Fernanda Serpeloni

Aim: The link between violence‐related epigenetic changes and attentional problems (APs) is still not well understood. This article examines if exposure to family and community violence during childhood and adolescence may shape DNA methylation patterns associated with attention in youth. Method: This study used data from a longitudinal cohort with 500 first‐grade Brazilian students. The following measures were investigated: attention problems, family violence, and community violence. Mann–Whitney‐ U and Kruskal–Wallis were used to identify group differences and Spearman correlation to access variables associations. Top 1% CpGs were overlapped. Epigenetics analyses were performed using Epigenome‐wide association study (EWAS, 850K) and Prediction Analysis of Microarray (PAM). Linear regression models were applied to candidate genes analyses. All models used significance level at 5%. Results: AP was correlated to three types of violence (family, psychological family, and community violence). EWAS and PAM identified five genes in common: SLC43A2 , SMN1 / 2 , TPO, DTNA , and CLMN, collectively implicating neurodevelopmental, cellular homeostatic, and endocrine mechanisms. PAM successfully predicted attention problems (AP) in two models (AP alone and AP combined with physical violence). Among the selected genes, several were related to neurodevelopment and neuronal maintenance ( SMN1/2, MYT1L ); structural organization ( DTNA, CLMN ); and cellular signaling ( DTNA ) functions; and immune, metabolic, and endocrine responses ( SLC43A2 , TPO ). These alterations were associated with attention problems and exposure to family and community violence. Conclusion: Early‐life violence is biologically embedded through epigenetic modifications affecting attention, pointing to a complex interplay between environmental adversity and gene regulation. Integrative prevention strategies targeting psychosocial/molecular pathways of vulnerability are needed.

Although exposure to violence has been linked to executive functioning impairments, the biological mechanisms underlying this association remain unclear. This study examined CpG sites associated with executive functions in 78 young adults and their links to family (psychological and physical) and community violence during childhood. The scales used were Conflict Tactics (family violence); Things I Have Seen and Heard (community violence); Barkley Deficits in Executive Functioning. Mean differences (Mann–Whitney‐ U /Kruskal–Wallis) and Spearman correlations were assessed. An epigenome‐wide association study identified differentially methylated CpGs, and linear regressions examined associations with violence exposures. Girls reported more family and psychological violence. Black participants experienced higher family violence. Executive dysfunction (ED) correlated with psychological family and community violence, and family violence forms were interrelated. Differentially methylated positions highlighted genes tied to key biological processes: MRGPRD (sensory neurons development); DPPA3 (germ‐cell development); UNKL (cell differentiation); GPR6 (learning and memory); DUSP5 (cell proliferation and differentiation); and CAPN13 (signal transduction, cytoskeletal remodeling and cell differentiation). Candidate gene analysis found associations between executive dysfunction and methylation levels in these genes. Exploratory pathway analysis suggested enrichment of neurodevelopment and synaptic plasticity, intracellular trafficking and cytoskeletal remodeling, genome stability and cellular stress responses, and neuroimmune and inflammatory signaling. These findings suggest associations between ED, childhood violence exposure, and differential DNA methylation in cognition‐ and health‐related genes, suggesting that epigenetic markers may be associated with pathways linking early adversity to later outcomes, although no causal inference can be drawn.

Background: The Russian invasion of Ukraine has resulted in forced displacement, with over six million Ukrainian refugees across Europe, of whom 81,770 are residing in Norway. This displacement and, in many cases, preceding war experiences, has led to increased vulnerability to trauma and mental health challenges. There is to date little knowledge about the extent to which structured mental health interventions can mitigate symptoms in Ukrainian refugees. Narrative Exposure Therapy (NET), a short-term trauma-focused intervention, has demonstrated efficacy in reducing post-traumatic stress disorder (PTSD), depression and dissociation symptoms among individuals exposed to organized violence and war.Aim: The protocol aims to assess the clinical effects of NET on PTSD, dissociation, and depression symptoms among Ukrainian refugees in Norway and to facilitate training and supervised praxis for Ukrainian health professionals in using NET.Methods: This study employs a pretest-posttest randomized controlled experimental design (RCT). Ukrainian health workers in Norway will receive a total of 450 hours of NET training through an online course. As a part of the training, they will, under supervision, administrate NET to Ukrainian refugees. Participants will be screened and assessed at three time points: baseline, immediately after treatment, and at a 6-month follow-up. Validated instruments in Ukrainian and Russian will be used to assess trauma experiences, symptoms, and comorbidities. Exclusion criteria: active psychotic spectrum disorders, neurodevelopmental disorders and concurrent trauma therapy. The study also contains an embedded qualitative sub study that will involve phronetic iterative thematic analysis of anonymized therapy narratives collected during NET sessions, aiming to understand how participants construct meaning from traumatic events, how narrative coherence evolves throughout therapy, and how identity reconstruction occurs post-trauma.Trial registration: ClinicalTrials.gov identifier: NCT07062042..

Resumo Este artigo reflete sobre os desafios e as particularidades do trabalho em saúde mental e atenção psicossocial em desastres, tomando como referência as inundações do Rio Grande do Sul, especialmente as de 1941 e 2024. Entre relatos pessoais, memórias transgeracionais e experiências profissionais, analisa-se como os desastres ultrapassam o impacto imediato e se inscrevem na memória, afetando práticas cotidianas, vínculos comunitários e dinâmicas intergeracionais. Argumenta-se que, diante das crises climáticas, a resiliência comunitária, embora essencial, não é suficiente sem políticas públicas robustas, éticas e intersetoriais que enfrentem desigualdades estruturais. Tecnicamente, defende-se o fortalecimento das redes comunitárias como base do cuidado, em consonância com a Gestão Integral de Riscos e Desastres, ressaltando a responsabilidade do poder público em garantir recursos e gestão qualificada. Conclui-se que enfrentar desastres exige reconhecer e fortalecer as narrativas, memórias e práticas comunitárias que sustentam a vida, garantindo dignidade, pertencimento e justiça socioambiental.

The Brazilian Journal of Psychiatry is the official publication of Brazilian Psychiatric Association (Associação Brasileira de Psiquiatria - ABP)

Introduction: While several studies have examined the relationship between adverse social exposures and epigenetic mechanisms, the association between DNA methylation, resilience, protective factors and factors that promote positive outcomes remains underexplored. Goals: This study aims to analyse scientific publications on epigenetics, specifically focusing on DNA methylation in relation to resilience and individual/social protective/positive factors. Method: A scoping review was conducted using the descriptors DNA methylation, resilience, self‐esteem, emotional regulation, social support and social and emotional functioning, covering the years 2008–2019. The databases used included Web of Science, PubMed and Embase. The analysis included 110 articles, reviewed for identification and profile, article focus, objectives, epidemiological and epigenetic methods, protective/positive factors and impacts on physical and mental health. Results: There has been a significant, gradual increase in publications over the years, particularly regarding epidemiological studies involving human participants. Most studies utilized a candidate gene approach to assess DNA methylation, while broader genome‐wide methylation profiles were less frequently examined. Histone modifications and noncoding RNAs were also discussed, especially in review articles. Resilience was identified as the most studied topic, with analyses focusing on (1) mental disorders, (2) parental mental health, (3) early life stress, (4) biological age and development, (5) clinical and physiological conditions and (6) environmental/socioeconomic factors. A wide variety of genes associating resilience and epigenetics were pointed out, for example, NR3C1 , SLC6A4 , BDNF , and FKBP5 . Additionally, individual and social bonds and competencies such as social and emotional functioning, maternal care and social interaction among others were grouped as protective factors or that promote positive outcomes and were linked to genes such as OXTR , followed by FKBP5 and NR3C1 . Discussion: The significance of epigenetics in neuroscience and its potential public health applications is still emerging. This field invites reflection on prevention and health promotion strategies and highlights growing evidence that social inequalities, adversities and early‐life experiences may have lasting effects on gene expression throughout the lifespan.

O transtorno de estresse pós-traumático (TEPT) configura-se como um importante desafio para a saúde mental global, especialmente em contextos marcados por violência cumulativa, migração forçada e desigualdades estruturais. A Terapia de Exposição Narrativa (NET, acrônimo em inglês) é uma intervenção breve e focada no trauma, que promove a reconstrução da memória autobiográfica por meio da narrativa cronológica dos eventos de vida. Ao possibilitar a integração de experiências traumáticas fragmentadas em uma narrativa coerente, a NET facilita o processamento emocional e restaura a continuidade das histórias de vida interrompidas. Esta série de casos regionais examina a integração da NET nos sistemas de saúde mental do Brasil, República Democrática do Congo, Alemanha, Suíça, Japão, México, Reino Unido e Escandinávia. Com base em experiências diversas de implementação, o estudo identifica tanto condições favoráveis quanto desafios persistentes. Os resultados mostram que a NET é uma intervenção viável e adaptável a diferentes contextos socioculturais e níveis de recursos, especialmente quando apoiada por supervisão contínua, estratégias de deslocamento de tarefas e colaboração intersetorial. A incorporação da NET nas estruturas de serviços existentes ampliou o acesso a cuidados com enfoque no trauma baseados em evidências para populações frequentemente excluídas do tratamento especializado. Esses achados ressaltam o papel crítico de políticas públicas informadas pelo trauma na resposta às consequências da violência para a saúde mental em escala global.

Post-traumatic stress disorder represents a substantial global mental health burden, particularly in the face of cumulative violence, forced migration, and structural inequities. Narrative Exposure Therapy (NET) configures a brief trauma-focused intervention that supports the reconstruction of autobiographical memory by the chronological narration of life events. By integrating fragmented traumatic experiences into a coherent narrative, NET facilitates emotional processing and restores continuity to disrupted life stories. This regional case series examines the integration of NET into the mental health systems in Brazil, the Democratic Republic of Congo, Germany, Switzerland, Japan, Mexico, the United Kingdom, and Scandinavia. Drawing on diverse implementation experiences, the study identifies both enabling conditions and persistent challenges. Results highlight that NET is feasible and adaptable across different sociocultural and resource settings, especially when supported by sustained supervision, task-shifting strategies, and intersectoral collaboration. Embedding NET into existing service structures expanded access to evidence-based trauma care for populations often excluded from specialized treatment. These findings underscore the critical role of trauma-informed public policies in responding to the mental health consequences of violence on a global scale.

A large proportion of the world’s incarcerated population is concentrated in the Americas. Research has consistently shown that mental health disorders are more prevalent among incarcerated individuals compared to the general population. Despite this, mental health necessities in prisons are often neglected, and in the Americas, the treatment gap for mental disorders remains substantial. This study aimed to conduct a scoping review of the scientific literature on the prevalence of mental health problems among incarcerated populations in American countries, from a global mental health perspective. The search included databases such as SciELO, Embase, PubMed/MEDLINE, Web of Science, Scopus, PsycINFO, and CINAHL (EBSCO) and covered publications from 2013 to 2023 in Portuguese, English, and Spanish. The final sample comprised 42 articles, of which South American countries were the most studied, followed by North American countries, while Central America had the least representation. The focus of the studies were as follows: the prevalence of mental health problems among incarcerated populations in the Americas; the links between mental disorders, aggressive behavior, and criminal recidivism; mortality among incarcerated individuals; and stigma as a barrier to accessing mental health services. According to the outcomes, investing in mental health services is essential to provide adequate care to prisoners, which could help reduce incarceration rates. However, overcrowding in prisons across the continent poses a significant barrier to the provision of mental health treatments.

O artigo tem como objetivo refletir sobre os efeitos da violência armada sobre a saúde mental da população moradora e trabalhadora de territórios de favela, tendo como foco o estado do Rio de Janeiro, Brasil. Trata-se de um estudo teórico e crítico, com subsídio de pesquisas empíricas desenvolvidas pelas autoras a partir de uma abordagem pós-colonial, tomando como elemento central o fenômeno do racismo. Discute-se a violência armada no Rio de Janeiro, seus impactos sobre a saúde mental e algumas ações de seu enfrentamento, identificando como territórios favelizados e sua população, em sua maioria negra, estão no centro do problema, sofrendo efeitos que matam e fazem adoecer. Ainda que insuficientes, ações de enfrentamento angariadas pelo setor público e pela sociedade civil buscam dar visibilidade ao problema e ser formas de denúncia e resistência quanto aos efeitos deletérios da violência armada na saúde.