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      Dissociation in victims of childhood abuse or neglect: a meta-analytic review

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          Abstract

          Childhood abuse and neglect are associated with dissociative symptoms in adulthood. However, empirical studies show heterogeneous results depending on the type of childhood abuse or neglect and other maltreatment characteristics. In this meta-analysis, we systematically investigated the relationship between childhood interpersonal maltreatment and dissociation in 65 studies with 7352 abused or neglected individuals using the Dissociative Experience Scale (DES). We extracted DES-scores for abused and non-abused populations as well as information about type of abuse/neglect, age of onset, duration of abuse, and relationship to the perpetrator. Random-effects models were used for data synthesis, and meta-regression was used to predict DES-scores in abused populations from maltreatment characteristics. The results revealed higher dissociation in victims of childhood abuse and neglect compared with non-abused or neglected subsamples sharing relevant population features ( M Abuse = 23.5, M Neglect = 18.8, M Control = 13.8) with highest scores for sexual and physical abuse. An earlier age of onset, a longer duration of abuse, and parental abuse significantly predicted higher dissociation scores. This meta-analysis underlines the importance of childhood abuse/neglect in the etiology of dissociation. The identified moderators may inform risk assessment and early intervention to prevent the development of dissociative symptoms.

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          Childhood adversity and neural development: deprivation and threat as distinct dimensions of early experience.

          A growing body of research has examined the impact of childhood adversity on neural structure and function. Advances in our understanding of the neurodevelopmental consequences of adverse early environments require the identification of dimensions of environmental experience that influence neural development differently and mechanisms other than the frequently-invoked stress pathways. We propose a novel conceptual framework that differentiates between deprivation (absence of expected environmental inputs and complexity) and threat (presence of experiences that represent a threat to one's physical integrity) and make predictions grounded in basic neuroscience principles about their distinct effects on neural development. We review animal research on fear learning and sensory deprivation as well as human research on childhood adversity and neural development to support these predictions. We argue that these previously undifferentiated dimensions of experience exert strong and distinct influences on neural development that cannot be fully explained by prevailing models focusing only on stress pathways. Our aim is not to exhaustively review existing evidence on childhood adversity and neural development, but to provide a novel framework to guide future research.
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            The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction.

            Childhood abuse and other adverse childhood experiences (ACEs) have historically been studied individually, and relatively little is known about the co-occurrence of these events. The purpose of this study is to examine the degree to which ACEs co-occur as well as the nature of their co-occurrence. We used data from 8,629 adult members of a health plan who completed a survey about 10 ACEs which included: childhood abuse (emotional, physical, and sexual), neglect (emotional and physical), witnessing domestic violence, parental marital discord, and living with substance abusing, mentally ill, or criminal household members. The bivariate relationship between each of these 10 ACEs was assessed, and multivariate linear regression models were used to describe the interrelatedness of ACEs after adjusting for demographic factors. Two-thirds of participants reported at least one ACE; 81%-98% of respondents who had experienced one ACE reported at least one additional ACE (median: 87%). The presence of one ACE significantly increased the prevalence of having additional ACEs, elevating the adjusted odds by 2 to 17.7 times (median: 2.8). The observed number of respondents with high ACE scores was notably higher than the expected number under the assumption of independence of ACEs (p <.0001), confirming the statistical interrelatedness of ACEs. The study provides strong evidence that ACEs are interrelated rather than occurring independently. Therefore, collecting information about exposure to other ACEs is advisable for studies that focus on the consequences of a specific ACE. Assessment of multiple ACEs allows for the potential assessment of a graded relationship between these childhood exposures and health and social outcomes.
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              Modeling dependent effect sizes with three-level meta-analyses: a structural equation modeling approach.

              Meta-analysis is an indispensable tool used to synthesize research findings in the social, educational, medical, management, and behavioral sciences. Most meta-analytic models assume independence among effect sizes. However, effect sizes can be dependent for various reasons. For example, studies might report multiple effect sizes on the same construct, and effect sizes reported by participants from the same cultural group are likely to be more similar than those reported by other cultural groups. This article reviews the problems and common methods to handle dependent effect sizes. The objective of this article is to demonstrate how 3-level meta-analyses can be used to model dependent effect sizes. The advantages of the structural equation modeling approach over the multilevel approach with regard to conducting a 3-level meta-analysis are discussed. This article also seeks to extend the key concepts of Q statistics, I2, and R2 from 2-level meta-analyses to 3-level meta-analyses. The proposed procedures are implemented using the open source metaSEM package for the R statistical environment. Two real data sets are used to illustrate these procedures. New research directions related to 3-level meta-analyses are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

                Author and article information

                Journal
                Psychological Medicine
                Psychol. Med.
                Cambridge University Press (CUP)
                0033-2917
                1469-8978
                November 2018
                April 10 2018
                November 2018
                : 48
                : 15
                : 2467-2476
                Article
                10.1017/S0033291718000740
                29631646
                3968e993-4ee1-4e8f-a1a6-8e1ecc245417
                © 2018

                https://www.cambridge.org/core/terms

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