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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by SLS on October 12, 2013, at 5:28:19
The etiologies of a portion of psychiatric illnesses include childhood abuse and neglect. It is proposed that these ecophenotypes are different in presentation and treatment response.
- Scott-----------------------------------------
Am J Psychiatry. 2013 Oct 1;170(10):1114-1133.
Childhood Maltreatment and Psychopathology: A Case for Ecophenotypic Variants as Clinically and Neurobiologically Distinct Subtypes.
Teicher MH, Samson JA.
AbstractOBJECTIVE Childhood maltreatment increases risk for psychopathology. For some highly prevalent disorders (major depression, substance abuse, anxiety disorders, and posttraumatic stress disorder) a substantial subset of individuals have a history of maltreatment and a substantial subset do not. The authors examined the evidence to assess whether those with a history of maltreatment represent a clinically and biologically distinct subtype.
METHOD The authors reviewed the literature on maltreatment as a risk factor for these disorders and on the clinical differences between individuals with and without a history of maltreatment who share the same diagnoses. Neurobiological findings in maltreated individuals were reviewed and compared with findings reported for these disorders.
RESULTS Maltreated individuals with depressive, anxiety, and substance use disorders have an earlier age at onset, greater symptom severity, more comorbidity, a greater risk for suicide, and poorer treatment response than nonmaltreated individuals with the same diagnoses. Imaging findings associated with these disorders, such as reduced hippocampal volume and amygdala hyperreactivity, are more consistently observed in maltreated individuals and may represent a maltreatment-related risk factor. Maltreated individuals also differ from others as a result of epigenetic modifications and genetic polymorphisms that interact with experience to increase risk for psychopathology.
CONCLUSIONS Phenotypic expression of psychopathology may be strongly influenced by exposure to maltreatment, leading to a constellation of ecophenotypes. While these ecophenotypes fit within conventional diagnostic boundaries, they likely represent distinct subtypes. Recognition of this distinction may be essential in determining the biological bases of these disorders. Treatment guidelines and algorithms may be enhanced if maltreated and nonmaltreated individuals with the same diagnostic labels are differentiated.
PMID:
23982148
[PubMed - as supplied by publisher]
Posted by sigismund on October 13, 2013, at 16:42:07
In reply to Childhood Maltreatment and Psychopathology, posted by SLS on October 12, 2013, at 5:28:19
Talking about neglect, in particular affectionate touch.....in the 70's in Queensland a man was found with records of sex with more than a thousand underage adolescent boys not one of whom had complained.
Which raises questions the more you think about it.
Did they want to complain but felt they could not?
Had they been deprived of intimacy and friendly touch for years on end?
Cold culture for boys back then here? Too much sink or swim?Questions that come to mind.
Posted by sigismund on October 13, 2013, at 16:44:59
In reply to Re: Childhood Maltreatment and Psychopathology, posted by sigismund on October 13, 2013, at 16:42:07
Make a man of him, they used to say.
This is the end of the thread.
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