Childhood Maltreatment Linked with Poor Course of Emotional Disorders in Adulthood

Andrea Danese, MD, PhD

Credit: Academy on Violence & Abuse

New data support the importance of considering both objective and subjective measures of childhood maltreatment when examining its impact on the course of emotional disorders. The precise origins and underlying mechanisms that link childhood maltreatment and unfavorable experiences of emotional disorders remain poorly understood, according to the study.¹

While the objective experience alone did not significantly predict the unfavorable trajectory of emotional disorders, investigators acknowledged the impact of the subjective experience in the prospective cohort study.

Adverse outcomes later in life have been shown to be impacted by experiencing mistreatment in childhood, indicating it as a risk factor for emotional disorders such as depression and anxiety.²

Andrea Danese, MD, PhD, Social, Genetic and Developmental Psychiatry Centre and Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, and investigators aimed to evaluate the relative associations of objective and subjective measures of childhood maltreatment and continuity in psychopathology with the course of emotional disorders in adulthood.¹

The study’s prospective cohort included almost 1200 individuals up to the age of 40 years. The participants were residents of a metropolitan county in the US Midwest and were divided into 2 groups: those with substantiated records of childhood physical and sexual abuse and/or neglect between 1967 and 1971, and a demographically matched control group without any history of abuse or neglect.

Current and lifetime psychopathology was also evaluated at the same time point. For the measurement of objective experience of childhood maltreatment, investigators used official court records, while the subjective experience was assessed through retrospective self-report at an average age of 29 years.

According to the subjective experience analysis of childhood maltreatment, investigators identified a higher number of subsequent follow-up phases with depression or anxiety. However, based on the objective experience of maltreatment measured through official court records did not show a similar association.

Results showed those with both objective and subjective measures of childhood maltreatment had a significantly greater number of follow-up phases with depression or anxiety compared with the control group. Similarly, investigators found individuals with subjective-only measures also experienced a higher incidence of emotional disorders.

Those with objective-only measures did not exhibit an elevated risk of depression or anxiety. An association was observed between the subjective experience of maltreatment and the later course of emotional disorders influenced by the presence of current and lifetime psychopathology.

The study reported it was evident in participants who did not have objective measures of maltreatment, suggesting that the subjective experience was partly explained by continuity in psychopathology.

The findings of this study provided valuable insights into the role of subjective experiences in the association between childhood maltreatment and the course of emotional disorders in adulthood. The data indicated modifying the subjective experience of childhood maltreatment could potentially improve the longitudinal course of emotional disorders.

Interventions targeting the subjective perceptions and psychological consequences of maltreatment may be beneficial in reducing the burden of emotional disorders among individuals with a history of childhood maltreatment, the study noted.

The presence of current and lifetime psychopathology further contributed to this association as findings emphasized the need for comprehensive assessments and targeted interventions that address both the objective and subjective dimensions of childhood maltreatment to promote better mental health outcomes in individuals affected by early-life adversity.

References:

1. Danese A, Widom CS. Associations Between Objective and Subjective Experiences of Childhood Maltreatment and the Course of Emotional Disorders in Adulthood. JAMA Psychiatry. Published online July 05, 2023. doi:10.1001/jamapsychiatry.2023.2140
2. Iapoce C. Personality Disorders Present in Children Following Emotional Abuse. HCPLive. May 2, 2021. https://www.hcplive.com/view/personality-disorders-present-in-children-following-emotional-abuse