Kids Bullied by Siblings May Have Mental Health Issues in Early 20s

UK researchers have discovered that kids bullied at home and at school are more likely to have mental health issues in young adulthood. Investigators found that depression, self-harm and suicidal ideation are more prominent in young adults if they were bullied.

Notably, even sibling bullying can be harmful as it often leads to peer bullying and then issues later in life. Experts stress that education of parents and mental health professionals is necessary to mitigate what may have previously been viewed as harmless banter between siblings.

The new findings are not without precedent as previous studies have identified that sibling bullying has an effect on mental health in adolescence. However, University of Warwick researchers Professor Dieter Wolke and Dr. Slava Dantchev have now found that children who were bullied by siblings and friends are more likely to harm themselves.

The paper appears in the journal Frontiers in Psychiatry. The research shows that sibling bullying can lead to on self-harm, suicide attempts and depression at 24 years of age.

Using the Children of the 90s study, they were able to show that children who were bullied by siblings had more mental health issues in adulthood. If they were also bullied by peers this risk increased further.

The participants were asked to self-report bullying when they were 12 years old; depression, anxiety, suicidal ideation and self-harm were assessed at 24 years old.

Of 3,881 youths studied it was found that 31.2% experienced bullying by a sibling. Of those who both became victims and bullied siblings 15.1% were diagnosed with clinical depression, 35.7% experienced suicidal ideation and 16.1% self-harmed with a further 4.9% with the intent of suicide.

Those who experienced sibling bullying and peer bullying had double the odds of developing clinical depression and consider suicide.

Dantchev said this is the first study to show that being bullied by siblings has adverse effects on mental health into adulthood, when the siblings are not living together anymore. “Those bullied at home are also more likely to be bullied by peers and have no safe space at school or at home. This further increased their torment and affected their mental health.”

Wolke also commented, “As sibling bullying often starts when children are young it will be important to educate and help parents to deal and reduce bullying between siblings in early childhood. This is an area which has been completely overlooked in mental health provision and parent support.”

Source: University of Warwick

When Abuse Involves Controlling a Partner’s Education

A new study offers a closer look at a lesser-known form of psychological abuse: educational sabotage. This type of abuse involves behaviors aimed at hindering or stopping another person’s educational efforts.

“This form of violence is used by one of the partners as a means for furthering their own power and control over the other partner,” said Dr. Rachel Voth Schrag, a domestic violence expert and assistant professor in the School of Social Work at The University of Texas at Arlington. “Pursuing higher education can be perceived as a threat by the abusing party.”

Educational sabotage is a form of coercive control that directly affects a survivor’s efforts to obtain educational credentials, said Voth Schrag. Tactics may include disruption of financial aid or academic efforts, physical violence and/or inducing guilt related to academic efforts.

These strategies are a serious hindrance to the successful completion of educational programs and, ultimately, the economic independence and safety of survivors, she said.

For the study, the researchers conducted 20 interviews with community college students who reported current or recent intimate partner violence  (IPV). The participants identified several ways in which educational sabotage had impacted their lives. Impacts included reduced academic achievement, emotional or mental health challenges, but on a more positive note, an increased desire to overcome such obstacles.

Educational sabotage is considered a form of IPV, which is a factor in 16.5% of all homicides in the U.S., according to The Centers for Disease Control and Prevention. The agency estimates one in four women and nearly one in 10 men have experienced intimate partner violence during their lifetime.

Pursuing higher education can be a catalyst for breaking out of the isolation and cycles of dependency that often accompany IPV. According to Voth Schrag’s study, “by understanding, addressing, and preventing school sabotage, scholars, institutions of higher education, and their community partners have an opportunity to make an important contribution to the well-being and safety of students.”

The study is published in the journal Violence Against Women.

Source: University of Texas at Arlington


Many Patients Hide Life-Threatening Issues From Their Doctors

A new study finds that many patients who have faced domestic violence, sexual assault, depression or thoughts of suicide are likely to hide this information from their healthcare providers.

The findings, published online in JAMA Network Open, show that up to 47.5 percent of patients who have experienced one or more of these four threats do not disclose this critical information to care providers out of embarrassment, fear of judgment or the possible long-term implications of sharing such information.

Understanding how to make patients feel more comfortable with clinicians is key to helping patients address such life-threatening risks, says the study’s senior author Angela Fagerlin, PhD, chair of the department of Population Health Sciences at the University of Utah Health.

“For primary care providers to help patients achieve their best health, they need to know what the patient is struggling with,” says Fagerlin. For example, patients who withhold they have been sexually assaulted are potentially at risk for post-traumatic stress disorder and sexually-transmitted diseases, she explains.

“There are numerous ways providers can help patients, such as getting resources, therapy and treatment.”

The study involved more than 4,500 people in two national online surveys from 2015. Participants in one survey averaged 36 years old, while participants from the second had a median age of 61.

The respondents reviewed a list of medically relevant information and were asked to indicate whether they had ever withheld this information from a clinician. They were also asked the reasons why they withheld the information.

The surveys show that 40 to 47.5 percent of participants chose not to tell their provider that they had experienced at least one of the four threats. Over 70 percent said the reason why was embarrassment or fear of being judged or lectured.

If the patient was female or younger, the odds were higher they would keep this information to themselves. What compounds this issue is that several recent studies have shown how health care providers downplay or fail to take seriously women’s medical complaints.

One limitation noted by the study’s first author, Andrea Gurmankin Levy, PhD, MBe, a professor in social sciences at Middlesex Community College in Middletown, Connecticut, is that study participants may have not shared in their survey responses all the information they withheld, meaning that this phenomenon may be even more prevalent than the study reveals.

Levy says the survey reinforces that there is discomfort and a lack of trust between patients and providers. If patients filled out a questionnaire about sensitive information when they arrive at the provider’s office, might that improve the information flow? For example, is it easier to tell a piece of paper something sensitive than to look into your clinician’s eyes and say it?

This is the team’s second article based on the 2015 surveys. The first, published in November 2018, revealed that 60 to 80 percent of those surveyed did not share pertinent information with their provider regarding daily issues like diet and exercise. One third did not speak up when they disagreed with their provider’s recommendations.

Both surveys raise concerns about communication and trust between patients and their caregivers. Improving this relationship falls both on providers’ and patients’ shoulders, the authors say.

Providers need to establish an atmosphere where the patient feels neither judged nor rushed, but rather are able to share concerns fundamental to their well-being. In addition, patients will benefit by sharing sensitive information with their providers.

Researchers from University of Utah Health, Middlesex Community College, University of Michigan and University of Iowa collaborated on the study.

Source: University of Utah Health

Working With Animals Can Increase Risk of Depression, Anxiety and Suicide

“Talking about veterinarian suicide certainly gets people to pay attention, but it does not tell the whole, nuanced story about what may be contributing to poor well-being in this population,” said Katherine Goldberg, DVM, LMSW, community consultation and intervention specialist at Cornell Health and founder of Whole Animal Veterinary Geriatrics and Palliative Care Services, who also presented at the meeting. “More research is under way to help better understand why veterinarians might be at an increased risk, but a combination of personality traits, professional demands and the veterinary learning environment all likely contribute.”

Economic challenges could be a contributing factor, according to Goldberg, who noted that the average veterinary school graduate reported having more than $143,000 of school loan debt while earning a starting salary of around $73,000 in 2016.

“Personal finance concerns are stressful for many veterinarians, especially recent graduates, and at the same time, many clients regularly question the cost of care for their animals and may be suspicious that their vet is trying to ‘push’ services that their pet doesn’t need,” she said.

Goldberg also described a multi-center study that looked at rates of adverse childhood experiences — a term used to describe all types of abuse, neglect and other traumatic experiences — in veterinary students, in an effort to understand what may be causing their poor mental health.

However, veterinarians just starting their practice were not more predisposed to poor mental health than the general population as a result of adverse childhood experiences, she said.

“This indicates that something is happening over the course of veterinary student training or once veterinarians are working to cause poor well-being outcomes,” she said. “Well-being education should be integrated into the veterinary curriculum, emphasizing resiliency behaviors and cultivating professional partnerships between veterinary medicine and mental health care.”

Substance use among veterinarians is also an understudied area, she noted. Veterinary medicine is the only medical profession in the U.S. that does not have a national monitoring program for substance use and mental health issues, she added.

While veterinarians who are dealing with mental health issues may exhibit symptoms common to all populations, such as sadness that interferes with daily activities or changes in appetite, there are a few specific warning signs to watch for in a clinical veterinary setting, according to Goldberg.

“Increased medical errors, absenteeism, client complaints and spending too little or too much time at work” are factors to watch for, she said. “For potential substance use issues, warning signs could include missing drugs or missing prescription pads.”

Goldberg said there needs to be a shift in veterinary training to better prepare veterinarians not only for the animal-related aspects of their jobs, but the human elements as well.

“We need core curricular material that focuses on coping with the emotional demands of the profession,” she said. “Mindfulness, moral stress, ethics literacy, grief and bereavement, mental health first aid and suicide awareness all have a role in veterinary education. Colleges of veterinary medicine that have embedded mental health professionals are a step ahead of those that do not, and I would like to see this become a requirement for all schools accredited by the Association of American Veterinary Medical Colleges.”

Meanwhile, Fournier’s presentation looked at employees and volunteers in animal shelters, and animal welfare and animal rights activists, who are at risk for compassion fatigue and psychological distress.

“Animal welfare agents, as these people are often called, are exposed to animal abuse, neglect and oppression on a regular basis, as well as routine euthanasia that is common in these settings,” said Fournier.

More than 2.4 million healthy cats and dogs are euthanized each year in the U.S., most often homeless animals in shelters, according to the Humane Society of the United States.

“Shelter workers are then caught in a dilemma because they are charged with caring for an animal and they may ultimately end that animal’s life,” she said. “Research suggests that this causes significant guilt, which can lead to depression, anxiety and insomnia, as well as greater family-work conflict and low job satisfaction.”

Animal welfare agents may also hear gruesome stories of animal abuse or witness the consequences firsthand when they are rehabilitating the animals, which can cause a lot of distress and lead to compassion fatigue, said Fournier.

“Experts suggest that animal welfare agents carry an even heavier burden than those in other helping professions who are susceptible to compassion fatigue because of the issues unique to working with animals, such as euthanasia and caring for living beings who have experienced pain and suffering, but cannot articulate their needs and experiences,” said Fournier.

She suggests that psychotherapists who work with animal welfare agents offer patients strategies to reframe negative experiences, identify ways in which they get fulfillment and gratification from the work they do, and establish healthy boundaries between their work and personal lives.

“There are certainly positive and negative aspects of the job and over time or during times of acute stress, it can be difficult to see the positive,” she said. “It may be necessary to help someone focus on the big picture that overall they are making a difference and animals have been saved, rather than ruminating on individual stories of crisis and loss. Self-care is also critical to ensuring the best mental health outcomes for those who work and volunteer with animals.”

Source: The American Psychological Association

Traumatized Adults May Find Touch, Closeness Less Appealing

Adults who were traumatized as children may be more likely to keep a greater physical distance between themselves and strangers, and may also find touch stimuli less comforting than people without a history of trauma, according to a team of researchers from Bonn University Hospital (UKB) and Ruhr University Bochum in Germany.

Research has shown that people who have been humiliated, beaten or sexually abused in childhood are more likely to suffer from mental illnesses such as depression or anxiety attacks in adulthood than those without a history of abuse.

But according to controlled analyses, these mental disorders are not responsible for the stronger aversion to touch and closeness — but rather the traumatization itself.

The findings, published in the American Journal of Psychiatry, suggest that experiences of violence as a child may lead to a permanently changed perception of social stimuli.

The study involved 92 adults (64 women) who were interviewed about their experiences with violence and accompanying illnesses.

The researchers tested sensory perception by stroking the bare skin of the shins with one hand with either a fast or a slower movement.

“Touch is of central importance because it influences brain development, provides a feeling for one’s own body and serves as a stress regulator,” said Dr. Dirk Scheele of the UKB’s Division of Medical Psychology.

Interpersonal contact is mediated via two different nerve fibers in the skin: Aß fibers transmit sensory information and respond primarily to faster touches, while C tactile fibers transmit emotional well-being and are activated primarily by slow touches, said  lead author and doctoral student Ayline Maier.

The participants lay in the brain scanner during the experiments and could not see the experimenter who performed the movements. His hands were in cotton gloves to avoid direct skin contact. The functional magnetic resonance imaging system recorded the activity of the brain areas. After each measurement, the subjects were asked how comforting the touches were.

The more pronounced the maltreatment experiences during childhood, the more strongly two brain regions reacted to rapid touches. The somatosensory cortex is located in the brain approximately above the ear and registers where a touch occurs.

“This area encodes haptic sensations and is involved in the preparation and initiation of body movement — for example, pulling away the leg that has been touched,” Maier said.

The posterior insula cortex is an area deep in the brain behind the temple that is responsible for all body perceptions such as touch, hunger, thirst and pain.

“In traumatized people, the activity in these two areas in response to rapid touches is significantly increased,” Scheele said.

On the other hand, activation in the hippocampus was much weaker during slow touches in those with a history of abuse. The hippocampus serves the formation of memory and thus also stores negative and positive associations of stimuli.

“Specifically, the activity of the hippocampus could reflect how rewarding a touch was in the experiment,” said Maier. More traumatized participants might find a slow and thus more emotionally charged touch less pleasant.

The researchers also investigated social distance. The participants were asked to walk up to a person they did not know and to stop when the distance was just about perceived as pleasant. It was significantly larger in more severely traumatized people —  on average by twelve centimeters.

“The results show that the perception and sensory processing of people with traumatic childhood experiences have changed,” Scheele said, summarizing the results. Touching is less comforting in those with a trauma history compared to those without maltreatment experience.

Maier said, “This result may also open up opportunities for new therapies: Supplementary body-based therapies in a safe environment could make it possible to retrain this stimulus processing.” However, this potential would first have to be investigated in more detail in further studies.

Source: University of Bonn

Elder Financial Abuse Committed More Often by Family Than Strangers

A new study finds that the elderly are more likely to be financially abused by relatives than by strangers, despite the large number of Internet, mail and telephone scams directed at older adults.

“We expected to find that financial abuse was the most common abuse reported,” said Gali Weissberger, Ph.D., lead author of the study, and postdoctoral scholar in the Han Research Lab at the Keck School of Medicine at the University of Southern California (USC).

“But despite the high rates of financial exploitation perpetrated by scammers targeting older adults, we found that family members were the most commonly alleged perpetrators of financial abuse. In fact, across all abuse types, with the exception of sexual abuse and self-neglect, abuse by a family member was the most commonly reported.”

For the study, Keck School researchers evaluated data from the National Center on Elder Abuse (NCEA) resource line, a source where people can report or inquire about elder abuse.

The researchers coded nearly 2,000 calls, emails or messages recorded on the NCEA hotline between August 2014 and June 2017, reviewing for any mention of abuse. They categorized type of abuse alleged, whether multiple types of abuse occurred and who perpetrated the alleged abuse.

Of the nearly 2,000 reports, more than 42% (818 reports) alleged abuse. Financial abuse was the most commonly reported at nearly 55% (449 reports).

Family members were the most frequently identified perpetrators of alleged abuse at nearly 48% of calls in which a relationship could be determined.

The most common abuse perpetrated by family was financial abuse (61.8%), followed by emotional abuse (35%), neglect (20.1%), physical abuse (12%) and sexual abuse (0.3%). Of the calls that alleged abuse by a family member, more than 32% reported more than one abuse type.

“This is the first study to characterize elder abuse from calls made to the NCEA resource line, which serves as a public access point for people seeking information and resources about elder abuse,” said Duke Han, Ph.D., associate professor of family medicine at the Keck School and corresponding author of the study.

“Our findings highlight the importance of resource lines for those seeking information on elder abuse, as many calls were made to understand whether certain situations reflected abuse.”

Elder abuse affects an estimated one in 10 older adults annually, but is often underreported. Aside from its physical, psychological and social impact on victims, their families and society, elder abuse attributes to more than $5.3 billion in U.S. annual health care costs.

The researchers not that the study was limited by selection bias, as the data was from individuals proactively calling the NCEA line.

“The results highlight the importance of developing effective strategies to prevent future abuse,” said Weissberger. “Our next step is to conduct more studies targeting high-risk individuals and to better understand additional risk factors.”

Source: Keck School of Medicine of USC