Marc Schmid

Childhood maltreatment (CM) increases the risk of lifelong mental illness, yet the underlying biochemical mechanisms remain unclear. Oxidative stress (OS), alongside inflammation, may contribute to this link. This study examined whether OS mediates the link between CM and mental health in a highly vulnerable group of formerly out-of-home placed young adults and explored associations between OS and inflammatory markers. Data were collected from 131 participants (31% women, M age = 26.29 ± 3.5 years) with histories of youth residential care. CM was assessed using the Childhood Trauma Questionnaire (CTQ), and mental health via the Achenbach System of Empirically Based Assessment (ASEBA). Biomarkers of OS (Superoxide Dismutase [SOD], Glutathione Peroxidase/Glutathione Reductase ratio [GPx/GRed]) and inflammation (Interleukin-1 Receptor Antagonist [IL-1RA], Interleukin-6 [IL-6], Interleukin-10 [IL-10], C-Reactive Protein [CRP], Tumor Necrosis Factor [TNF𝛼]) were analyzed. Multiple regression models examined associations among CM, OS, inflammation, and mental health, adjusting for covariates. Greater CM exposure was associated with poorer mental health ( b = 0.34, p < .001). Initial analyses indicated that GPx/GRed ( b = 0.20, p = .04), —but not SOD— was related to CM, particularly emotional abuse ( b = 0.21, p = .03). However, this association did not remain significant after adjusting for medication use, suggesting that medication may confound links between CM and redox biology. TNF𝛼 predicted current mental health problems ( b = 0.22, p = .02), and OS and inflammatory markers were significantly interrelated. Neither OS nor inflammation mediated the CM–mental health relationship. These findings highlight a complex interplay between CM, OS, and inflammation in young adults with histories of residential care. They underscore the importance of considering medication effects when studying redox mechanisms and indicate that further research is needed to clarify the biological pathways linking CM to long-term mental health outcomes.

Zusammenfassung: Theoretischer Hintergrund: Fremdplatzierte Kinder und Jugendliche akkumulieren verschiedene belastende Kindheitserfahrungen und potenziell traumatische Lebensereignisse (PTEs). Fragestellung: In der vorliegenden Studie wurden die Prävalenz, Kumulation und Koinzidenz sowie Geschlechtsunterschiede belastender Kindheitserfahrungen und PTEs bei ehemals fremdplatzierten jungen Erwachsenen untersucht. Methode: 211 junge Erwachsene ( M _Alter =25.9; 31.8 % Frauen) aus einer schweizweiten Kohortenstudie wurden mit Hilfe eines umfassenden psychometrischen Fragebogens zu belastenden Kindheitserfahrungen (KERF) und zu PTEs (LEC-R) befragt. Ergebnisse: Durchschnittlich wurden 3.0 unterschiedliche Arten belastender Kindheitserfahrungen und 4.5 unterschiedliche PTEs berichtet. Häufigste Formen waren das Erleben emotionaler Vernachlässigung (65.8 %) sowie das Erleben oder Bezeugen physischer Übergriffe (63.0 %). Frauen erlebten signifikant mehr belastende Kindheitserfahrungen, hingegen fanden sich keine Unterschiede bezüglich der Anzahl berichteter PTEs. Bestimmte belastende Erfahrungen traten häufig gemeinsam auf, zum Beispiel in Form von systemübergreifender Gewaltexposition in und außerhalb von Familien, als auch das Erleben von Unfällen und das Erleben von physischer Gewalt. Diskussion und Schlussfolgerung: Die Ergebnisse verdeutlichen die hohe Kumulation und Verflechtung von belastenden Erfahrungen und unterstreichen die Notwendigkeit früher und anhaltender Präventions- und Interventionsmaßnahmen.

Background: Childhood maltreatment (CM) increases the risk for psychopathology and CM type, severity and timing are considered important modulating factors in this relationship. However, reported associations are heterogeneous and hardly considered vulnerable groups broadly exposed to CM. Methods: We investigated the association between CM types and timing and psychopathology in formerly out-of-home placed young adults ( N = 185; 32% women, age mean = 26.38 years, SD = 3.49). CM was assessed using the Maltreatment and Abuse Chronology of Exposure Scale. Conditional random forest regression was used to estimate the importance of CM types (abuse, neglect, peer victimization, and sexual abuse), timing (ages 3–18), and global measures (severity, multiplicity, and duration) on adult general, internalizing, and externalizing problems (Achenbach System of Empirically Based Assessment). We validated the results using diagnoses of mental disorders clustered with the Hierarchical Taxonomy of Psychopathology model. Results: Global CM measures were stronger predictors of internalizing problems than CM type and timing. Abuse in early childhood was a stronger predictor of externalizing problems compared to global CM measures. Conclusions: Considering CM type and timing might be valuable to guide maltreatment-informed interventions in therapeutic settings.

Background: Early adversity increases the risk for mental and physical disorders as well as premature death. Epigenetic processes, and altered epigenetic aging in particular, might mediate these effects. While the literature that examined links between early adversity and epigenetic aging is growing, results have been heterogeneous.Objective: In the current work, we explored the link between early adversity and epigenetic aging in a sample of formerly out-of-home placed young adults.Method: A total of N = 117 young adults (32% women, age mean = 26.3 years, SD = 3.6 years) with previous youth residential care placements completed the Childhood Trauma Questionnaire (CTQ) and the Life Events Checklist (LEC-R) and provided blood samples for the analysis of DNA methylation using the Illumina Infinium MethylationEPIC BeadChip Microarray. Epigenetic age was estimated using Hovarth's and Hannum's epigenetic clocks. Furthermore, Hovarth's and Hannum's epigenetic age residuals were calculated as a proxy of epigenetic aging by regressing epigenetic age on chronological age. The statistical analysis plan was preregistered (https://osf.io/b9ev8).Results: Childhood trauma (CTQ) was negatively associated with Hannum's epigenetic age residuals, β = -.23, p = .004 when controlling for sex, BMI, smoking status and proportional white blood cell type estimates. This association was driven by experiences of physical neglect, β = -.25, p = .001. Lifetime trauma exposure (LEC-R) was not a significant predictor of epigenetic age residuals.Conclusion: Childhood trauma, and physical neglect in particular, was associated with decelerated epigenetic aging in our sample. More studies focusing on formerly institutionalized at-risk populations are needed to better understand which factors affect stress-related adaptations following traumatic experiences.

Childhood maltreatment and mental health problems are common among young people placed out-of-home. However, evidence on the impact of maltreatment on the course of mental health problems in at-risk populations is sparse. The aim of this longitudinal study is twofold: (a) describe the course of mental health problems and the shift in symptom patterns among adolescents in youth residential care into young adulthood and (b) assess how childhood maltreatment is related to the course of mental health problems. One hundred and sixty-six adolescents in Swiss youth residential care were followed up into young adulthood (36.1% women; M_Age-Baseline = 16.1 years; M_{Age-Follow-Up} = 26.4 years). Latent transition analysis was employed to analyze transitions of symptom patterns and their association with maltreatment exposure. We found three latent classes of mental health problems: a “multiproblem”-class (51.8% baseline; 33.7% follow-up), a “low symptom”-class (39.2% baseline; 60.2% follow-up), and an “externalizing”-class (9.0% baseline; 6.0% follow-up). Individuals in the “multiproblem”-class were likely to transition towards less-complex symptom patterns. Higher severity of self-reported childhood maltreatment was associated with more complex and persistent mental health problems. Our study underlines the need for collaboration between residential and psychiatric care systems within and after care placements, with a specialized focus on trauma-informed interventions and care.

Background: With the implementation of the 11th edition of the International Classification of Diseases (ICD-11) in early 2022, there will be a radical change in the framework and process for diagnosing personality disorders (PDs), indicating a transition from the categorical to the dimensional model. Despite increasing evidence that PDs are not as stable as previously assumed, the long-term stability of PDs remains under major debate. The aim of the current paper was to investigate the categorical and dimensional mean-level and rank-order stability of PDs from adolescence into young adulthood in a high-risk sample.Methods: In total, 115 young adults with a history of residential child welfare and juvenile-justice placements in Switzerland were included in the current study. PDs were assessed at baseline and at a 10-year follow-up. On a categorical level, mean-level stability was assessed through the proportion of enduring cases from baseline to follow-up. Rank-order stability was assessed through Cohen’s κ and tetrachoric correlation coefficients. On a dimensional level, the magnitude of change between the PD trait scores at baseline and at follow-up was measured by Cohen’s d. Rank-order stability was assessed through Spearman’s ρ.Results: The prevalence rate for any PD was 20.0% at baseline and 30.4% at follow-up. The most frequently diagnosed disorders were antisocial, borderline, and obsessive-compulsive PDs, both at baseline and at follow-up. On a categorical level, the mean-level stability of any PD was only moderate, and the mean-level stability of specific PDs was low, except of schizoid PD. Likewise, the rank-order stability of any PD category was moderate, while ranging from low to high for individual PD diagnoses. On a dimensional level, scores increased significantly for most PDs, except for histrionic traits, which decreased significantly from baseline to follow-up. Effect sizes were generally low. The rank-order stability for dimensional scores ranged from low to moderate.Conclusion: The findings indicate low to moderate stability of Pds and Pd traits from adolescence to adulthood, which supports the growing evidence that categorical diagnoses of Pds are quite unstable. This in turn, emphasizes the use of the upcoming ICD-11 that Acknowledgments Pds to be only “relatively” stable.

Childhood adversity (CA) and adulthood traumatic experiences (ATEs) are common and unequally distributed in the general population. Early stressors may beget later stressors and alter life‐course trajectories of stressor exposure. Gender differences exist regarding the risk of specific stressors. However, few studies have examined the associations between specific types of CA and ATEs. Using a large‐scale sample of older adults, we aimed to (a) determine if specific or cumulative CA increased the risk for specific or cumulative ATEs and (b) examine whether these associations were moderated by gender. In a sample from the U.S. Health and Retirement Study (N = 15,717; M_age = 67.57 years, SD = 10.54), cross‐sectional Poisson and logistic regression models were fitted to assess the specific and cumulative associations between CA and ATEs. Overall, cumulative CA was associated with a larger risk ratio of ATEs, adjusted for covariates: aRRRs = 1.28, 1.63, and 1.97 for 1, 2, and 3–4 adverse events in childhood, respectively. Cumulative CA was particularly strongly associated with adulthood physical attacks, aOR = 5.66, and having a substance‐abusing spouse or child, aOR = 4.00. Childhood physical abuse was the strongest independent risk factor for cumulative ATEs, aRRR = 1.49, and most strongly associated with adulthood physical attacks, aOR = 3.41. Gender moderated the association between cumulative CA and cumulative ATEs, with slightly stronger associations between cumulative CA and ATEs for women than men. Given that CA and ATEs perpetuate health disparities worldwide, reducing their incidence and effects should be major priorities for public health.