Childhood verbal abuse and risk for personality disorders during adolescence and early adulthood

Data from a community-based longitudinal study were used to investigate whether childhood verbal abuse increases risk for personality disorders (PDs) during adolescence and early adulthood. Psychiatric and psychosocial interviews were administered to a representative community sample of 793 mothers and their offspring from two New York State counties in 1975, 1983, 1985 to 1986, and 1991 to 1993, when the mean ages of the offspring were 5, 14, 16, and 22 years, respectively. Data regarding childhood abuse and neglect were obtained from the psychosocial interviews and from official New York State records. Offspring who experienced maternal verbal abuse during childhood were more than three times as likely as those who did not experience verbal abuse to have borderline, narcissistic, obsessive-compulsive, and paranoid PDs during adolescence or early adulthood. These associations remained significant after offspring temperament, childhood physical abuse, sexual abuse, neglect, physical punishment during childhood, parental education, parental psychopathology, and co-occurring psychiatric disorders were controlled statistically. In addition, youths who experienced childhood verbal abuse had elevated borderline, narcissistic, paranoid, schizoid, and schizotypal PD symptom levels during adolescence and early adulthood after the covariates were accounted for. These findings suggest that childhood verbal abuse may contribute to the development of some types of PDs, independent of offspring temperament, childhood physical abuse, sexual abuse, neglect, physical punishment during childhood, parental education, parental psychopathology, and co-occurring psychiatric disorders.     

Childhood maltreatment and personality disorders in adult patients with binge eating disorder

OBJECTIVE: To examine the association between retrospective reports of different types of childhood maltreatment and current personality disorders (PDs) in patients with binge eating disorder (BED). METHOD: A total of 116 consecutive out-patients with DSM-IV BED were assessed with diagnostic interviews and completed the Childhood Trauma Questionnaire to assess childhood maltreatment in five domains (emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect). RESULTS: Eighty-two percent of patients reported some form of childhood maltreatment and 30% met criteria for at least one PD. Emotional abuse was significantly associated with cluster C PD overall and specifically with avoidant PD. CONCLUSION: Reports of emotional abuse - but not other forms of maltreatment - were associated with greater likelihood of a PDs in patients with BED.     

Childhood adversities,interpersonal difficulties,and risk for suicide attempts during late adolescence and early adulthood

BACKGROUND: Data from a community-based longitudinal study were used to investigate the association between childhood adversities, interpersonal difficulties during adolescence, and suicide attempts during late adolescence or early adulthood. METHODS: A community sample of 659 families from Upstate New York was interviewed in 1975, 1983, 1985 to 1986, and 1991 to 1993. During the 1991-1993 interview, the mean age of the offspring was 22 years. RESULTS: Maladaptive parenting and childhood maltreatment were associated with an elevated risk for interpersonal difficulties during middle adolescence and for suicide attempts during late adolescence or early adulthood after age, sex, psychiatric symptoms during childhood and early adolescence, and parental psychiatric symptoms were controlled statistically. A wide range of interpersonal difficulties during middle adolescence were associated with risk for suicidal behavior after the covariates were controlled. Profound interpersonal difficulties during middle adolescence mediated the association between maladaptive parenting or childhood maltreatment and suicide attempts during late adolescence or early adulthood. CONCLUSIONS: Maladaptive parenting and childhood maltreatment may be associated with a risk for severe interpersonal difficulties during adolescence. These interpersonal difficulties may play a pivotal role in the development of suicidal behavior. Youths who are at an elevated risk for suicide may tend to be in need of mental health services that can help them to cope with an extensive history of profound interpersonal difficulties, beginning in childhood and continuing through adolescence.     

Childhood adversity in association with personality disorder dimensions: New findings in an old debate

BackgroundVarious studies have reported a positive relationship between child maltreatment and personality disorders (PDs). However, few studies included all DSM-IV PDs and even fewer adjusted for other forms of childhood adversity, e.g. bullying or family problems.MethodWe analyzed questionnaires completed by 512 participants of the ZInEP epidemiology survey, a comprehensive psychiatric survey of the general population in Zurich, Switzerland. Associations between childhood adversity and PDs were analyzed bivariately via simple regression analyses and multivariately via multiple path analysis.ResultsThe bivariate analyses revealed that all PD dimensions were significantly related to various forms of family and school problems as well as child abuse. In contrast, according to the multivariate analysis only school problems and emotional abuse were associated with various PDs. Poverty was uniquely associated with schizotypal PD, conflicts with parents with obsessive-compulsive PD, physical abuse with antisocial PD, and physical neglect with narcissistic PD. Sexual abuse was statistically significantly associated with schizotypal and borderline PD, but corresponding effect sizes were small.ConclusionChildhood adversity has a serious impact on PDs. Bullying and violence in schools and emotional abuse appear to be more salient markers of general personality pathology than other forms of childhood adversity. Associations with sexual abuse were negligible when adjusted for other forms of adversity.     

Reported maltreatment in childhood in relation to the personality features of Norwegian adult psychiatric outpatients

To explore long-term associations between maltreatment in childhood and personality features in adulthood, 160 consecutive adult psychiatric outpatients completed self-administered questionnaires. Maltreatment was defined as either child abuse or neglect exerted by parents or other adults, coldness and overprotection by parents, or bullying by peers. The Childhood Trauma Questionnaire was used to detect childhood abuse by parents or other adults, while dimensions of parental coldness and overprotection were captured by the Parental Bonding Instrument. Bullying by peers was measured by an inventory used in schools. Personality variables were covered by the 5-PFa related to the "Big Five," The Rosenberg Self-Esteem Scale, and the Locus of Control of Behavior. Reports of bullying by peers were linked to poor self-esteem and external locus of control. Child maltreatment by parents or other adults were linked to the Big Five personality dimensions; bullying by peers was not.     

Personality disorders in adolescence and risk of major mental disorders and suicidality during adulthood

BACKGROUND: A community-based longitudinal study was conducted to investigate whether personality disorders (PDs) during adolescence increase the risk for Axis I psychiatric disorders and suicidality during early adulthood. METHOD: Psychosocial and psychiatric interviews were administered to a representative community sample of 717 youths and their mothers from 2 counties in the state of New York in 1975, 1983, 1985-1986, and 1991-1993. Anxiety, disruptive, eating, mood, personality, and substance use disorders and suicidal ideation and behavior were assessed in 1983 and 1985-1986, when the participants were adolescents, and in 1991-1993, when they were young adults. RESULTS: Adolescents with PDs were more than twice as likely as those without PDs to have anxiety, disruptive, mood, and substance use disorders during early adulthood. These associations remained statistically significant after co-occurring Axis I disorders during adolescence were controlled statistically. Cluster A, B, and C PDs and DSM-IV Appendix B PDs during adolescence were all associated with elevated risk for Axis I disorders during early adulthood after co-occurring Axis I and Axis II disorders during adolescence were controlled statistically. Cluster C PDs during adolescence were associated with elevated risk for suicidal ideation or behavior during early adulthood after co-occurring psychiatric disorders and suicidality during adolescence were controlled statistically. CONCLUSIONS: Adolescents in the community with personality disorders are at elevated risk for major mental disorders and suicidal ideation or behavior during early adulthood. This increase in risk is not accounted for by co-occurring Axis I disorders or suicidality during adolescence.     

A prospective investigation of major depressive disorder and comorbidity in abused and neglected children grown up

CONTEXT: Few prospective longitudinal studies have examined the relationship between abuse or neglect in childhood and depression in adulthood. OBJECTIVE: To determine whether abused and neglected children were at elevated risk of major depressive disorder (MDD) and psychiatric comorbidity, compared with matched control subjects, when followed up into young adulthood. DESIGN: Prospective cohort design study. SETTING: Midwestern metropolitan county area. PARTICIPANTS: Children with substantiated cases of physical and sexual abuse and neglect (before the age of 11 years) from January 1, 1967, to December 31, 1971 (n = 676) were matched based on age, race, sex, and approximate family social class with a group of non-abused and non-neglected children (n = 520) and followed up into young adulthood (mean age, 28.7 years). MAIN OUTCOME MEASURES: Between October 20, 1989, and December 22, 1995, 2-hour in-person interviews were conducted, using the National Institute of Mental Health Diagnostic Interview Schedule, Version III Revised, to determine DSM-III-R MDD and other psychiatric diagnoses. RESULTS: Child abuse and neglect were associated with an increased risk for current MDD (odds ratio [OR], 1.51; 95% confidence interval [CI], 1.06-2.14; P< or=.05) in young adulthood. Children who were physically abused (OR, 1.59; 95% CI, 1.00-2.52; P< or =.05) or experienced multiple types of abuse (OR, 1.75; 95% CI, 1.01-3.02; P< or =.05) were at increased risk of lifetime MDD, whereas neglect increased risk for current MDD (OR, 1.59; 95% CI, 1.10-2.29; P<.01). Childhood sexual abuse was not associated with elevated risk of MDD. Kaplan-Meier age-of-onset curves (log-rank statistic, 4.03; df = 1; P=.04) showed earlier onset of MDD for abused and neglected children compared with controls. Among those with MDD, comorbidity was higher for abused and neglected individuals than for controls. CONCLUSION: These results support the need for clinicians to increase efforts to detect and treat depression in physically abused and neglected children.     

Role of childhood traumatic experience in personality disorders in China

BackgroundThere has been no large-scale examination of the association between types of childhood abuse and personality disorders (PDs) in China using standardized assessment tools and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Hence, this study aimed to explore the relationship between retrospective reports of various types of childhood maltreatments and current DSM-IV PDs in a clinical population in China, Shanghai.MethodOne thousand four hundred two subjects were randomly sampled from the Shanghai Psychological Counselling Centre. PDs were assessed using the Personality Diagnostic Questionnaire, Fourth Edition Plus. Participants were also interviewed using the Structured Clinical Interview for DSM-IV axis II. The Child Trauma Questionnaire (CTQ) was used to assess childhood maltreatment in 5 domains (emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect).ResultsAccording to Pearson correlations, childhood maltreatment had a strong association with most PDs. Subsequently, using partial correlations, significant relationships were also demonstrated between cluster B PDs and all the traumatic factors except physical neglect. A strongest positive correlation was found between cluster B PD and CTQ total scores (r = .312, P < .01). Using the Kruskal-Wallis rank sum test, significant differences in 4 groups of subjects (clusters A, B, and C PD and non-PD) in terms of emotional abuse (χ² = 34.864, P < .01), physical abuse (χ² = 14.996, P < .05), sex abuse (χ² = 9.211, P < .05), and emotional neglect (χ² = 17.987, P < .01) were found. Stepwise regression analysis indicated that emotional abuse and emotional neglect were predictive for clusters A and B PD, and sexual abuse was highly predictive for cluster B PD; only emotional neglect was predictive for cluster C PD.ConclusionEarly traumatic experiences are strongly related to the development of PDs. The effects of childhood maltreatment in the 3 clusters of PDs are different. Childhood trauma has the most significant impact on cluster B PD.     

Childhood neglect is associated with reduced corpus callosum area.

BACKGROUND: Childhood abuse has been associated with abnormalities in brain development, particularly corpus callosum (CC) morphology. The impact of neglect has not been assessed, though it is the most prevalent form of childhood maltreatment. METHODS: Regional CC area was measured from magnetic resonance imaging scans in 26 boys and 25 girls admitted for psychiatric evaluation (28 with abuse or neglect) and compared with CC area in 115 healthy control subjects. Data were analyzed by multivariate analysis of covariance, with age and midsagittal area as covariates. RESULTS: Total CC area of the abused/neglected patients was 17% smaller than in control subjects (p =.0001) and 11% smaller than in psychiatric patients who had not been abused or neglected (contrast group; p =.01). Control subjects and the contrast group did not differ in total CC area. Neglect was the strongest experiential factor and was associated with a 15%-18% reduction in CC regions 3, 4, 5, and 7 (all p <.02). In contrast, sexual abuse seemed to be the strongest factor associated with reduced CC size in girls. CONCLUSIONS: These data are consistent with animal research that demonstrated reduced CC size in nursery-reared compared with semi-naturally reared primates. Early experience might also affect the development of the human CC.     

Association of maladaptive parental behavior with psychiatric disorder among parents and their offspring

BACKGROUND: A longitudinal study was conducted to investigate the role of maladaptive parental behavior in the association between parent and offspring psychiatric disorder. METHODS: Psychosocial and psychiatric interviews were administered to a representative community sample of 593 biological parents and their offspring from 2 counties in the state of New York in 1975, 1983, 1985 to 1986, and 1991 to 1993. In 1975, the offspring were a mean age of 6 years. Maladaptive parental behavior was assessed in 1975, 1983, and 1985 to 1986. Parent and offspring psychiatric symptoms were assessed in 1983, 1985 to 1986, and 1991 to 1993. RESULTS: Maladaptive parental behavior substantially mediated a significant association between parental and offspring psychiatric symptoms. Parents with psychiatric disorders had higher levels of maladaptive behavior in the household than did parents without psychiatric disorders. Maladaptive parental behavior, in turn, was associated with increased offspring risk for psychiatric disorders during adolescence and early adulthood. Most of the youths that experienced high levels of maladaptive parental behavior during childhood had psychiatric disorders during adolescence or early adulthood, whether or not their parents had psychiatric disorders. In contrast, the offspring of parents with psychiatric disorders were not at increased risk for psychiatric disorders unless there was a history of maladaptive parental behavior. CONCLUSIONS: Maladaptive parental behavior is associated with increased risk for the development of psychiatric disorders among the offspring of parents with and without psychiatric disorders. Maladaptive parental behavior appears to be an important mediator of the association between parental and offspring psychiatric symptoms.     

Childhood adversities associated with risk for eating disorders or weight problems during adolescence or early adulthood

OBJECTIVE: A community-based prospective longitudinal study was conducted to investigate the association between childhood adversities and problems with eating or weight during adolescence and early adulthood. METHOD: A community-based sample of 782 mothers and their offspring were interviewed during the childhood, adolescence, and early adulthood of the offspring. Childhood maltreatment, eating problems, environmental risk factors, temperament, maladaptive parental behavior, and parental psychopathology were assessed during childhood and adolescence. Eating disorders and problems with eating or weight in the offspring were assessed during adolescence and early adulthood. RESULTS: A wide range of childhood adversities were associated with elevated risk for eating disorders and problems with eating or weight during adolescence and early adulthood after the effects of age, childhood eating problems, difficult childhood temperament, parental psychopathology, and co-occurring childhood adversities were controlled statistically. Numerous unique associations were found between specific childhood adversities and specific types of problems with eating or weight, and different patterns of association were obtained among the male and female subjects. Maladaptive paternal behavior was uniquely associated with risk for eating disorders in offspring after the effects of maladaptive maternal behavior, childhood maltreatment, and other co-occurring childhood adversities were controlled statistically. CONCLUSIONS: Childhood adversities may contribute to greater risk for the development of eating disorders and problems with eating and weight that persist into early adulthood. Maladaptive paternal behavior may play a particularly important role in the development of eating disorders in offspring.     

Parenting behaviors associated with risk for offspring personality disorder during adulthood

CONTEXT: Research has suggested that some types of parental child-rearing behavior may be associated with risk for offspring personality disorder (PD), but the association of parenting with offspring PD has not been investigated comprehensively with prospective longitudinal data. OBJECTIVE: To investigate the association of parental child-rearing behavior with risk for offspring PD during adulthood. DESIGN: The Children in the Community study, a prospective longitudinal investigation. SETTING AND PARTICIPANTS: A community-based sample of 593 families interviewed during childhood (mean age, 6 years), adolescence (mean ages, 14 and 16 years), emerging adulthood (mean age, 22 years), and adulthood (mean age, 33 years) of the offspring. MAIN OUTCOME MEASURE: The Structured Clinical Interview for DSM-IV Personality Disorders. RESULTS: Ten types of parenting behavior that were evident during the child-rearing years were associated with elevated offspring risk for PD during adulthood when childhood behavioral or emotional problems and parental psychiatric disorders were controlled statistically. Parental behavior in the home during the child-rearing years was associated with elevated risk for offspring PD at mean ages of 22 and 33 years. Risk for offspring PD at both assessments increased steadily as a function of the number of problematic parenting behaviors that were evident. Low parental affection or nurturing was associated with elevated risk for offspring antisocial (P = .003), avoidant (P = .01), borderline (P = .002), depressive (P = .02), paranoid (P = .002), schizoid (P = .046), and schizotypal (P<.001) PDs. Aversive parental behavior (eg, harsh punishment) was associated with elevated risk for offspring borderline (P = .001), paranoid (P = .004), passive-aggressive (P = .046), and schizotypal (P = .02) PDs. CONCLUSIONS: Parental behavior during the child-rearing years may be associated with risk for offspring PD that endures into adulthood. This risk may not be attributable to offspring behavioral and emotional problems or parental psychiatric disorder, and it may not diminish over time. Low parental nurturing and aversive parental behavior during child rearing may both be associated with elevated risk for offspring PDs.     

Childhood family structure and personality disorders in adulthood.

BACKGROUND: The association between childhood family structure and sociodemographic characteristics and personality disorders (PDs) in a general population sample was studied. METHODS: This study is a substudy of the prospective Northern Finland 1966 Birth Cohort Project with 1588 young adult subjects. The case-finding methods according to the DSM-III-R criteria for PDs were: (1) Structured Clinical Interview for DSM-III-R (SCID) for 321 cases who participated in a 2-phase field study, (2) Finnish Hospital Discharge Register data, and (3) analysis of the patient records in public outpatient care in 1982-1997. Statistical analyses were performed on the association between PDs and family background factors. RESULTS: Altogether 110 (7.0%) of the subjects had at least one probable or definite PD. After adjusting for confounders (gender, parental social class and parental psychiatric disorder) the results indicated that single-parent family type in childhood was associated with cluster B PDs in adulthood. Being an only child in childhood was associated with cluster A PDs. No special childhood risk factors were found for cluster C PDs. CONCLUSIONS: Results suggest that single-parent family type at birth and being an only child in the 1960s are associated with PD in adulthood. Further studies are needed to explore the psychosocial aspects of family environment which may nowadays promote vulnerability to PDs in adulthood.     

Maladaptative parenting and the association between parental and offspring psychiatric disorders

A longitudinal study was conducted to investigate the role of maladaptive parental behavior and the association between parent and offspring psychiatric disorders. Psychosocial and psychiatric interviews were carried out in a representative community sample of 593 biological parents and their offspring from two counties in the state of New York in 1975, 1983, 1985-86, and 1991-93. In 1975, the mean age of offspring was 6 years. Maladaptive parental behavior was assessed in 1975, 1983, and 1985-86. Parent and offspring psychiatric symptoms were assessed in 1983, 1985-86, and 1991-93. Maladaptive parental behavior substantially mediated a significant association between parental and offspring psychiatric symptoms. Parents with psychiatric disorders had higher levels of maladaptive behavior in the household than did parents without psychiatric disorders. Maladaptive parental behavior, in turn, was associated with increased offspring risk for psychiatric disorders during adolescence and early adulthood. Most of the youths that experienced high levels of maladaptive parental behavior during childhood had psychiatric disorders during adolescence or early adulthood, independent of whether or not their parents had psychiatric disorders. In contrast, the offspring of parents with psychiatric disorders were not at increased risk for psychiatric disorders unless there was a history of maladaptive parental behavior. Maladaptive parental behavior is associated with increased risk for the development of psychiatric disorders among the offspring of parents with and without psychiatric disorders. Maladaptive parental behavior appears to be an important mediator of the association between parental and offspring psychiatric symptoms.     

Childhood abuse and neglect: specificity of effects on adolescent and young adult depression and suicidality

OBJECTIVE: To investigate the magnitude and independence of the effects of childhood neglect, physical abuse, and sexual abuse on adolescent and adult depression and suicidal behavior. METHOD: A cohort of 776 randomly selected children was studied from a mean age of 5 years to adulthood in 1975, 1983, 1986, and 1992 during a 17-year period. Assessments included a range of child, family, and environmental risks and psychiatric disorders. A history of abuse was determined by official abuse records and by retrospective self-report in early adulthood on 639 youths. Attrition rate since 1983 has been less than 5%. RESULTS: Adolescents and young adults with a history of childhood maltreatment were 3 times more likely to become depressed or suicidal compared with individuals without such a history (p < .01). Adverse contextual factors, including family environment, parent and child characteristics, accounted for much of the increased risk for depressive disorders and suicide attempts in adolescence but not in adulthood (p < .01). The effects of childhood sexual abuse were largest and most independent of associated factors. Risk of repeated suicide attempts was 8 times greater for youths with a sexual abuse history (odds ratio = 8.40, p < .01). CONCLUSIONS: Individuals with a history of sexual abuse are at greater risk of becoming depressed or suicidal during adolescence and young adulthood. Adolescence is the most vulnerable period for those youths who may attempt suicide repeatedly. Many of the apparent effects of neglect, in contrast, may be attributable to a range of contextual factors, suggesting broader focus for intervention in these cases.     

Childhood maltreatment as a risk factor for adult cardiovascular disease and depression

BACKGROUND: Traumatic experiences in childhood are linked to adult depression and cardiovascular disease. Depression is twice as common in women than men, and depression after cardiovascular events is more common in women than men. However, sex differences in these relationships have not been comprehensively investigated using a nationally representative sample in which demographic factors related to these illnesses can be controlled. METHOD: Data come from the Part 2 sample of the U.S. National Comorbidity Survey, a nationally representative sample containing over 5000 adults. Relationships between childhood maltreatment (sexual abuse, physical abuse, neglect), adult depression (DSM-III-R), and cardiovascular disease were examined using multiple logistic regression models with a specific emphasis on the evaluation of sex differences. RESULTS: Childhood maltreatment was associated with a significant increase in cardiovascular disease for women only and with a significant increase in lifetime depression for both genders. A history of childhood maltreatment removed the natural protection against cardiovascular disease for women and depression for men. Although depression and cardiovascular disease were correlated, depression did not contribute to the prediction of cardiovascular disease in women when controlling for history of childhood maltreatment. CONCLUSIONS: Gender is important in evaluating potential psychiatric and physical correlates of childhood maltreatment. Maltreatment is a potent risk factor for cardiovascular disease in women and for depression in both women and men. Effective clinical assessment should recognize the role of childhood abuse or neglect in adult health and disease. Research on the consequences of childhood maltreatment should focus on both psychiatric and physical outcomes.     

Personality traits of women with a history of childhood sexual abuse

This study examined relationships between specific dimensions of childhood sexual abuse and personality traits in adulthood. Study participants were 74 hospitalized female psychiatric patients with a self-reported history of childhood sexual abuse. Characteristics of childhood sexual abuse were obtained from a structured life-events interview. Personality was measured with the NEO-Five-Factor Inventory (NEO-FFI), which yields scores on neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness. We hypothesized that parental abuse, intercourse, and the combination of these two childhood sexual abuse characteristics would be associated with personality traits. Supporting this hypothesis, women who were abused by a parent had lower scores on openness to experience than women who were abused by someone else. Patients whose abuse history included both parental abuse and intercourse had very low extraversion scores. Our findings suggest that there are associations between personality traits and childhood sexual abuse characteristics in psychiatric patients. Specifically, women who experienced intercourse by a parent may be more introverted and less open to experience than women whose sexual abuse history does not include parental incest.     

Sexual and physical abuse of chronically ill psychiatric outpatients compared with a matched sample of medical outpatients

Because there are few controlled studies, we aimed to determine the prevalence of sexual and physical abuse reported by psychiatric outpatients compared with matched controls. The sample consisted of 158 outpatients with major mental disorders including schizophrenia and bipolar disorder who responded to a semi-structured interview (response rate = 64.8%) and who were individually matched for gender, age, and ethnicity with 158 outpatients who had never been treated for psychiatric illness. They answered questions about whether and when they had ever been sexually or physically abused, and about the type and circumstances of abuse. Abuse was more common during adulthood (16 years or older); 45 psychiatric patients (28.5%) were sexually abused and 43 (27.3%) were physically abused. Compared with the controls, patients were significantly more likely to report a history of sexual or physical abuse during adulthood (chi2 = 5.15, df = 1, p = .02; chi2 = 4.09, df = 1, p = .04 respectively). During adulthood, female patients were significantly more likely to be sexually and physically abused than male patients, and those sexually abused were significantly more likely to report a history of sexual abuse during childhood. However, patients were not significantly more likely to report a history of sexual or physical abuse during childhood compared with the controls. These findings demonstrate that psychiatrically ill patients are vulnerable to sexual and physical abuse during adulthood and underscore psychiatrists' responsibility to routinely inquire about abuse experiences.     

Psychometric functioning,socio‐demographic variability of childhood maltreatment in the general population and its effects of depression

Maltreatment of children is a major public‐health and social‐welfare problem but socio‐demographic variability has received little attention. This work addresses such variability in a general population cohort and associations with depression. Analyses were based on the cross‐sectional SHIP‐LEGEND examination among 2265 adults (29–89 years). Childhood maltreatment was multi‐dimensionally assessed with the German 28‐item Childhood Trauma Questionnaire (CTQ): emotional neglect; emotional abuse; physical neglect; physical abuse; sexual abuse. Non‐linear associations between CTQ responses and age were assessed with fractional polynomials and cubic splines. Scale properties were analysed with confirmatory factor analyses and item response models. Associations between childhood maltreatment domains and depression [Beck Depression Inventory‐II (BDI‐II)] were assessed. The majority (58.9%) reported events indicative of at least mild levels of childhood maltreatment. CTQ subscales showed characteristically different non‐linear associations to age across the five studied domains, indicating methodological issues like recall bias and the influence of seminal events. Psychometric scale properties were acceptable to good for all subscales except for physical neglect. Associations to depression measures varied systematically across socio‐demographic strata. We conclude that socio‐demographic variability is a major issue when studying self‐reported childhood maltreatment in a community sample. This needs to be taken into account for the study of associations to psychiatric key outcomes. Copyright © 2014 John Wiley & Sons, Ltd.     

Exploring psychological abuse in childhood: I. Developing a new interview scale

Definitions of psychological abuse are reviewed and a new definition proposed, operationalized as an extension of an existing measure of childhood, the Childhood Experience of Care and Abuse (CECA). This semistructured, investigator-based interview is designed for use with adults to collect retrospective accounts of childhood adverse experience. The CECA extension identifies nine subtypes of psychological abuse, with a single global severity rating. The definition is clearly differentiated from other adverse experiences with emotionally abusive elements such as parental antipathy (hostile parenting), neglect, and role reversal. Examples are given. A community-based series of 301 women were interviewed using the extended CECA to gather a range of experiences of childhood maltreatment on which to devise the new measure. Interrater reliability was satisfactory, and several features of psychological abuse were examined, including its prevalence, frequency, and the characteristics of the abused child and perpetrator. The new scale is discussed in terms of its potential use not only by researchers but also by practitioners such as clinicians and social workers in the child protection field in order to more accurately identify and assess multiples of abuse in childhood. A companion article (Bifulco, Moran, Baines, Bunn, & Stanford, 2002) examines the relationship of psychological abuse to adult major depression.