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References pertaining to abuse and development of depression:
Arch Womens Ment Health. 2003 Feb;6(1):15-22.
Neurobiological effects of childhood abuse: implications for the pathophysiology
of depression and anxiety.
Penza KM, Heim C, Nemeroff CB.
Department of Psychiatry and Behavioral Sciences, Emory University School of
Medicine, Atlanta, GA 30322, USA.
Mood and anxiety disorders are highly prevalent psychiatric disorders, especially
in women, and they are associated with significant morbidity and mortality. A
considerable literature indicates that vulnerability to depression and anxiety
disorders is markedly increased by childhood abuse, e.g., physical, sexual, and
psychological abuse, as well as adulthood stressors, e.g., death of a spouse.
Little is known about the developmental neurobiological mechanisms by which
childhood abuse increases the susceptibility of women to the development of
depression and anxiety disorders in adulthood. Recent research on the effects of
adverse early life experiences on central nervous system (CNS) stress systems has
provided a greater understanding of the link between childhood abuse and
susceptibility to mood and anxiety disorders. Specifically, early life traumatic
events, occurring during a period of neuronal plasticity, appear to permanently
render neuroendocrine stress response systems supersensitive. These physiological
maladaptations likely represent long-term risk factors for the development of
psychopathology after exposure to additional stress.
Publication Types:
Research Support, U.S. Gov't, P.H.S.
PMID: 12715261 [PubMed - indexed for MEDLINE]
Dev Psychopathol. 2001 Summer;13(3):451-71.
Effects of early stress on brain structure and function: implications for
understanding the relationship between child maltreatment and depression.
Kaufman J, Charney D.
Department of Psychiatry, Yale University, New Haven, CT 06511, USA.
joan.kaufman@yale.edu
Child abuse is associated with markedly elevated rates of major depression (MDD)
in child, adolescent, and adult cohorts. This article reviews preclinical (e.g.,
animal) studies of the effects of early stress and studies of the neurobiological
correlates of MDD in adults and children, and it highlights differences in the
neurobiological correlates of MDD and stress at various developmental stages. The
preclinical studies demonstrate that stress early in life can alter the
development multiple neurotransmitter systems and promote structural and
functional alterations in brain regions similar to those seen in adults with
depression. Preclinical and clinical studies suggest, however, that long-term
neurobiological changes associated with early stress can be modified by
familial/genetic factors, the quality of the subsequent caregiving environment,
and pharmacological interventions. Little is known about how developmental
factors interact with experiences of early stress and these other modifying
factors. Moreover, in cases of child maltreatment, the effects of early abuse are
often exacerbated by failures in the child protection system and repeat
out-of-home placements. Given the number of factors that impact on the long-term
outcome of maltreated children, multidisciplinary research efforts are
recommended to address this problem-with foci that span from neurobiology to
social policy.
Publication Types:
Review
PMID: 11523843 [PubMed - indexed for MEDLINE]
Psychol Med. 2004 Nov;34(8):1475-82.
Childhood sexual abuse, stressful life events and risk for major depression in
women.
Kendler KS, Kuhn JW, Prescott CA.
Department of Psychiatry, Medical College of Virginia, Richmond, VA 23298-0126,
USA.
BACKGROUND: In animals, early trauma can produce long-lasting changes in
sensitivity to the pathogenic effects of stress. To explore whether similar
processes occur in humans, we examine whether childhood sexual abuse (CSA) in
women alters sensitivity in adulthood to the depressogenic effects of stressful
life events (SLEs). METHOD: A history of CSA was obtained from a population-based
sample of 1404 female adult twins. Cox Proportional hazard models were used to
predict onsets of episodes of DSM-III-R major depression (MD) in the past year
from previously assessed levels of neuroticism (N), CSA and past-year SLEs scored
on long-term contextual threat. RESULTS: In the best-fit model, onset of MD was
predicted by CSA, SLEs and N. Individuals with CSA (and especially with severe
CSA) had both an overall increased risk for MD and a substantially increased
sensitivity to the depressogenic effects of SLEs. A 'dose-response' relationship
between severity of CSA and sensitivity to SLEs was clearer in those with low to
average levels of N than in those with high levels of N. CONCLUSION: As
documented with physiological responses to a standardized laboratory stressor,
CSA increases stress sensitivity in women in a more naturalistic setting. Both
genetic and early environmental risk factors can produce long-term increase in
the sensitivity of individuals to depressogenic life experiences.
Publication Types:
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Twin Study
Am J Psychiatry. 1999 Jun;156(6):816-28.
Childhood sexual abuse as a risk factor for depression in women: psychosocial and
neurobiological correlates.
Weiss EL, Longhurst JG, Mazure CM.
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
carolyn.mazure@yale.edu
OBJECTIVE: Depression is twice as common in women as in men, but the reason for
this sexual dimorphism is unknown. This article reviews recent studies of the
role of childhood sexual abuse in the subsequent development of major depressive
disorder, and the biological and psychosocial mechanisms by which early stressors
may contribute to adult-onset depression in women. Particular attention is paid
to investigations of the long-term effects of early stress on
hypothalamic-pituitary-adrenal (HPA) axis function. METHOD: Studies were
identified by means of computerized and manual searches; further references were
obtained from the bibliographies of reviewed articles. RESULTS: Childhood sexual
abuse is associated with adult-onset depression in both men and women, and
occurrence of such abuse is more common in girls than in boys. There is evidence
from both animal and human studies that early stressors produce long-term
dysregulation of the HPA axis similar to that seen in depressed patients and that
such dysregulation results in a differential response to stressors in adulthood.
In addition, it appears that the HPA axis in females may be more susceptible to
stress-induced dysregulation, which might contribute to an increased
vulnerability to depression in adulthood. CONCLUSIONS: Childhood sexual abuse is
an important early stressor that may predispose individuals to adult-onset
depression by means of dysregulation of the HPA axis. Investigation of the
mechanisms mediating the relationship between childhood sexual abuse and
adult-onset depression, and the study of gender differences in exposure to this
and other stressors, may improve our understanding of the etiology of depressive
illness in general.
Publication Types:
Review
PMID: 10360118 [PubMed - indexed for MEDLINE]
Sci STKE. 2004 Mar 16;2004(225):re5.
Life stress, genes, and depression: multiple pathways lead to increased risk and
new opportunities for intervention.
Charney DS, Manji HK.
Mood and Anxiety Disorders Research Program, National Institute of Mental Health,
15K North Drive, Room 101, MSC 2670, Bethesda, MD 20892-2670, USA.
charneyd@nih.gov
Major depression is a common, severe, chronic, and often life-threatening
illness. There is a growing appreciation that, far from being a disease with
purely psychological manifestations, major depression is a systemic disease with
deleterious effects on multiple organ systems. Stressful life events have a
substantial causal association with depression, and there is now compelling
evidence that even early life stress constitutes a major risk factor for the
subsequent development of depression. The emerging evidence suggests that the
combination of genetics, early life stress, and ongoing stress may ultimately
determine individual responsiveness to stress and the vulnerability to
psychiatric disorders, such as depression. It is likely that genetic factors and
life stress contribute not only to neurochemical alterations, but also to the
impairments of cellular plasticity and resilience observed in depression. Recent
preclinical and clinical studies have shown that signaling pathways involved in
regulating cell plasticity and resilience are long-term targets for the actions
of antidepressant agents. Agents capable of reversing the hypothesized
impairments of cellular resilience, reductions in brain volume, and cell death or
atrophy in depression have the potential of becoming new therapeutic classes of
antidepressant drugs. Novel cellular targets include agents targeting
neurotrophic pathways, glucocorticoid signaling, phosphodiesterase activity, and
glutamatergic throughput. The future development of treatments that more directly
target molecules in critical CNS (central nervous system) signaling pathways that
regulate cellular plasticity thus hold promise as novel, improved long-term
treatments for major depression.
Publication Types:
Review
PMID: 15039492 [PubMed - indexed for MEDLINE]
Arch Gen Psychiatry. 2008 Feb;65(2):190-200.
Influence of child abuse on adult depression: moderation by the
corticotropin-releasing hormone receptor gene.
Bradley RG, Binder EB, Epstein MP, Tang Y, Nair HP, Liu W, Gillespie CF, Berg T,
Evces M, Newport DJ, Stowe ZN, Heim CM, Nemeroff CB, Schwartz A, Cubells JF,
Ressler KJ.
Atlanta VA Medical Center, Georgia, USA.
CONTEXT: Genetic inheritance and developmental life stress both contribute to
major depressive disorder in adults. Child abuse and trauma alter the endogenous
stress response, principally corticotropin-releasing hormone and its downstream
effectors, suggesting that a gene x environment interaction at this locus may be
important in depression. OBJECTIVE: To examine whether the effects of child abuse
on adult depressive symptoms are moderated by genetic polymorphisms within the
corticotropin-releasing hormone type 1 receptor (CRHR1) gene. DESIGN: Association
study examining gene x environment interactions between genetic polymorphisms at
the CRHR1 locus and measures of child abuse on adult depressive symptoms.
SETTING: General medical clinics of a large, public, urban hospital and Emory
University, Atlanta, Georgia. PARTICIPANTS: The primary participant population
was 97.4% African American, of low socioeconomic status, and with high rates of
lifetime trauma (n = 422). A supportive independent sample (n = 199) was distinct
both ethnically (87.7% Caucasian) and socioeconomically (less impoverished). MAIN
OUTCOME MEASURES: Beck Depression Inventory scores and history of major
depressive disorder by the Structured Clinical Interview for DSM-IV Axis I
Disorders. RESULTS: Fifteen single-nucleotide polymorphisms spanning 57 kilobases
of the CRHR1 gene were examined. We found significant gene x environment
interactions with multiple individual single-nucleotide polymorphisms (eg,
rs110402, P = .008) as well as with a common haplotype spanning intron 1 (P <
.001). Specific CRHR1 polymorphisms appeared to moderate the effect of child
abuse on the risk for adult depressive symptoms. These protective effects were
supported with similar findings in a second independent sample (n = 199).
CONCLUSIONS: These data support the corticotropin-releasing hormone hypothesis of
depression and suggest that a gene x environment interaction is important for the
expression of depressive symptoms in adults with CRHR1 risk or protective alleles
who have a history of child abuse.
Publication Types:
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
PMID: 18250257 [PubMed - in process]
J Abnorm Psychol. 2006 Nov;115(4):730-41.
The role of childhood abuse and neglect in the sensitization to stressful life
events in adolescent depression.
Harkness KL, Bruce AE, Lumley MN.
Department of Psychology, Queen's University, Kingston, Ontario, Canada.
harkness@post.queensu.ca
This study examined the role of childhood abuse and neglect in sensitizing
adolescents to the effects of proximal stressful life events in a cross-sectional
sample of 103 depressed and nondepressed adolescents. Consistent with hypotheses,
adolescents with a history of childhood abuse and/or neglect reported a lower
level of threat of stressful life events prior to episode onset than that
reported by those without. This effect was specific to those on their 1st episode
of depression and was specific to independent events (i.e., stressors outside of
adolescents' control). Further, this effect was robust when controlling for level
of chronic difficulties, which was higher in those with childhood abuse and/or
neglect. The authors suggest that childhood abuse and/or neglect may be an
important risk factor that sensitizes individuals to the effects of acute
independent life events. (c) 2006 APA, all rights reserved.
Publication Types:
Research Support, Non-U.S. Gov't
PMID: 17100530 [PubMed - indexed for MEDLINE]
Depress Anxiety. 2007;24(4):256-63.
Childhood emotional, physical, and sexual abuse, and diagnoses of depressive and
anxiety disorders in adult psychiatric outpatients.
Gibb BE, Chelminski I, Zimmerman M.
Department of Psychology, Binghamton University, Binghamton, New York 13902, USA.
bgibb@binghamton.edu
Although a number of theorists have hypothesized a link between negative
experiences during childhood (e.g., abuse) and the presence of psychopathology in
adults, little is known about the relative specificity of childhood emotional,
physical, or sexual abuse to different forms of psychopathology. In this study,
we hypothesized that adult psychiatric outpatients' reports of childhood
emotional abuse would exhibit a specific relationship with diagnoses of
depression. Analyses partially supported our hypothesis. Specifically, diagnoses
of major depression were significantly more strongly related to reports of
childhood emotional abuse than to physical or sexual abuse. However, the same
effect was observed for social phobia. In addition, patients with major
depression reported equivalent levels of childhood emotional abuse as patients
with social phobia, but lower levels of emotional abuse than those with
posttraumatic stress disorder.
Publication Types:
Comparative Study
Research Support, N.I.H., Extramural
PMID: 17041933 [PubMed - indexed for MEDLINE]
J Nerv Ment Dis. 2006 May;194(5):382-5.
Childhood sexual abuse and depressive symptom severity: the role of neuroticism.
Gamble SA, Talbot NL, Duberstein PR, Conner KR, Franus N, Beckman AM, Conwell Y.
University of Rochester School of Medicine and Dentistry, Rochester, New York
14642-8409, USA.
This study examined neuroticism's role in the association between childhood
sexual abuse and severity of depressive symptoms in a sample of 105 psychiatric
patients 50 years of age and older diagnosed with major depressive disorder. As
hypothesized, men and women who reported histories of childhood sexual abuse had
more severe depressive symptoms than those without abuse histories. Further,
neuroticism partially accounted for the association between severe childhood
sexual abuse and depressive symptom severity. Self-consciousness, a facet of
neuroticism conceptually related to shame, also partially accounted for that
relationship. These findings suggest that neuroticism may be one way in which
childhood sexual abuse contributes to depressive symptoms in later life.
Prospective studies are needed.
Publication Types:
Comparative Study
Research Support, N.I.H., Extramural
PMID: 16699389 [PubMed - indexed for MEDLINE]
Child Maltreat. 2005 Feb;10(1):37-48.
Child maltreatment in depressed adolescents: differences in symptomatology based
on history of abuse.
Danielson CK, de Arellano MA, Kilpatrick DG, Saunders BE, Resnick HS.
Medical University of South Carolina, Charleston, SC 29425, USA.
danielso@musc.edu
Research has demonstrated that youth who are sexually or physically abused are at
greater risk for developing depression. Although the association between
depression and child maltreatment has been well documented, much less is known
about the potential differences in the clinical presentation of depressive
symptomatology among these victims. The current study examines differences in
symptoms of depression in adolescents based on differing histories of abuse
(i.e., sexual abuse only, physical abuse only, sexual and physical abuse, and no
history of sexual or physical abuse), abuse incident characteristics, and gender.
Participants were drawn from a subsample (n = 548) from the National Survey of
Adolescents who met criteria for major depressive episode in the past year.
Results indicate significant differences in severity of depression and specific
depressive symptoms based on type of abuse experienced and gender. Implications
for the clinical assessment and treatment of depressed adolescents with regard to
abuse history are discussed.
Publication Types:
Research Support, Non-U.S. Gov't
PMID: 15611325 [PubMed - indexed for MEDLINE]
Int J Offender Ther Comp Criminol. 2004 Dec;48(6):683-96.
Childhood sexual abuse, gender, and depression among incarcerated youth.
Gover AR.
University of Florida Center for Studies in Criminology and Law P.O. Box 115950,
209 Walker Hall Gainesville, Florida 32611-5950, USA.
This study examined whether sexual abuse was related to higher levels of
psychological distress among incarcerated youth and if the effects were invariant
across gender. Participants were male and female adolescents, aged 11 to 20
years, incarcerated in six juvenile correctional institutions in five states.
Using data from a national study of juveniles confined to secure institutions,
this study assessed the relationship between gender, sexual abuse, and
depression. Adolescents who were sexually abused during childhood compared to
adolescents who were not report higher levels of depression. Sexually abused
girls and boys report higher levels of depression compared to boys not sexually
abused. These findings suggest the importance of understanding the relationship
between childhood sexual abuse and depressive symptoms among incarcerated youth.
Additionally, the findings suggest that the effects of childhood sexual abuse are
similar for males and females among a high-risk sample of institutionalized
juvenile delinquents. Implications for treatment of incarcerated youth are
discussed.
Publication Types:
Research Support, U.S. Gov't, Non-P.H.S.
PMID: 15538026 [PubMed - indexed for MEDLINE]
Am J Geriatr Psychiatry. 2004 Sep-Oct;12(5):536-8.
Preliminary report on childhood sexual abuse, suicidal ideation, and suicide
attempts among middle-aged and older depressed women.
Talbot NL, Duberstein PR, Cox C, Denning D, Conwell Y.
University of Rochester School of Medicine and Dentistry, 300 Crittenden Blvd.,
Rochester, NY 14642-8409, USA. Nancy_Talbot@URMC.Rochester.edu
OBJECTIVE: Authors examined the relationship between childhood sexual abuse
histories and suicidal ideation and behavior among depressed women age 50 years
and older. METHODS: After admission to a psychiatric unit, participants were
administered the Structured Clinical Interview for DSM-III-R and measures of
suicidal ideation and behavior. RESULTS: Women who reported abuse histories were
more likely to report suicidal ideation at the time of hospitalization and a
history of multiple suicide attempts. CONCLUSIONS: These preliminary findings
underscore the need for more study of how childhood abuse amplifies risk for
suicidal ideation and behavior among women across the life course.
Publication Types:
Research Support, U.S. Gov't, P.H.S.
PMID: 15353394 [PubMed - indexed for MEDLINE]
Am J Psychiatry. 2003 May;160(5):933-8.
Comment in:
Am J Psychiatry. 2004 Apr;161(4):762-3; author reply 763-4.
The relationship between childhood physical abuse and suicidality among depressed
women: results from a community sample.
McHolm AE, MacMillan HL, Jamieson E.
Canadian Center for Studies of Children at Risk, Faculty of Health Sciences,
McMaster University, Hamilton, Ontario, Canada L8N 3Z5.
OBJECTIVE: The aim of this study was to examine the distribution and determinants
of suicidal ideation and suicide attempts in a community sample of women with
major depressive disorder. Variables of interest included childhood physical
abuse, individual and familial psychiatric history, and sociodemographic factors.
METHOD: Women (age 15 to 64 years) from a community sample who met criteria for
major depressive disorder (lifetime prevalence) (N=347) were assessed with a
modified version of the Composite International Diagnostic Interview. Childhood
physical abuse history was collected through a self-administered questionnaire.
RESULTS: Approximately one-quarter (23.9%, N=83) of the women with major
depressive disorder reported that they had made a suicide attempt, and more than
half (55.6%, N=193) had experienced suicidal ideation. A history of suicide
attempt was most strongly related to the number of comorbid psychiatric disorders
(odds ratio=2.04, 95% confidence interval [CI]=1.21-3.43). Suicidal ideation was
most strongly associated with a history of childhood physical abuse (odds
ratio=2.77, 95% CI=1.26-6.12). CONCLUSIONS: Suicidal ideation and suicide
attempts were reported frequently by women with a history of major depressive
disorder. Correlates for suicide attempts showed some differences from those for
ideation. This finding is of clinical importance, since it relates to the
identification of individuals at risk for suicidal behavior.
Publication Types:
Comparative Study
Research Support, Non-U.S. Gov't
PMID: 12727698 [PubMed - indexed for MEDLINE]
J Am Acad Child Adolesc Psychiatry. 2003 Mar;42(3):269-78.
Ten-year research update review: child sexual abuse.
Putnam FW.
Children's Hospital Medical Center, Cincinnati, Ohio, 45229-3039, USA.
Frank.Putnam@chmcc.org
OBJECTIVE To provide clinicians with current information on prevalence, risk
factors, outcomes, treatment, and prevention of child sexual abuse (CSA). To
examine the best-documented examples of psychopathology attributable to
CSA.METHOD Computer literature searches of and for key words. All
English-language articles published after 1989 containing empirical data
pertaining to CSA were reviewed.RESULTS CSA constitutes approximately 10% of
officially substantiated child maltreatment cases, numbering approximately 88,000
in 2000. Adjusted prevalence rates are 16.8% and 7.9% for adult women and men,
respectively. Risk factors include gender, age, disabilities, and parental
dysfunction. A range of symptoms and disorders has been associated with CSA, but
depression in adults and sexualized behaviors in children are the best-documented
outcomes. To date, cognitive-behavioral therapy (CBT) of the child and a
nonoffending parent is the most effective treatment. Prevention efforts have
focused on child education to increase awareness and home visitation to decrease
risk factors.CONCLUSIONS CSA is a significant risk factor for psychopathology,
especially depression and substance abuse. Preliminary research indicates that
CBT is effective for some symptoms, but longitudinal follow-up and large-scale
"effectiveness" studies are needed. Prevention programs have promise, but
evaluations to date are limited.
PMID: 12595779 [PubMed - indexed for MEDLINE]
Drug Alcohol Depend. 2003 Jan 24;69(1):51-60.
Physical and sexual abuse, depression and alcohol use disorders in adolescents:
onsets and outcomes.
Clark DB, De Bellis MD, Lynch KG, Cornelius JR, Martin CS.
Department of Psychiatry and Pharmaceutical Sciences, Western Psychiatric
Institute and Clinic, University of Pittsburgh Medical Center, 3811 O'Hara
Street, Pittsburgh, PA 15213, USA. clarkdb@msx.upmc.edu
Adolescents with alcohol use disorders (AUDs) often have major depressive
disorder (MDD). While physical abuse and sexual abuse (PS Abuse) have been
observed to be common in adolescents with AUDs, the influence of PS Abuse on
comorbid MDD and AUD has not been determined. The effect of pre-existing PS Abuse
on the young adulthood outcomes of adolescents with AUDs has also not been
adequately explored. This study examined the relationships among PS Abuse, MDD,
and AUD in adolescence, as well as related young adult outcomes. Adolescents
(mean age: 16.4 years; range: 14-18 years) were recruited from clinical and
community sources and classified into four groups: (1) AUD+PS Abuse (n=154), (2)
AUD only (n=255), (3) PS Abuse only (n=74), and (4) Controls (n=268). Subjects
were longitudinally assessed through young adulthood (age 19 years or older).
Measures included interview assessments of DSM-IV AUD and MDD, classified as
"primary" or "secondary", and questionnaire measures of alcohol consumption and
depression. Primary MDD preceded AUD whereas secondary MDD had a later onset than
AUD. PS Abuse accelerated the onsets of primary MDD, secondary MDD and AUD. While
affected adolescents had typically improved in both alcohol consumption and
depression at the young adult assessment, the majority of those with adolescent
AUD had AUDs in young adulthood, and MDD remained common in those with a history
of PS Abuse. These results indicate that MDD among adolescents with AUD may be
partly attributable to PS Abuse.
Publication Types:
Comparative Study
Research Support, U.S. Gov't, P.H.S.
PMID: 12536066 [PubMed - indexed for MEDLINE]
Bull Menninger Clin. 2002 Summer;66(3):241-58.
Exploring psychological abuse in childhood: II. Association with other abuse and
adult clinical depression.
Bifulco A, Moran PM, Baines R, Bunn A, Stanford K.
Department of Health and Social Care, University of London, United Kingdom.
lifespan@rhul.ac.uk
A new retrospective interview assessment of childhood psychological abuse, an
extension to the Childhood Experience of Care and Abuse (CECA) instrument, is
described in a companion article (Moran, Bifulco, Ball, Jacobs, & Benaim, 2002).
The purpose of the present article is to examine the relationship of childhood
psychological abuse to other adverse childhood experiences and to major
depression and suicidal behavior in adult life. Childhood experience and lifetime
disorder were assessed retrospectively in a high-risk, community series of London
women (n = 204). Psychological abuse from parents was examined in relation to
seven other parental behaviors (neglect, antipathy, role reversal, discipline,
supervision, physical abuse, and sexual abuse). Psychological abuse was
significantly related to all seven behaviors. The highest associations found were
to antipathy (gamma = .76), neglect (.73), and sexual abuse (.72). Factor
analysis showed the existence of two factors reflecting care and control, with
psychological abuse associated with both factors. Childhood psychological abuse
was highly related to chronic or recurrent adult depression, with a
"dose-response" evident for severity of abuse. The rates ranged from 83% for
"marked" to 55% for "mild" abuse and 37% for "little/no" psychological abuse (p <
.002). Psychological abuse was also related to lifetime suicidal behavior but
here any level of abuse from marked to mild had similar rates (36% overall vs.
18% with no psychological abuse, p < .04). There was no evidence of specificity
of childhood experience to adult depression; nearly all types of childhood
adversity examined were significantly related. An analysis using an index of
multiple abuse, including psychological abuse, showed a clear dose-response
relationship to disorder. Somewhat fewer forms of maltreatment were related to
suicidal behavior, but again multiples showed a clear dose-response effect.
Publication Types:
Research Support, Non-U.S. Gov't
PMID: 12448629 [PubMed - indexed for MEDLINE]
Am J Psychiatry. 2001 Nov;158(11):1878-83.
Childhood abuse and lifetime psychopathology in a community sample.
MacMillan HL, Fleming JE, Streiner DL, Lin E, Boyle MH, Jamieson E, Duku EK,
Walsh CA, Wong MY, Beardslee WR.
Canadian Centre for Studies of Children at Risk, Ontario, Canada.
macmilnh@mcmaster.ca
OBJECTIVE: The authors assessed lifetime psychopathology in a general population
sample and compared the rates of five psychiatric disorder categories between
those who reported a childhood history of either physical or sexual abuse and
those who did not. METHOD: A modified version of the Composite International
Diagnostic Interview and a self-completed questionnaire on child abuse were
administered to a probability sample (N=7,016) of Ontario residents 15 to 64
years of age. RESULTS: Those reporting a history of childhood physical abuse had
significantly higher lifetime rates of anxiety disorders, alcohol
abuse/dependence, and antisocial behavior and were more likely to have one or
more disorders than were those without such a history. Women, but not men, with a
history of physical abuse had significantly higher lifetime rates of major
depression and illicit drug abuse/dependence than did women with no such history.
A history of childhood sexual abuse was also associated with higher rates of all
disorders considered in women. In men, the prevalence of disorders tended to be
higher among those who reported exposure to sexual abuse, but only the
associations with alcohol abuse/dependence and the category of one or more
disorders reached statistical significance. The relationship between a childhood
history of physical abuse and lifetime psychopathology varied significantly by
gender for all categories except for anxiety disorders. Although not
statistically significant, a similar relationship was seen between childhood
history of sexual abuse and lifetime psychopathology. CONCLUSIONS: A history of
abuse in childhood increases the likelihood of lifetime psychopathology; this
association appears stronger for women than men.
Publication Types:
Research Support, Non-U.S. Gov't
PMID: 11691695 [PubMed - indexed for MEDLINE]
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