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Nagar, M.; Nakash, O. Associations between Childhood Abuse and Adult Psychopathology. Encyclopedia. Available online: https://encyclopedia.pub/entry/55751 (accessed on 28 April 2024).
Nagar M, Nakash O. Associations between Childhood Abuse and Adult Psychopathology. Encyclopedia. Available at: https://encyclopedia.pub/entry/55751. Accessed April 28, 2024.
Nagar, Maayan, Ora Nakash. "Associations between Childhood Abuse and Adult Psychopathology" Encyclopedia, https://encyclopedia.pub/entry/55751 (accessed April 28, 2024).
Nagar, M., & Nakash, O. (2024, February 29). Associations between Childhood Abuse and Adult Psychopathology. In Encyclopedia. https://encyclopedia.pub/entry/55751
Nagar, Maayan and Ora Nakash. "Associations between Childhood Abuse and Adult Psychopathology." Encyclopedia. Web. 29 February, 2024.
Associations between Childhood Abuse and Adult Psychopathology
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This entry is adapted from the peer-reviewed paper 10.3390/healthcare12030412

Research consistently shows that abuse during childhood is related to adult psychopathology. Adverse childhood experiences, including emotional, physical, and sexual abuse, have been consistently linked to mental health problems in children and adults.

childhood abuse trauma post-traumatic stress disorder mood and anxiety disorders

1. Introduction

Adverse childhood experiences, including emotional, physical, and sexual abuse, have been consistently linked to mental health problems in children and adults [1][2]. A review of 52 studies on in-patient care [3] found that more than 50% of the men and over 60% of the women were exposed to sexual or physical abuse in their childhood. Rates of reported childhood abuse in clinical populations vary for different types of abuse, with studies showing the highest prevalence for emotional abuse (25–54%) [4][5], followed by physical abuse (21–30%) [6] and sexual abuse (4.3–28%) [4][7].
Studies have consistently documented the association between childhood abuse and mental health problems in adulthood, including depression, anxiety, post-traumatic stress disorder (PTSD), substance abuse, eating disorders, personality disorders, and dissociative disorders [8][9]. Additionally, psychiatric patients who have been exposed to sexual or physical childhood abuse were found to have an earlier first admission, longer hospitalizations, received more medication, a higher likelihood to commit suicide and self-mutilate, and a higher symptomatology [10][11]. Maladaptive processes of the emotional-processing system and general physiological reactivity have been assumed to contribute the vulnerability of deleterious sequelae of exposure to childhood traumatic experiences [12][13].
Despite this robust body of literature, the information regarding childhood abuse in research to date has frequently relied on a sole source such as previous documentation (e.g., social services charts) or participants’ self-reports.

2. Childhood Abuse and Adult Personality Disorders

Ample research has examined the association between exposure to neglect and abuse during childhood and adult diagnoses of personality disorders (PDs) [14][15]. Research most frequently based the investigation on a sample of patients in community mental health clinics or a representative community sample [16]. Studies that have included patients in mental health clinics frequently relied on a sole source to collect information on childhood abuse, including patients’ self-reports and interviews or clinical records [17][18]. Findings show that childhood adverse experiences are particularly prevalent among persons diagnosed with PDs, specifically, borderline PD (BPD), and they are associated with greater symptom severity, as well as with worse psychopathology [19][20]. For example, a study conducted among adults seeking mental health care diagnosed with PDs, relying on self-reported history of abuse, showed that individuals diagnosed with PDs reported increased rates of childhood abuse (73%) and neglect (82%). BPD was, in particular, marked as being associated with childhood abuse and neglect [19]. A study among patients from different mental health care settings (outpatient, inpatient, and forensic) documented associations between specific types of childhood maltreatment and adult PDs. Sexual abuse was associated with symptoms of borderline, paranoid, schizoid, and avoidant PDs; physical abuse was associated with antisocial PD; emotional abuse was associated with paranoid, borderline, and schizotypal PDs; and neglect was associated with borderline and histrionic PDs [20]. Importantly, studies that used multiple sources of information pointed to potential gaps in reports of childhood experiences of abuse. For example, a study by Rossiter et al. [6] among adult patients in community and hospital-based clinics compared information from self-reports and clinical notes. Authors documented that 93–100% of patients with antisocial, passive-aggressive, paranoid, and borderline PDs self-reported childhood-abuse experiences, while only 40–69% of clinical notes included similar information for these patients [6].
Studies that have examined PD symptoms and childhood adversities in the general population (non-clinical samples) have used mainly structured interviews for assessing psychiatric diagnosis (SCID I and II) and self-reports for collecting information on histories of trauma. These assessments have shown similar results. For example, Johnson et al. [21], using psychosocial and psychiatric interviews, found that an exposure to abuse and neglect during childhood was associated with greater PD symptomatology, and that persons that were abused or neglected during childhood were up to four times more likely to be diagnosed with PDs in adulthood compared to those who did not experience maltreatment in childhood. Another study, conducted by Tyrka et al. [22], applying methods of psychiatric diagnostic interviews and self-report questionnaires assessing exposure to abuse during childhood have shown similar results. Childhood maltreatment, including emotional, physical, and sexual abuse, as well as neglect, was associated with elevated symptoms of PDs, specifically of borderline, paranoid, avoidant, obsessive-compulsive, and dependent PDs. A different study also used structured diagnostic interviews, as well as self-reports, to document that childhood adversities, including emotional, physical, and sexual abuse, were highly prevalent among persons with PDs [23]. Indeed, a recent review of 44 studies regarding early-life stress has confirmed the robust connection between emotional abuse and neglect with PDs [24].

3. Childhood Abuse and Mood and Anxiety Disorders

Similar to the literature on adult PDs and childhood abuse, research has documented the association between exposure to abuse during childhood and symptoms of mood and anxiety disorders in adulthood. A meta-analysis, conducted by Mandelli et al. [25], documented that, regardless of research method, childhood experiences of emotional neglect were highly correlated with adult symptoms of depression [25]. Another meta-analysis showed similar results, indicating that childhood exposure to physical and sexual abuse, as well as neglect, was associated with common adult mental disorders [24]. It is noteworthy that all studies to date have used diagnostic information and information regarding childhood abuse from either one (participants or interviewers) or two sources (participants and independent interviewers), with diagnostic assessment mostly based on structured clinical interviews (e.g., SCID) or self-report questionnaires, and childhood abuse information gathered mostly through self-reports or semi-structured interviews [25][26][27].
Using data from self-report measures, Kounou et al. [26] found that compared to individuals without psychiatric history, patients with major depression reported higher rates of childhood maltreatment, including emotional, physical, and sexual abuse, as well as neglect. Similarly, Mall et al. [28] showed that childhood exposure to emotional abuse and/or neglect predicted adult depression during the preceding year. As for studies using interviews, Hovens et al. [29] reported that childhood exposure to emotional and physical abuse, as well as emotional neglect, was correlated with adult depressive and anxiety disorders. Surprisingly, exposure to childhood sexual abuse was not associated with depression during adulthood. Another study relying on interviews showed that sexual abuse during childhood was related to lifetime mood and anxiety disorders, while physical abuse during childhood was associated with lifetime anxiety disorders [30].

References

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  2. Musetti, A.; Starcevic, V.; Boursier, V.; Corsano, P.; Billieux, J.; Schimmenti, A. Childhood emotional abuse and problematic social networking sites use in a sample of Italian adolescents: The mediating role of deficiencies in self-other differentiation and uncertain reflective functioning. J. Clin. Psychol. 2021, 77, 1666–1684.
  3. Read, J.; Harper, D.; Tucker, I.; Kennedy, A. Do adult mental health services identify child abuse and neglect? A systematic review. Int. J. Ment. Health Nurs. 2018, 27, 7–19.
  4. Duhig, M.; Patterson, S.; Connell, M.; Foley, S.; Capra, C.; Dark, F.; Gordon, A.; Singh, S.; Hides, L.; McGrath, J.J. The prevalence and correlates of childhood trauma in patients with early psychosis. Aust. N. Z. J. Psychiatry 2015, 49, 651–659.
  5. Wota, A.; Byrne, C.; Murray, I.; Ofuafor, T.; Nisar, Z.; Neuner, F.; Hallahan, B. An examination of childhood trauma in individuals attending an adult mental health service. Ir. J. Psychol. Med. 2014, 31, 259–270.
  6. Rossiter, A.; Byrne, F.; Wota, A.P.; Nisar, Z.; Ofuafor, T.; Murray, I.; Byrne, C.; Hallahan, B. Childhood trauma levels in individuals attending adult mental health services: An evaluation of clinical records and structured measurement of childhood trauma. Child Abuse Negl. 2015, 44, 36–45.
  7. MacMillan, H.L.; Fleming, J.E.; Streiner, D.L.; Lin, E.; Boyle, M.H.; Jamieson, E.; Duku, E.K.; Walsh, C.A.; Wong, M.Y.-Y.; Beardslee, W.R. Childhood abuse and lifetime psychopathology in a community sample. Am. J. Psychiatry 2001, 158, 1878–1883.
  8. Merrick, M.T.; Ports, K.A.; Ford, D.C.; Afifi, T.O.; Gershoff, E.T.; Grogan-Kaylor, A. Unpacking the impact of adverse childhood experiences on adult mental health. Child Abuse Negl. 2017, 69, 10–19.
  9. Schilling, E.A.; Aseltine, R.H.; Gore, S. Adverse childhood experiences and mental health in young adults: A longitudinal survey. BMC Public Health 2007, 7, 30.
  10. Mullen, P.E.; Martin, J.L.; Anderson, J.C.; Romans, S.E.; Herbison, G.P. Childhood sexual abuse and mental health in adult life. Br. J. Psychiatry 1993, 163, 721–732.
  11. Read, J.; Agar, K.; Barker-Collo, S.; Davies, E.; Moskowitz, A. Assessing suicidality in adults: Integrating childhood trauma as a major risk factor. Prof. Psychol. Res. Pract. 2001, 32, 367–372.
  12. Wauthia, E.; Rossignol, M. Emotional processing and attention control impairments in children with anxiety: An integrative review of event-related potentials findings. Front. Psychol. 2016, 7, 562.
  13. Stout, D.M.; Powell, S.; Kangavary, A.; Acheson, D.T.; Nievergelt, C.M.; Kash, T.; Simmons, A.N.; Baker, D.G.; Risbrough, V.B. Dissociable impact of childhood trauma and deployment trauma on affective modulation of startle. Neurobiol. Stress 2021, 15, 100362.
  14. Grover, K.E.; Carpenter, L.L.; Price, L.H.; Gagne, G.G.; Mello, A.F.; Mello, M.F.; Tyrka, A.R. The relationship between childhood abuse and adult personality disorder symptoms. J. Pers. Disord. 2007, 21, 442–447.
  15. Cohen, L.J.; Tanis, T.; Bhattacharjee, R.; Nesci, C.; Halmi, W.; Galynker, I. Are there differential relationships between different types of childhood maltreatment and different types of adult personality pathology? Psychiatry Res. 2014, 215, 192–201.
  16. Zlotnick, C.; Johnson, J.; Kohn, R.; Vicente, B.; Rioseco, P.; Saldivia, S. Childhood trauma, trauma in adulthood, and psychiatric diagnoses: Results from a community sample. Compr. Psychiatry 2008, 49, 163–169.
  17. McLean, L.M.; Gallop, R. Implications of childhood sexual abuse for adult borderline personality disorder and complex posttraumatic stress disorder. Am. J. Psychiatry 2003, 160, 369–371.
  18. Soloff, P.H.; Lynch, K.G.; Kelly, T.M. Childhood abuse as a risk factor for suicidal behavior in borderline personality disorder. J. Pers. Disord. 2002, 16, 201–214.
  19. Battle, C.L.; Shea, M.T.; Johnson, D.M.; Yen, S.; Zlotnick, C.; Zanarini, M.C.; Sanislow, C.A.; Skodol, A.E.; Gunderson, J.G.; Grilo, C.M. Childhood maltreatment associated with adult personality disorders: Findings from the Collaborative Longitudinal Personality Disorders Study. J. Pers. Disord. 2004, 18, 193–211.
  20. Lobbestael, J.; Arntz, A.; Bernstein, D.P. Disentangling the relationship between different types of childhood maltreatment and personality disorders. J. Pers. Disord. 2010, 24, 285–295.
  21. Johnson, J.G.; Cohen, P.; Brown, J.; Smailes, E.M.; Bernstein, D.P. Childhood maltreatment increases risk for personality disorders during early adulthood. Arch. Gen. Psychiatry 1999, 56, 600–606.
  22. Tyrka, A.R.; Wyche, M.C.; Kelly, M.M.; Price, L.H.; Carpenter, L.L. Childhood maltreatment and adult personality disorder symptoms: Influence of maltreatment type. Psychiatry Res. 2009, 165, 281–287.
  23. Afifi, T.O.; Mather, A.; Boman, J.; Fleisher, W.; Enns, M.W.; MacMillan, H.; Sareen, J. Childhood adversity and personality disorders: Results from a nationally representative population-based study. J. Psychiatr. Res. 2011, 45, 814–822.
  24. Carr, C.P.; Martins, C.M.S.; Stingel, A.M.; Lemgruber, V.B.; Juruena, M.F. The role of early life stress in adult psychiatric disorders: A systematic review according to childhood trauma subtypes. J. Nerv. Ment. Dis. 2013, 201, 1007–1020.
  25. Mandelli, L.; Petrelli, C.; Serretti, A. The role of specific early trauma in adult depression: A meta-analysis of published literature. Childhood trauma and adult depression. Eur. Psychiatry 2015, 30, 665–680.
  26. Kounou, K.B.; Bui, E.; Dassa, K.S.; Hinton, D.; Fischer, L.; Djassoa, G.; Birmes, P.; Schmitt, L. Childhood trauma, personality disorders symptoms and current major depressive disorder in Togo. Soc. Psychiatry Psychiatr. Epidemiol. 2013, 48, 1095–1103.
  27. Paterniti, S.; Sterner, I.; Caldwell, C.; Bisserbe, J.-C. Childhood neglect predicts the course of major depression in a tertiary care sample: A follow-up study. BMC Psychiatry 2017, 17, 113.
  28. Mall, S.; Mortier, P.; Taljaard, L.; Roos, J.; Stein, D.J.; Lochner, C. The relationship between childhood adversity, recent stressors, and depression in college students attending a South African university. BMC Psychiatry 2018, 18, 63–73.
  29. Hovens, J.G.; Giltay, E.J.; Wiersma, J.E.; Spinhoven, P.; Penninx, B.W.; Zitman, F.G. Impact of childhood life events and trauma on the course of depressive and anxiety disorders. Acta Psychiatr. Scand. 2012, 126, 198–207.
  30. Gal, G.; Levav, I.; Gross, R. Psychopathology among adults abused during childhood or adolescence: Results from the Israel-based World Mental Health Survey. J. Nerv. Ment. Dis. 2011, 199, 222–229.
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Maayan Nagar
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