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Biomedical subjects

Christine D Scher

Publications and source records attributed to Christine D Scher.

7 recordsLinked to original sources

An evaluation of screening questions for childhood abuse in 2 community samples: implications for clinical practice.

BACKGROUND: A number of practice guidelines and recommendations call for the assessment of childhood abuse in adult medical patients, but none specifies how best to do this. The objective of this study was to use evidence from 2 community-based population samples to evaluate abuse-screening questions that are often asked in medical clinics and to identify a small set of questions to improve screening practices. METHODS: The Childhood Trauma Questionnaire-Short Form (CTQ-SF) was administered in 2 randomized telephone interview surveys with adults aged 18 to 65 years. RESULTS: A total of 880 (2003 survey) and 998 (1997 survey) respondents completed the CTQ-SF in the 2 surveys. In both surveys, the rates of physical (16% and 15%), emotional (31% and 29%), and sexual (10% and 9%) abuse elicited using 3 behaviorally descriptive items in each abuse category were approximately twice the rates elicited using the explicit labeling terms physically abused (8% and 8%), emotionally abused (15% and 13%), or sexually abused (5% and 5%) (P<.001 for each). Inquiries explicitly using the labeling term abuse successfully identified a low percentage of respondents who reported behaviorally described abusive experiences for each type of abuse (34%-51%). In addition, after adjustment for the number and frequency of abusive experiences in both surveys, women were more likely than men to label themselves as explicitly abused for any abuse (odds ratio [OR], 1.7; P = .11 and OR, 2.8; P<.01), physical abuse (OR, 2.1; P = .14 and OR, 2.9; P<.01), emotional abuse (OR, 2.7; P<.01 and OR, 3.3; P<.01), and sexual abuse (OR, 3.5; P = .08 and OR, 1.5; P = .55). CONCLUSION: Inquiries about childhood abuse that use broad labeling questions identify a substantially smaller number of patients than behaviorally specific questions and may be less effective in initial screening for a history of abuse.

Adolescent↗

Cognitive reactivity and vulnerability: empirical evaluation of construct activation and cognitive diatheses in unipolar depression.

Cognitive vulnerability is a central concept in cognitive theories of unipolar depression. This idea suggests that negative cognitive factors emerge during stressful situations, and that this cognitive reactivity is critical for the onset, relapse, and recurrence of depression. The number of empirical investigations that model the diathesis-stress nature of cognitive reactivity has substantially increased within the last decade. This review examines this literature, with a focus on priming and longitudinal designs. Extant research supports the concept of cognitive vulnerability to depression among adults, and support is accruing for the validity of this concept among children. Research that examines direct links between cognitive vulnerability and depression onset, relapse, and recurrence and the attachment origins of cognitive vulnerability is also accruing, although at a slower pace.

Cognition Disorders↗

Cognitive mediation of childhood maltreatment and adult depression in recent crime victims.

Childhood maltreatment has been linked to adult depressive disorders. However, few studies have examined mechanisms through which childhood maltreatment may contribute to adult depression. Thus, we examined the role of one potential mechanism of this relationship, maladaptive cognitions, in a recently traumatized sample. Participants were adult women who had been recently raped (n = 133) or physically assaulted (n = 73). We examined whether maladaptive self-and other-cognitions mediated relationships between childhood sexual, physical, and emotional abuse and current depression. Relationships between childhood sexual abuse and both current depression symptoms and diagnosis were mediated by maladaptive cognitions about self. Relationships between both childhood sexual abuse and childhood physical abuse and adult depressive symptoms were mediated by maladaptive cognitions about others.

Journal Article↗

Hopelessness as a risk factor for post-traumatic stress disorder symptoms among interpersonal violence survivors.

Post-traumatic stress disorder often co-occurs with depression, and they may share common risk factors. One possible common cognitive risk factor is hopelessness. Thus, we examined whether hopelessness was related to symptoms of post-traumatic stress disorder. Participants were 202 female survivors of interpersonal violence. Relationships between self-reported and interviewer-rated measures of hopelessness gathered at 2 weeks post-trauma and self-reported and interviewer-rated symptoms of post-traumatic stress disorder gathered at 2 weeks and 3 months post-trauma were examined. Hierarchical, simultaneous regression analyses that co-varied trauma type revealed that hopelessness was related to self-reported symptoms of post-traumatic stress disorder, both concurrently and prospectively. Follow-up analyses revealed that relationships between hopelessness and symptoms of post-traumatic stress disorder were due almost entirely to shared variance with depression. No relationships were found between hopelessness and interviewer-rated symptoms of post-traumatic stress disorder.

Adolescent↗

Prevalence and demographic correlates of childhood maltreatment in an adult community sample.

PURPOSE: This study had two aims: (1) to determine the prevalence of five categories of retrospectively reported childhood maltreatment in an adult community sample and (2) to examine relationships between three theoretically and practically chosen demographic variables and childhood maltreatment. METHOD: Participants were a representative sample of 967 adult men and women in the metropolitan Memphis, Tennessee area. They completed a telephone survey that included a reliable, valid questionnaire assessing five types of childhood maltreatment (i.e., emotional abuse, emotional neglect, physical abuse, physical neglect, and sexual abuse) and demographic questions. Simultaneous logistic regression analyses were used to identify demographic correlates of specific trauma types. RESULTS: Prevalence of childhood maltreatment ranged from approximately 30% for women to over 40% for men. Approximately 13% of participants reported multiple forms of maltreatment. The most common forms of trauma for both men and women were physical abuse, physical neglect, and emotional abuse, all of which were highly likely to co-occur. Race, sex, and current educational level were each associated with an increased likelihood of childhood maltreatment; differential relationships with particular maltreatment types were also observed. IMPLICATIONS: These findings highlight the importance of research on the prevalence of and risks for multiple types of childhood maltreatment, particularly in the somewhat neglected area of emotional abuse and neglect. These findings can be used to highlight the need for preventive interventions aimed at the negative sequelae of childhood maltreatment and to tailor preventive interventions to the needs and expectations of those at high risk.

Adult↗

Developmental antecedents of anxiety sensitivity.

Anxiety sensitivity (AS) has been implicated in the etiology of anxiety and depressive disorders. Nonetheless, little is known about the developmental antecedents of AS or about its role as a mediator of emotional distress. To investigate these issues, 249 university students completed a battery of self-report measures. Regression analyses and partial correlations were used to evaluate hypotheses. Analyses revealed that exposure to parental threatening, hostile, and rejecting behaviors (1) predicted overall AS and (2) appeared differentially related to AS factors. Additionally, AS acted as a mediator between parenting and both current emotional distress and history of emotional disorder symptoms. These data support the notion that parental behaviors hypothesized as etiologic in the development of emotional disorders may also be etiologic in the development of AS and that AS may serve as a mediator between childhood experience and emotional distress.

Adolescent↗

The Parent Threat Inventory: development, reliability, and validity.

OBJECTIVE: The goal was to develop a retrospective inventory of parental threatening behavior to facilitate a better understanding of such behavior's role in the etiology of psychological distress. METHOD: Inventory items were developed based on theory and 135 students' responses to a question eliciting examples of threatening parental behavior. Following item development, two additional student samples (n = 200 and n = 603) completed batteries of self-report measures. Responses were used to eliminate unstable or redundant items from the inventory and to examine the inventory's psychometric properties. RESULTS: Factor analysis of the inventory revealed three factors, accounting for 66.2% of variance; this factor structure is compatible with theory, and consistent across maternal behavior scores, paternal behavior scores, and combined maternal and paternal scores. Cronbach's coefficient alphas indicated acceptable internal consistency; Pearson correlation coefficients indicated acceptable 4-week test-retest reliability. Moderate intercorrelations with two retrospective measures of childhood experiences suggested construct validity. Regression analyses demonstrated the ability of the inventory to predict both anxious and depressive symptomatology and lifetime symptoms of anxiety and depressive disorder. Normative data on combined parent scores, maternal scores, and paternal scores are also presented. CONCLUSIONS: Initial psychometric testing of the Parent Threat Inventory (PTI) suggests it is a reliable and valid tool for investigating the developmental antecedents of adult psychological distress. Further research should focus on addressing two limitations: (1) lack of normative and psychometric data on men and women suffering from clinical disorders, and (2) lack of validation by parental reporting.

Adolescent↗