July 6, 2010 Abuse and neglect during childhood appear to be associated with increased rates of mood, anxiety and substance use disorders among young adults, according to a report in the June issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Most studies of child maltreatment and later mental health outcomes have relied on reports of past abuse, according to background information in the article. Doubts have been raised about the reliability and validity of these reports, given that past maltreatment is often unreported, memories can be reconstructed and the reports can be unstable over time.
Kate M. Scott, Ph.D., M.A. Appl. (Clin Psych), and colleagues at University of Otago-Wellington, Wellington, New Zealand, linked national child protection agency records with data from a nationally representative community survey of mental disorders among young adults age 16 to 27. The survey included 2,144 young adults, 221 of whom had a history of child maltreatment as indicated by child protection agency records.
After adjusting for demographic and socioeconomic factors, a history of abuse or neglect was associated with having any mental disorder and with five individual mental disorders -- including anxiety, mood and substance abuse conditions -- both over a lifetime and in the previous year. The strongest associations were with post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder.
When asked in young adulthood, 15 percent of the participants in the group without a child protection agency record reported maltreatment. "After excluding these individuals from the comparison group, the magnitude of associations increased, with child protection agency history conferring a 10-fold higher odds of 12-month PTSD, together with elevated odds of other anxiety disorders, mood disorders and drug use disorders," the authors write.
The findings suggest that maltreatment, not just the memory of maltreatment, is associated with mental health disorders in young adulthood. "This implies, first, that targeted mental health interventions with present or past clients of child welfare agencies are indicated in addition to the interventions currently provided to stop or reduce the maltreatment; and second, that concerted population-level strategies are required to address the needs of the many other children who also experience maltreatment."
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- Kate M. Scott; Don R. Smith; Pete M. Ellis. Prospectively Ascertained Child Maltreatment and Its Association With DSM-IV Mental Disorders in Young Adults. Arch Gen Psychiatry, 2010; 67 (7): 712-719 [link]
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