From Childhood Trauma to Adult Dissociation: The Role of PTSD and Alexithymia

Background: The mechanism of how childhood trauma leads to increased risk for adult dissociation is not sufficiently understood. We sought to investigate the predicting effects and the putatively mediating roles of PTSD and alexithymia on the path from childhood trauma to adult dissociation. Methods: A total of 666 day-clinic outpatients were administered the Childhood Trauma Questionnaire (CTQ), the Toronto Alexithymia Scale (TAS-20), the Posttraumatic Diagnostic Scale (PDS), and the Dissociative Experiences Scale (DES) and controlled for sex, age, and the Global Symptom Index (GSI). Linear regression analyses and mediation analyses were applied. Results: Independent predictive effects on dissociation were found for childhood trauma, alexithymia and PDS, even after adjusting for GSI. Effects of childhood neglect on dissociation were slightly stronger than of abuse. Alexithymia did not mediate the path from childhood trauma to dissociation. Mediation by PDS was specific for childhood abuse, with all PTSD symptom clusters being significantly involved. Conclusions: Childhood abuse and neglect are important predictors of dissociation. While the effects of abuse are mediated by PTSD, the mechanism of how neglect leads to dissociation remains unclear. The results further support the predictive value of alexithymia for adult dissociation above and beyond the effects of childhood trauma, PTSD, and GSI scores

Norwegische 'Wehrmachtskinder': Psychosoziale Aspekte, Identitätsentwicklung und Stigmatisierung

Am 09. April 1940 überfielen deutsche Truppen Norwegen. Neun Monate später kamen die ersten 'Wehrmachtskinder' zur Welt. Im Laufe des Krieges wurden 72 Heime des 'Lebensborn' (ein von der SS getragener Verein zur Erhöhung der Geburtenrate 'arischer' Kinder) in Norwegen gegründet, so viele wie in keinem anderen durch das NS-Regime besetzten Land; darunter befand sich das erste außerhalb des damaligen Deutschen Reiches gelegene. In den Archiven des Lebensborn wurden knapp 8000 Kinder registriert. Schätzungen gehen davon aus, dass während der deutschen Okkupationszeit in Norwegen 10000 bis 12 000 Kinder geboren wurden, deren Väter den deutschen Truppen angehörten und deren Mütter norwegische Staatsbürgerinnen waren. Die 'Wehrmachtskinder' trugen ein doppeltes Stigma: Sie waren häufig unehelich geboren und waren durch die Beziehung mit dem Feind entstanden. Aus Zeitzeugnissen geht hervor, dass ihr soziales Umfeld sie diskriminierte und ausgrenzte; sie wurden verhöhnt und zum Teil körperlich und seelisch misshandelt. Auch von staatlicher Seite widerfuhren Ihnen unterschiedliche Repressalien. Die geistes- und sozialwissenschaftlichen Fächer haben die Umstände und Bedingungen der norwegischen 'Wehrmachtskinder' bereits Ende des letzten Jahrhunderts als Forschungsgegenstand aufgegriffen. Die psychosozialen Fächer haben dieses Thema jedoch erst kürzlich begonnen zu bearbeiten. Im Rahmen des hier vorgestellten Forschungsvorhabens werden erstmalig mittels eines umfangreichen Fragebogens die psychosozialen Konsequenzen des Aufwachsens als 'Wehrmachtskind' im Nachkriegsnorwegen erfasst. Das Projekt ist in eine bereits etablierte internationale und interdisziplinäre Forschungsstruktur zu den 'Kinder[n] des Krieges' eingebunden (www.childrenbornofwar.org), wobei an den Universitäten Leipzig und Greifswald die psychosoziale Belastung von Besatzungskindern in Deutschland parallel untersucht wird. Eine Besonderheit der norwegischen Situation sind die umfangreichen Aktivitäten des 'Lebensborn', der während des Krieges für viele Wehrmachtskinder und deren Mütter eine wichtige Rolle spielte.On 9 April 1940, German troops invaded Norway. Nine months later the first 'Wehrmacht children' were born. In the course of the war, 13 'Lebensborn' homes were established in Norway, more than in any other country occupied by the Nazis and including the first ever of these homes to be set up outside the former German Reich. (The Lebensborn was an SS-initiated association dedicated to raising the number of 'Aryan' births via extramarital relations between people living up to Nazi standards of health and racial purity). In the archives of the Lebensborn almost 8,000 children were registered. It is estimated that 10,000 to 12,000 children were born during the German occupation of Norway whose fathers belonged to the German troops and whose mothers were Norwegian nationals. 'Wehrmacht children' labored under a dual stigma. They were (often) born out of wedlock and they were the fruit of relations with the enemy. Socially they were discriminated and marginalized. They were ridiculed and, in many cases, physically and mentally abused. These children also suffered a variety of reprisals from the state. Initial investigations of the biographies and careers of the 'Wehrmacht children' in Norway date back to the end of the last century, most of them undertaken by scholars working in the humanities and the social sciences. Recently, the psychosocial sciences have also taken up this issue. The research project discussed here is the first to investigate the psychosocial consequences of growing up as a 'Wehrmacht child' in post-war Norway. The project is part of an established international and interdisciplinary research network named 'Children Born of War' (www.childrenbornofwar.org). The Universities of Leipzig and Greifswald have conducted a parallel study on occupation-born German children after WWII. A special feature of the Norwegian situation is the extensive activity of the 'Lebensborn', which played an important role for many 'Wehrmacht children' and their mothers during the war

Functional polymorphisms of the mineralocorticoid receptor gene NR3C2 are associated with diminished memory decline: Results from a longitudinal general‐population study

Abstract Background The mineralocorticoid receptor (MR) in the brain has a key role in the regulation of the central stress response and is associated with memory performance. We investigated whether the genetic polymorphisms rs5522 and rs2070951 of NR3C2 showed main and interactive effects with childhood trauma on memory decline. Methods Declarative memory was longitudinally assessed in 1,318 participants from the community‐dwelling Study of Health in Pomerania using the Verbal Learning and Memory Test (VLMT). In a subsample of 377 participants aged 60 and older, the Mini‐Mental Status Examination (MMSE) was additionally applied. Mean follow‐up time for the VLMT and MMSE were 6.4 and 10.7 years, respectively. Results Homozygous carriers of the G allele of rs2070951 (p < .01) and of the A allele of rs5522 (p < .001) showed higher immediate recall of words as compared to carriers of C allele (rs2070951) or the G allele (rs5522). The CG haplotype was associated with decreased recall (p < .001). Likewise, in the subsample of older patients, the AA genotype of rs5522 was associated with higher MMSE scores (p < .05). CG haplotypes showed significantly reduced MMSE scores in comparison to the reference haplotype (β = −0.60; p < .01). Conclusions Our results indicate that the GG genotype of rs2070951 as well as the AA genotype of rs5522 are associated with diminished memory decline

The interplay between genetic variation and gene expression of the glucocorticoid receptor gene NR3C1 and blood cortisol levels on verbal memory and hippocampal volumes

The hypothalamus–pituitary–adrenal axis is the main physiological stress response system and regulating the release of cortisol. The two corticoid receptors encoded by the genes NR3C1 and NR3C2 are the main players in regulating the physiological response to cortisol. This biological system has been linked to neurocognitive processes and memory, yet the mechanisms remain largely unclear. In two independent general population studies (SHIP, total sample size > 5500), we aim to diseantangle the effects of genetic variation, gene expression and cortisol on verbal memory and memory associated brain volume. Especially for NR3C1 results exhibited a consistent pattern of direct an interactive effects. All three biological layers, genetic variation (rs56149945), gene expression for NR3C1 and cortisol levels, were directly associated with verbal memory. Interactions between these components showed significant effects on verbal memory as well as hippocampal volume. For NR3C2 such a complex association pattern could not be observed. Our analyses revealed that different components of the stress response system are acting together on different aspects of cognition. Complex phenotypes, such as cognition and memory function are regulated by a complex interplay between different genetic and epigenetic features. We promote the glucocorticoid receptor NR3C1 as a main target to focus in the context of verbal memory and provided a mechanistic concept of the interaction between various biological layers spanning NR3C1 function and its effects on memory. Especially the NR3C1 transcript seemed to be a key element in this complex system

Supplementary Material for: From Childhood Trauma to Adult Dissociation: The Role of PTSD and Alexithymia

<p><strong><em>Background:</em></strong> The mechanism of how childhood trauma leads to increased risk for adult dissociation is not sufficiently understood. We sought to investigate the predicting effects and the putatively mediating roles of PTSD and alexithymia on the path from childhood trauma to adult dissociation. <b><i>Methods:</i></b> A total of 666 day-clinic outpatients were administered the Childhood Trauma Questionnaire (CTQ), the Toronto Alexithymia Scale (TAS-20), the Posttraumatic Diagnostic Scale (PDS), and the Dissociative Experiences Scale (DES) and controlled for sex, age, and the Global Symptom Index (GSI). Linear regression analyses and mediation analyses were applied. <b><i>Results:</i></b> Independent predictive effects on dissociation were found for childhood trauma, alexithymia and PDS, even after adjusting for GSI. Effects of childhood neglect on dissociation were slightly stronger than of abuse. Alexithymia did not mediate the path from childhood trauma to dissociation. Mediation by PDS was specific for childhood abuse, with all PTSD symptom clusters being significantly involved. <b><i>Conclusions:</i></b> Childhood abuse and neglect are important predictors of dissociation. While the effects of abuse are mediated by PTSD, the mechanism of how neglect leads to dissociation remains unclear. The results further support the predictive value of alexithymia for adult dissociation above and beyond the effects of childhood trauma, PTSD, and GSI scores.</p