Research master thesis | Psychology (research) (MSc)
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Childhood maltreatment (CM) is a public health issue affecting mental and physical well-being of individuals across the lifespan. The literature so far suggests that CM is a risk factor for the...Show moreChildhood maltreatment (CM) is a public health issue affecting mental and physical well-being of individuals across the lifespan. The literature so far suggests that CM is a risk factor for the development and severity of EDs in adulthood. This study aims to build upon and update the findings of Molendijk et al. (2017) by integrating both pre-2016 and post-2016 literature on the relationship between all types of CM (physical, sexual, and emotional) and all types of EDs. A random-effects meta-analysis with moderator analyses was performed to assess the associations between all types of CM and all types of ED, focusing on their prevalence, severity, and related comorbid conditions. The prevalence of CM was consistently and significantly higher in ED patients (18.4- 57.7%) than in healthy controls (7.2-29.2%) and mostly higher compared to psychiatric controls (21.2 - 31.1%). The odds of developing EDs were significantly elevated in individuals exposed to CM, with ORs ranging from 2.81 to 4.60. CM exposure was associated with greater severity of EDs (r = .21, 95% CI [0.10, 0.32], p < .001) and was also associated with higher levels of depression and anxiety (r = .19, 95% CI [0.11, 0.26], p < .001). Additionally, we found that CM exposure significantly increased the likelihood of comorbid mental health disorders in patients with EDs compared to non-exposed counterparts (ORs 1.15 to 3.96), with the strongest associations observed for Axis I disorders, especially depression and anxiety. Moderator analyses revealed that recent studies reported slightly higher CM prevalence in AN samples. Sample size influenced the sexual CM-BED relationship (R2 =0.42, p =.04), and higher study quality was linked to lower prevalence rates (R2 = 0.07, p < .001), though these factors explained only a small part of the heterogeneity. Our findings highlight that all types of childhood maltreatment (physical, sexual, and emotional) are associated with a range of EDs in adulthood and influence both the severity and course of EDs.Show less
Variants of exposure-based therapy have been found to be effective in ameliorating childhood abuse-related post-traumatic stress disorder (CA-PTSD). This study aims to investigate whether three...Show moreVariants of exposure-based therapy have been found to be effective in ameliorating childhood abuse-related post-traumatic stress disorder (CA-PTSD). This study aims to investigate whether three variants of Prolonged Exposure (PE) improve comorbid depressive symptoms, suicidality and personality disorders amongst patients with CA-PTSD. Data from the IMPACT study was used, which included 149 participants who were randomly assigned to one of three treatment conditions: PE, intensified PE (iPE) or Skills Training in Affective and Interpersonal Regulation followed by PE (STAIR+PE). Participants were assessed at multiple time points ranging from baseline to 12-month follow-up. Linear mixed effect models were utilized to test the effect of treatment on depressive symptoms, suicide risk, personality disorder symptom severity and the prevalence of diagnosed personality disorders. Such models were then extended to test whether the three variants of PE differed in their treatment effects. The findings demonstrated that treatment led to large improvements in depressive symptoms and suicide risk from baseline assessment to 12-month follow-up. Moreover, personality disorder symptom severity and the prevalence of diagnosed personality disorders significantly declined between baseline and 6-month follow-up. It was found that PE, iPE and STAIR+PE did not differ in their treatment effects, implying that deviations from the original PE protocol do not lead to superior treatment outcomes. In conclusion, variants of exposure- based therapy lead to sustained improvements in comorbid psychopathologies amongst patients with CA-PTSD.Show less
