent development. Relative risk ratios and confidence intervals were calculated in predicting youth disorder (depression or anxiety) from parental depression in a sample offspring. Both maternal and paternal depression increased the likelihood of internalizing disorders among youth. Youth with depressed fathers had an increased risk of MDD (n=99; RR, 1.7; 95% CI, 1.1–2.6; P=.02) and anxiety (n=94; RR, 1.9; 95% CI, 1.2–3.2; P=.01) when compared to youth with nondepressed fathers. Analyses on age of child at onset of paternal depression implicate early adulthood as a critical period, specifically age 18 or over (RR, 2.0; 95% CI, 1.1–3.6; P=.02); whereas a differential effect by age was not detected in the case of maternal depression. Interestingly, paternal MDD did not significantly impact youth younger than 13. This research suggests that depression in fathers independently impacts disorder in their offspring, particularly later in their adolescence (i.e., after age 18). Future research can examine whether pubertal status interacts with the sex of the affected parent in predicting onset of disorder in offspring. Funded by NIMH 5R01MH036197, 5P50MH090966, and 5T32MH016434. http://dx.doi.org/10.1016/j.comppsych.2012.07.028
A prospective study to assess the relation between different traumatic events and the risk of six physical health conditions in a population-based sample K.M. Keyes a, K. McLaughlin a, R. Demmer a, M. Cerda a, K. Koenen a, M. Uddin b, S. Galea a a New York, NY b Ann Arbor, MI Introduction: Traumatic event experiences are associated with increased risk for psychiatric disorders. Although a relation between traumatic event exposure and adverse physical health has also been documented, few studies have examined the associations between a range of potentially traumatic events and physical health conditions in the same study. This research is critical to understand the role of the social environment in the production of
E5
physical health conditions, and to clarify the processes by which psychiatric and physical health disorders co-occur. Methods: Data were drawn from the Detroit Neighborhood Health Study, a community sample of predominately African Americans living in Detroit, MI interviewed in 2008–2009 (N=1547) and again prospectively in 2009– 2010 (N=1054). Kaplan Meier and Cox proportional hazards models were used to assess whether number and type of traumatic events experienced were associated with the hazard of five self-reported physical health conditions: cardiovascular disease, arthritis, diabetes, atrial fibrillation, and respiratory disease. Results: We observed a monotonic dose–response relationship between number of traumatic events experienced and arthritis risk. Compared to those who reported no lifetime traumatic events, respondents with 1–2, 3–4, 5–7, and 8+ traumatic events had 1.07, 1.12, 1.74, and 2.44 times the hazard of arthritis, controlling for socio-demographics, post-traumatic stress disorder, depressive symptoms, binge drinking, and smoking. Assaultive violence (HR=1.7, 95% CI 1.3–2.3) and other threats to physical integrity (HR=1.5, 95% CI 1.1–2.1) were particularly robust risk factors for arthritis. There was a suggestion of a relation between traumatic events and cardiovascular disease, although the association was unstable. We found no evidence for an association between traumatic events and diabetes, atrial fibrillation or respiratory disease nor with the total number of physical health conditions. Conclusion: These results provide novel evidence linking traumatic events, particularly those involving violence and threat to life, to elevated risk for arthritic conditions. This suggests that some mental and physical health conditions may share traumatic event experience as a common cause, illuminating one pathway through which adverse mental and physical health become comorbid. Identifying biologic mechanisms underlying both mental and physical health phenotypes, such as inflammatory pathways, is an important goal for future research.
http://dx.doi.org/10.1016/j.comppsych.2012.07.029
Further evidence for the differential familial aggregation of agoraphobia and panic disorder S. Knappe a, A. Nocon b, K. Beesdo-Baum a, H.U. Wittchen a,b Dresden, Germany b Munich, Germany a
Background: Over the past 30 years, Agoraphobia (AG) and Panic Disorder (PD) have been included in our diagnostic systems. The relationship between the two disorders is however controversial, particular with regard to the question of whether AG exists as a discrete diagnostic entity apart from PD. Studies on the patterns of familial aggregation of AG and PD may help to elucidate differential pathogenetic mechanisms involved in either disorder. Findings from family and genetic studies are nonetheless conflicting due to hierarchical rules of diagnostic criteria and diverging assessment strategies. Given the significance of this issue in relation to the up-coming DSM-5 revision, convincing evidence for the position of AG relative to the panic/anxiety-spectrum is needed, and therefore also other anxiety disorders should be taken into account to picture homotypic and heterotypic familial transmission pathways. Methods: Familial transmission of panic attacks (PA), PD and AG was examined in a 10-year prospective-longitudinal community study of 3021 adolescents and young adults including completed direct and indirect information on parental psychopathology. Standardized diagnostic assessments using the Munich-Composite International Diagnostic Interview allowed generating exclusive diagnostic groups irrespective of diagnostic hierarchy rules. Associations between cumulated lifetime parental and offspring psychopathology (up to age 34) were assessed with odds ratios (ORs) from logistic regressions, controlled for offspring age and gender, and for other offspring anxiety disorders. Results: Rates for parental PA, PD without AG and AG without PD were 8.8%, 4.1% and 3.9%. In offspring up to age 34, observed lifetime rates for PA, PD without AG, and AG without PD were 9.4%, 1.6% and 3.3%, respectively.
E6
Abstracts / Comprehensive Psychiatry 54 (2013) E1–E14
PD, but not AG aggregates in families: Parental PD without AG was associated with an increased risk for PA and PD+AG (OR range 2.7–3.9, Pb.05), but not for AG without PD or PD without AG in offspring. Parental AG without PD and parental PD+AG were not associated with the offsprings’ risk for PA, exclusive PD or AG or PD+AG. Additionally, associations between parental specific phobias and parental generalized anxiety disorder with offspring AG without PD emerged (OR range 3.1–3.5, Pb.05). All findings were largely unaffected by adjustment for other offspring anxiety disorders. Conclusions: We found no indication that AG without the involvement of PA/PD aggregates in families; moreover, etiological pathways for offspring AG are likely heterotypic and probably different from those for PA and PD — providing further evidence for the independence of AG apart from the PD-spectrum.
http://dx.doi.org/10.1016/j.comppsych.2012.07.030
Maternal depression and parenting: associations with HPA axis reactivity in early childhood K.R. Kryski, H.J. Smith, H.I. Sheikh, S.M. Singh, E.P. Hayden Western Ontario, Canada While activation of the hypothalamic–pituitary–adrenal (HPA) axis is an adaptive response to stress, HPA axis reactivity is excessive in many individuals with depressive and anxiety disorders (Gunnar & Talge, 2005; Risbrough & Stein, 2006) and is likely an important marker of childhood vulnerability to psychopathology (Belsky & Pluess, 2009). With respect to the development of HPA axis reactivity, a family history of depression may be an important marker of vulnerability to early adverse experiences (Ashman et al., 2002), which may together shape the developing HPA system. This study tested this model in 122 three-year-old children (72 girls; 58.5%) and their caregivers. Maternal depression history, obtained from structured clinical interviews, and ratings of observed parenting by the child's primary caregiver were examined as predictors of child cortisol reactivity. Cortisol samples were obtained at baseline and at 5 time points following a standardized stress task tapping responses to social evaluation. For children with maternal depression history, greater parent hostility was associated with a significantly higher baseline cortisol level, higher slope, and slower rate of quadratic curvature, suggestive of greater cortisol reactivity and a slower recovery. Low parental sensitivity was associated with higher baseline cortisol for children with a family history of maternal depression compared to children without this history. Results indicate that early parenting may exacerbate the risk associated with maternal depression history by heightening children's cortisol reactivity in early childhood. http://dx.doi.org/10.1016/j.comppsych.2012.07.031
Construct overlap between depression and frailty in later life: evidence from the health and retirement study M. Lohman, B. Mezuk Richmond, VA Background: In epidemiologic research, late-life depression and frailty are often conceptualized and modeled as independent constructs despite having shared risk factors and consequences. Ignoring the interrelationships between depression and frailty may lead to false inferences about the relative importance of these syndromes for morbidity, disability, and mortality. The goal of this study was to use confirmatory latent class analysis to examine the joint relationship between the constructs of depression and frailty among community-dwelling older adults. Method: Data come from the 2008 wave of the Health and Retirement Study, a nationally-representative sample of adults over the age of 50. Analysis is limited to participants 65 and older with complete data on depressive symptoms and frailty indicators (N=3665). Depressive symptoms were indexed by the 8-item Centers for Epidemiologic Studies
Depression (CES-D) scale, and frailty was indexed by modified Fried criteria (i.e., low weight, inactivity, slowness, exhaustion, and weakness). Latent class analysis was used to model the depression and frailty constructs, and latent Kappa coefficients were estimated from competing models to assess the chance-corrected agreement between depression and frailty. Results: Latent class analyses suggested that depression and frailty could best be modeled as distinct syndromes, each with 3 classes. In the joint modeling of depression and frailty latent constructs, 13.0% of participants were classified as high depressive symptoms, 19.0% as mild, and 68.0% as low depressive symptoms. Regarding frailty, 18.2% were classified as severely frail, 18.5%, as mild, and 63.3% with low frailty symptoms. A latent Kappa statistic representing chance-corrected agreement between depression and frailty indicated substantial construct overlap (Кl: 0.56, 95% CI: 0.53–0.59). Conclusion: Findings suggest that late-life depression and frailty, as commonly defined in epidemiologic research, are substantially interrelated constructs and identify overlapping populations of older adults. Future research should explicitly examine this relationship to better understand both late-life depression and frailty, and to identify intervention strategies to delay or prevent functional decline in later life.
http://dx.doi.org/10.1016/j.comppsych.2012.07.032
The association between parental mood/anxiety disorders and psychiatric symptoms and disorders in young adult offspring N.C.P. Low a, E. Dugas a, E. Constantin a, I. Karp a, D. Rodriguez b, J. O'Loughlin a a Montréal, Québec, Canada b Philadelphia, PA Background: Mood/anxiety disorders affect up to 15%–20% of adolescents/young adults. Parental history of the disorders is the strongest risk factor for the disorders. This study tested if maternal or paternal history of mood/anxiety disorders increases the risk of mood disorders, anxiety disorders, or symptoms of specific anxiety disorders, in offspring. Methods: Data were from the Nicotine Dependence in Teens Study, a prospective population-based cohort. Data used in this analyses were from self-reports when participants were aged 20.4 years and from parental selfreports. This analysis pertains to 565 participants with maternal and/or paternal data. The association between maternal and paternal history and each of diagnosed anxiety disorder, diagnosed mood disorder, and specific anxiety disorder symptoms in offspring was studied in multivariate logistic regression. Results: More mothers than fathers had been diagnosed with a mood/ anxiety disorder (23% versus 12%). 14% of female offspring had a diagnosed mood/anxiety disorder, compared to 6% of male offspring. The adjusted OR (95% CI) for maternal history was 2.2 (1.1, 4.5) for diagnosed mood disorders, 4.0 (2.1, 7.8) for diagnosed anxiety disorders, and 2.2 (1.2, 4.0) for social phobia symptoms. Paternal history was not associated with any of the mental health outcomes in offspring. Conclusion: Maternal disorders were associated with diagnosed psychiatric disorders, as well as symptoms of specific anxiety disorders, in offspring. Efforts to detect offspring anxiety in those with a maternal mood/anxiety disorder history should be encouraged.
http://dx.doi.org/10.1016/j.comppsych.2012.07.033
Reactions to research participation in victims of childhood sexual abuse: a comparison of court-substantiated and retrospectively self-reported cases C. Massey, C.S. Widom New York, NY Objective: To determine whether adults with a history of childhood sexual abuse (CSA) report more negative reactions to research participation,