Epidemiology of Dissociative Disorders: An Overview

January 7, 2013 Comments Off on Epidemiology of Dissociative Disorders: An Overview

Epidemiology of Dissociative Disorders: An Overview

Vedat Sar – Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey 2011

General psychiatric assessment instruments do not cover DSM-IV dissociative disorders. Many large-scale epidemiological studies led to biased results due to this deficit in their methodology. Nevertheless, screening studies using diagnostic tools designed to assess dissociative disorders yielded lifetime prevalence rates around 10% in clinical populations and in the community. Special populations such as psychiatric emergency ward applicants, drug addicts, and women in prostitution demonstrated the highest rates. Data derived from epidemiological studies also support clinical findings about the relationship between childhood adverse experiences and dissociative disorders. Thus, dissociative disorders constitute a hidden and neglected public health problem. Better and early recognition of dissociative disorders would increase awareness about childhood traumata in the community and support prevention of them alongside their clinical consequences.

http://downloads.hindawi.com/journals/eri/2011/404538.pdf

excerpts:

“Most of the published clinical case series are focused on chronic and complex forms of dissociative disorders.

Data collected in diverse geographic locations such as North America [2], Puerto Rico [3], Western Europe [4], Turkey [5], and Australia [6] underline the consistency in clinical symptoms of dissociative disorders. These clinical case series have also documented that dissociative patients report highest frequencies of childhood psychological trauma among all psychiatric disorders. Childhood sexual (57.1%–90.2%), emotional (57.1%), and physical (62.9%–82.4%) abuse and neglect (62.9%) are among them (2–6).”

“Several studies conducted on consecutive series of inpatients and outpatients in general psychiatric settings in diverse countries yielded
results depending on the hinterland of the particular institution (Table 1).

Two studies in North America demonstrated that 13.0–20.7 % of psychiatric inpatients had a dissociative disorder [22, 23]. Studies on dissociative disorders in Istanbul, Turkey, yielded a prevalence slightly above 10% among psychiatric inpatients and outpatients [8, 24, 25]. Although still considerable, these rates were lower in the Netherlands [26], Germany [18], and Switzerland [27] among inpatients, that is, between 4.3%–8.0%. A Finnish study [28] reported higher rates for psychiatric outpatients (14.0%) and inpatients (21.0%).

Emergency admissions of a university psychiatric clinic in Istanbul, Turkey yielded the highest rate in the country: 35.7% [29]. In a study from Zurich, Switzerland, among severely impaired psychiatric outpatients, prevalence of all dissociative disorders were 25.0% [30]. Two recent studies on inpatient and outpatient psychiatric units in North America reported higher rates than those of the previous studies [31, 32].”

Parents of teen accused of shootings faced charges, Brain Development Harmed in Mistreated Kids

February 29, 2012 Comments Off on Parents of teen accused of shootings faced charges, Brain Development Harmed in Mistreated Kids

articles:
– Parents of teen accused of shootings faced charges
– Brain Development Harmed in Mistreated Kids

Parents of teen accused of shootings faced charges
Tuesday, February 28, 2012, Rachel Dissell, The Plain Dealer

CHARDON, Ohio — It appears that T.J. Lane had violence in his life from the beginning.

Geauga County court records show the father of the teen who authorities say shot five students at Chardon High School on Monday had been arrested many times for violent crimes against women in his life, including Lane’s mother. More than once, police or courts warned him to stay away from the boy and his mother.

Authorities said the teen walked into the high school cafeteria early Monday morning, took out a gun and aimed it at several boys. In the end, three students were seriously wounded and one was killed. A fifth student died early Tuesday. T.J. Lane is to appear in Geauga County Juvenile Court Tuesday….

T.J. Lane attended Lake Academy, an alternative school in Willoughby for students in Lake and Geauga counties….

The teen had one prior case in Geauga County Juvenile court two years ago. Officials would not release information on the case. But several at the court said the family’s troubles were known to social workers in the county.

The father, Thomas Lane Jr., was known to county authorities because of a series of arrests for abusing women in his life, court records show. It’s not clear how much contact the father and son had.

But between 1995 and 1997, the boy’s father and mother, Sara A. Nolan, were each charged with domestic violence against each other.

The father was later charged with assaulting a police officer and served time in prison after trying to suffocate another woman he married several years after his son was born, according to court records.

He held the woman’s head under running water and bashed it into a wall, leaving a dent in the drywall, court records show….http://www.cleveland.com/chardon-shooting/index.ssf/2012/02/parents_of_teen_accused_of_sho.html

Brain Development Harmed in Mistreated Kids
Study May Help Explain Why Child Abuse Often Leads to Mental Problems Like Depression, Post-Traumatic Stress
By Brenda Goodman, MA WebMD Health News
Reviewed by Laura J. Martin, MD

Feb. 13, 2012 — A new study shows that the stress of child abuse appears to shrink a key region of the brain that regulates emotion, memory, and learning.

The finding may help explain why mistreated kids often experience lasting mental problems like depression and other psychiatric disorders.

The study is a counterpoint to recent research that found that children who were nurtured early in life were more likely to have larger brain centers for memory and emotion.

“Stress has a negative impact on brain development; support has a positive impact,” says Joan Luby, MD, a child psychiatrist at Washington University in St. Louis, Mo. Luby studies early emotional development, but she was not involved in the research.

The impact on brain development caused by child abuse may have lasting consequences.

“Having adverse life experiences clearly puts people at risk for mental disorders,” she says….

Researchers found that three key regions of the hippocampus were nearly 6% to 7% smaller in people who were significantly mistreated as kids compared to those who were not….

But he says people who had rough childhoods should also know that although early life experiences may be important for brain function, other studies have shown that some of the brain changes can be undone.

“Things like vigorous exercise will change it. Mental stimulation will influence it,” Teicher says. “Changes in the hippocampus are plastic and can be modified.” http://children.webmd.com/news/20120213/brain-development-harmed-in-mistreated-kids

Child Abuse Leaves Mark on Brain

February 15, 2012 Comments Off on Child Abuse Leaves Mark on Brain

Child Abuse Leaves Mark on Brain
Jennifer Welsh  Live Science Mon, 13 Feb 2012

Childhood abuse and maltreatment can shrink important parts of the brain, a new study of adults suggests.

Reduced brain volume in parts of the hippocampus could help to explain why childhood problems often lead to later psychiatric disorders, such as depression, drug addiction and other mental health problems, the researchers say. This link could help researchers find better ways to treat survivors of childhood abuse.

“These results may provide one explanation for why childhood abuse has been identified with an increased risk for drug abuse or psychosis,” study researcher Martin Teicher, of Harvard University, told LiveScience. “Now that one can look at these sub-regions [in the brain], we can get a better idea of what treatments are helping.”

The researchers used magnetic resonance imaging (MRI) to scan the brains of 193 individuals between 18 and 25 years old, who had already undergone several rounds of testing to be qualified. They then analyzed the size of areas in the hippocampus and compared the results with the patient’s history. They saw that those who had been abused, neglected or maltreated (based on well-established questionnaires) as children had reduced volume in certain areas of the hippocampus by about 6 percent, compared with kids who hadn’t experienced child abuse.

They also had size reductions in a related brain area called the subiculum, which relays the signals from the hippocampus to other areas of the brain, including the dopamine system, also known as the brain’s “reward center.” Volume reduction in the subiculum has been associated with drug abuse and schizophrenia, as well….

The study was published today (Feb. 13) in the journal Proceedings of the National Academies of Sciences.
http://www.livescience.com/18453-child-abuse-brain.html

child sex crimes in US sharply increasing, Sex Abuse Survivors Increased Disorders

August 4, 2010 Comments Off on child sex crimes in US sharply increasing, Sex Abuse Survivors Increased Disorders

Officials issue national strategy to fight child sex crimes By Terry Frieden, CNN Justice Producer August 3, 2010 Washington (CNN) — With child sex crimes in the United States sharply increasing, federal officials Monday issued a “national strategy” to combat child exploitation in homes, on streets and over the internet. Top federal law enforcement officials led by Attorney General Eric Holder vowed to take new steps to stem rampant child pornography, online enticements, child prostitution and child sex tourism. In a detailed report submitted to Congress on Monday, the Justice Department says that since 2006, when the government launched Project Safe Childhood, federal prosecutions have increased by 40 percent, and more than 8,600 defendants have been indicted. More than 2,400 alleged sex offenders were indicted in 2009 alone. “Tragically, the only place we’ve seen a decrease is in the age of the victims,” Holder said. Officials said the average age of girls targeted for child pornography is 12 to 14, while the average age of boys targeted is 11 to 13. http://www.cnn.com/2010/CRIME/08/02/pol.strategy.child.exploitation/index.html

Office of Public Affairs FOR IMMEDIATE RELEASE Monday, August 2, 2010 Department of Justice Releases First National Strategy for Child Exploitation Prevention and Interdiction
U.S. Marshals Service to Launch Nationwide Operation Targeting Top 500 Most Dangerous, Non-compliant Sex Offenders
WASHINGTON – Attorney General Eric Holder today announced that the Department of Justice released its first-ever National Strategy for Child Exploitation Prevention and Interdiction. The strategy also provides the first-ever comprehensive threat assessment of the dangers facing children from child pornography, online enticement, child sex tourism, commercial sexual exploitation and sexual exploitation in Indian Country, and outlines a blueprint to strengthen the fight against these crimes. The strategy builds upon the department’s accomplishments in combating child exploitation by establishing specific, aggressive goals and priorities and increasing cooperation and collaboration at all levels of government and the private sector.
http://www.justice.gov/opa/pr/2010/August/10-opa-887.html

Sexual Abuse Survivors Have Increased of Psychiatric Disorders
ScienceDaily (July 12, 2010) — New research finds that a history of sexual abuse, regardless of the victim’s gender or age when the abuse occurred, correlates strongly with a lifetime diagnosis of multiple psychiatric disorders. In the July issue of Mayo Clinic Proceedings, researchers report that a history of sexual abuse is associated with suicide attempts, post-traumatic stress disorder, anxiety disorders, depression, and eating and sleep disorders. Additionally, associations between sexual abuse and depression, eating disorders, and post-traumatic stress disorder were strengthened by a history of rape….The study reports prevalence rates of sexual abuse in some populations are as high as 21 percent in adults and 33 percent in children. Furthermore, sexual abuse survivors can represent up to 25 percent of patient panels in primary care practices. Researchers also explored why some abuse survivors do not experience psychiatric symptoms and suggest that genetic variability may confer a level of protection. “The protective effect of certain genes against the development of psychiatric disorders in abuse survivors is an intriguing prospect.
http://www.sciencedaily.com/releases/2010/07/100712133129.htm

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