Attachment Style and Early Maladaptive Schemas as Mediators of the Relationship between Childhood Emotional Abuse and Intimate Partner Violence

Theoretical and empirical research suggests possible pathways between women's experiences of childhood emotional abuse (CEA) and later intimate partner violence victimization (IPV-V) and perpetration (IPV-P), including attachment style and early maladaptive schemas. This study tested a model examining the unique mediating effects of insecure attachment and early maladaptive schemas on the relationship between CEA and IPV-V (n?=?396) or IPV-P (n?=?409) in college women. Contrary to hypotheses that both attachment style and maladaptive schema endorsement would mediate the relationship between CEA and IPV-V and IPV-P, regression analyses indicated the disconnection/rejection schema domain was the only significant mediator between CEA and IPV-V (p = .01). This same relation held for childhood emotional abuse and IPV-P (p < .001). These findings provide preliminary clinical utility for examining schema endorsement, the use of schema therapy (Young, Klosko, &; Weishar, 2003 Young, J. E., Klosko, J. S. and Weishar, M. E. 2003. Schema therapy: A practitioner's guide, New York: NY: Guilford.  [Google Scholar]), or both with women who have emotional abuse and IPV histories.     

Intergenerational Transmission of Trauma: The Mediating Role of Parenting Styles on Toddlers' DSM-Related Symptoms

Although the intergenerational transmission of trauma has been well documented, the pathways by which trauma symptoms are passed between parents and children remain unclear. This study examined the mediating role of parenting styles in the transmission of maternal trauma to children. Participants were a sample of 105 mothers of toddlers (18–30 months old). Mothers who had experienced interpersonal trauma were more likely to have an authoritarian parenting style, including verbal hostility, physical coercion, and low nurturance. Verbal hostility especially predicted more prevalent and increasing toddler symptoms associated with affective, hyperactive, and oppositional defiant disorders. Thus, the verbal hostility component of authoritarian parenting could serve as a major intergenerational pathway between maternal trauma and early child symptoms.     

Developmental Trauma Disorder: A Provisional Diagnosis

Developmental trauma disorder is a provisional disorder that characterizes multiple trauma exposure that impairs certain domains of human development. These domains are attachment, cognition, behavior regulation, affect regulation, self-concept, dissociation, and biological functioning and maturation. This article reviews the literature and discusses the present understanding of these 7 domains. It discusses the effects of developmental trauma exposure on each domain and alludes to the importance of clinicians understanding the complexity and diversity of development trauma outcomes.     

Meeting Survivors Where They Are: The Vital Role of Trauma-Informed and Competent Clinicians in Primary Care

For adult survivors of adverse childhood experiences, primary care is the entryway to treatment of post-traumatic stress disorder (PTSD). It is estimated 25% of adult primary care patients have PTSD, and they present to their provider more often with pain and non-specific physical symptoms rather than mental health issues. Physicians, even those somewhat knowledgeable about trauma and PTSD, are unlikely to assess for it in order to avoid issues they may not have the time and/or skills to sufficiently address. This is due to PTSD treatment not being a core training competency in graduate-level education and professional training being timely and expensive. Usual care for PTSD consists of medication to manage symptoms and a referral to a mental health clinician. However, substantial disparities and patient, provider, and delivery system-level barriers means survivors are unlikely to follow-through with referrals nor receive adequate treatment when they do. In this theoretical article, we review the trials and tribulations experienced by research teams and argue what is lacking is trauma-informed care. None of the trials reviewed mentioned trauma-informed care as a component of their intervention nor as a recommendation for future studies. We also outline a host of recommendations for best practice protocols that benefit patients and the collaborative care teams meeting them where they are. Trauma-informed care deepens the focus on relational, physiological, and physical safety. Attention to soothing physiological arousal through the physician-patient-clinician triad creates more positive associations toward moving forward in treatment for survivors and providers.     

Self-reported Diabetes Prevalence and Risk factors in South Africa: Results from the World Health Survey

Using the data from the South African World Health Survey (WHS), the current study aims to assess the self-reported prevalence of diabetes and associated risk factors by socio-economic characteristics in South Africa. A population-based survey of 2314 participants (1116 men and 1236 women) was conducted in South Africa in 2003. Results indicate an overall self-reported diabetes prevalence of 9.1%, 7.1% for men and 10.8% for women. In terms of diabetes risk factors, high rates of overweight or obesity (58.4%), physical inactivity (55.2%), less than 5 servings of fruits and vegetables in a day (69.3%), and medium or high stress levels (63.3%) were found; 18.4% were smoking daily and 7.3% were risky drinkers. Univariate regression analyses found that from the six different risk factors none apart from having high stress were associated with the occurrence of diabetes. Greater age was associated with obesity and inversely associated with insufficient consumption of fruits and vegetables. Daily smoking and being physically inactive were inversely associated with risky drinking. Low socioeconomic background was associated with unhealthy diet, physical inactivity and stress.     

The relation of the conceptual self to recent and distant autobiographical memories

Based on the self-memory system model (SMS; Conway, Singer, & Tagini, 2004) of autobiographical memory, this study uses a large sample of young and middle-aged adults to investigate the relation between individuals’ current self-characteristics and the content of both their earliest childhood memory and a recent memory. In the first session, participants’ current self-characteristics were assessed. In the second session, individuals provided a written narrative of their earliest childhood memory and a more recent memory (within-participants design) and rated the self themes present in each memory. In keeping with the SMS model, findings show that current self-characteristics were reflected in individuals’ memories. As predicted, however, recent memories were more frequently linked to current self-characteristics than were earliest memories. All six current self-characteristics predicted the inclusion of these themes in recent memories, but only four self-characteristics were associated with memory themes in earliest memories. The relation between current self-characteristics and memory themes did not differ across young and middle-aged adults, suggesting developmental stability in these relations. Findings provide general support for the SMS model but also suggest possibilities for its extension and refinement.     

利拉鲁肽与甘精胰岛素治疗初诊2型糖尿病的疗效及安全性比较

试验以对比利拉鲁肽与甘精胰岛素分别联合二甲双胍对初诊为2型糖尿病患者血糖控制效果及其安全性为目的.将60例初诊为2型糖尿病患者随机分为两组,予以利拉鲁肽(1.2u/d)及甘精胰岛素(0.3u/kg·d)分别联合二甲双胍(1g,Bid)治疗8周,比较治疗前后的血糖、糖化血红蛋白等指标.结果显示两组治疗后血糖、糖化血红蛋白均明显减低(P＜0.05);利拉鲁肽组低血糖发生率明显低于甘精胰岛素组(P＜0.05);而该组治疗后体重及收缩压下降,与胰岛素组有明显差异(P＜0.05).故对糖尿病患者,利拉鲁肽与甘精胰岛素同样有效控制血糖,而利拉鲁肽能够明显降低体重及收缩压,并且低血糖发生率更低.     

Perceptions of treatment control moderate the daily association between negative affect and diabetes problems among adolescents with type 1 diabetes

Perceived control over diabetes may serve to buffer the relationship between adolescents’ experience of daily negative affect and daily problems with diabetes. In a daily diary study including 209 adolescents (ages 10.5–15.5) with type 1 diabetes, we examined how daily affect related to daily fluctuations in experience of diabetes problems, and whether perceptions of control moderated these daily associations. Using hierarchical linear modelling, we found that day-to-day experiences of negative affect were associated with more frequent daily diabetes problems. Perceptions of treatment control moderated associations between negative affect and number of problems; negative affect was more strongly associated with number of problems among teens perceiving lower versus higher treatment control over their illness. The same pattern of association was not apparent for personal control. Results suggest that perceived treatment control may help to buffer detrimental associations between negative affect and adolescents’ ability to successfully manage their diabetes.     

Individual Growth Curve Modeling of Specific Risk Factors and Memory in Youth with Type 1 Diabetes: An Accelerated Longitudinal Design

Objective: To examine if diabetes risk factors disrupt memory score trajectories in youth with T1D over three years with a powerful accelerated longitudinal method and individual growth curve modeling. Methods: Participants aged 9–17 completed memory measures at study enrollment and two years later. Results: Poorer metabolic control over the course of the study related to a significant decrease in visual memory scores. Compared to baseline, these youth scored 1.99 points lower at follow-up. Generally appropriate developmental gains were made in memory trajectories and girls' visual and verbal memory improved more than boys. No significant effects of disease duration, age of onset, or severe hypoglycemia were found on visual or verbal memory over three years time. Conclusions: Of the risk factors studied, only poorer metabolic control had a significant impact upon visual memory after three years. Verbal memory was unaffected. However, given that level of metabolic control tends to remain relatively consistent over time, the effect of continued poorer metabolic control on memory should be monitored.     

Predictors of Diabetes Self‐care,Metabolic Control,and Mental Health in Youth with Type 1 Diabetes

The purpose of this study was to explore the psychosocial predictors of diabetes self‐care (adherence to care regimes), metabolic control (glycated haemoglobin), and mental health among rural‐ and urban‐dwelling youth with type 1 diabetes. One hundred and twenty three adolescents/young adults (aged 13?25 years, mean = 16 years, standard deviation = 3.8 years) with type 1 diabetes, 50 males and 73 females, completed questionnaires reporting on diabetes self‐care, metabolic control, mental health (negative affect, quality of life), risk‐taking behaviours and attitudes, diabetes self‐efficacy, community engagement, and perceived social support. No rural/urban differences were detected on key predictors or outcome variables. Structural equation modelling revealed that high diabetes self‐efficacy, lower risk behaviour, and more conservative attitudes to risk taking predicted better diabetes self‐care, which in turn predicted better metabolic control and mental health. Social support and engagement in community activities did not influence diabetes self‐care. The study has significance because both diabetes self‐efficacy and propensity towards risk behaviour are potential targets for educational and counselling interventions designed to improve diabetes self‐care regimes and resultant metabolic and mental health outcomes.