Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-26T23:06:10.521Z Has data issue: false hasContentIssue false

An examination of childhood trauma in individuals attending an adult mental health service

Published online by Cambridge University Press:  23 September 2014

A. P. Wota
Affiliation:
Department of Psychiatry, Clinical Science Institute, NUI Galway, Galway, Ireland
C. Byrne
Affiliation:
Department of Psychiatry, Clinical Science Institute, NUI Galway, Galway, Ireland
I. Murray
Affiliation:
Department of Psychiatry, Clinical Science Institute, NUI Galway, Galway, Ireland
T. Ofuafor
Affiliation:
Department of Psychiatry, Clinical Science Institute, NUI Galway, Galway, Ireland
Z. Nisar
Affiliation:
Department of Psychiatry, Clinical Science Institute, NUI Galway, Galway, Ireland
F. Neuner
Affiliation:
Department of Psychiatry, Clinical Science Institute, NUI Galway, Galway, Ireland
B. P. Hallahan*
Affiliation:
Department of Psychiatry, Clinical Science Institute, NUI Galway, Galway, Ireland
*
*Address for Correspondence: B. P. Hallahan, Department of Psychiatry, Clinical Science Institute, NUI Galway, Galway, Ireland. (Email: brian.hallahan@nuigalway.ie)

Abstract

Objectives

Childhood sexual abuse has previously been associated with adult mental health difficulties, however, few studies have evaluated all forms of childhood maltreatment in individuals attending adult mental health services. Consequently, this study investigates the association of five forms of childhood trauma with a range of clinical symptoms and mental health disorders in 136 individuals attending a mental health service in Ireland utilising the Childhood Trauma Questionnaire (CTQ).

Method

One hundred and thirty-six patients attending the Roscommon Mental Health Services completed the CTQ and a number of additional psychometric instruments evaluating illness severity, impulsivity, disability and the presence of a personality disorder(s) (PD) to ascertain the prevalence of childhood trauma and any potential associations between childhood trauma and a range of demographic and clinical factors.

Result

Seventy-six per cent of individuals reported childhood trauma, with emotional neglect most frequently reported (61%). Individuals who had experienced childhood trauma had higher rates of clinical symptoms, distress and impulsivity. Substance abuse and paranoid, borderline and antisocial PDs most associated with childhood trauma.

Conclusion

This study demonstrates the need to routinely elicit information on all forms of childhood traumatic experiences from patients.

Type
Original Research
Copyright
© College of Psychiatrists of Ireland 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Afifi, TO, Brownridge, DA, Cox, BJ, Sareen, J (2006). Physical punishment, childhood abuse and psychiatric disorders. Child Abuse & Neglect 30, 10931103.Google Scholar
Anda, RF, Felitti, VJ, Bremner, JD, Walker, JD, Whitfield, C, Perry, BD, Dube, SR, Giles, WH (2006). The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience 256, 174186.Google Scholar
Bergen, HA, Martin, G, Richardson, AS, Allison, S, Roeger, L (2004). Sexual abuse, antisocial behaviour and substance use: gender differences in young community adolescents. Australian and New Zealand Journal of Psychiatry 38, 3441.Google Scholar
Bernstein, D, Fink, L (1998). Childhood Trauma Questionnaire. A Retrospective Self Report-Manual. Harcourt Brace & Company: San Antonio.Google Scholar
Bernstein, D, Fink, L, Handelsman, L, Foote, J, Lovejoy, M, Wenzel, K, Sapareto, E, Ruggiero, J (1994). Initial reliability and validity of a new retrospective measure of child abuse and neglect. American Journal of Psychiatry 151, 11321136.Google Scholar
Bernstein, D, Stein, J, Handelsman, L (1998). Predicting personality pathology among adult patients with substance use disorders: effects of childhood maltreatment. Addictive Behaviors 23, 855868.Google Scholar
Brodsky, B, Oquendo, M, Ellis, S, Haas, G, Malone, K, Mann, J (2001). The relationship of childhood abuse to impulsivity and suicidal behavior in adults with major depression. American Journal of Psychiatry 158, 18711877.Google Scholar
Byrne, C, Velamoor, V, Cernovsky, Z, Cortese, L, Losztyn, S (1990). A comparison of borderline and schizophrenic patients for childhood life events and parent-child relationships. Canadian Journal of Psychiatry 35, 590595.CrossRefGoogle ScholarPubMed
Chapman, DP, Anda, RF, Felitti, VJ, Dube, SR, Edwards, VJ, Whitfield, CL (2004). Epidemiology of adverse childhood experiences and depressive disorders in a large health maintenance organization population. Journal of Affective Disorders 82, 217225.Google Scholar
Chartier, M, Walker, J, Naimark, B (2007). Childhood abuse, adult health, and health care utilization: results from a represantative community sample. American Journal of Epidemiology 165, 10311038.CrossRefGoogle Scholar
Chu, J, Dill, D (1990). Dissociative symptoms in relation to childhood physical and sexual abuse. American Journal of Psychiatry 147, 887892.Google ScholarPubMed
Crouch, JL, Milner, JS (1993). Effects of child neglect on children. Criminal Justice and Behavior 20, 4965.Google Scholar
Derogatis, LR (1994). SCL-90-R, Symptom Checklist-90-R. Pearson: Minneapolis.Google Scholar
Dong, M, Anda, R, Felitti, VJ, Dube, SR, Williamson, DF, Thompson, TJ, Loo, CM, Giles, WH (2004). The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse and Neglect 28, 771784.Google Scholar
Dube, SR, Felitti, VJ, Dong, M, Chapman, DP, Giles, WH, Anda, RF (2003). Childhood abuse, neglect and household dysfunction and the risk of illicit drug use: The Adverse Childhood Experience Study. Pediatrics 111, 564572.Google Scholar
Edwards, VJ, Holden, G, Felitti, V, Anda, R (2003). Relationship between multiple forms of childhood maltreatment and adult mental health. American Journal of Psychiatry 160, 14531460.Google Scholar
Ferguson, KS, Dacey, CM (1997). Anxiety, depression, and dissociation in women health care providers reporting a history of childhood psychological abuse. Child Abuse and Neglect 21, 941952.Google Scholar
Finestone, H, Stenn, P, Davies, F, Stalker, C, Fry, R, Koumanis, J (2000). Chronic pain and health care utilization in women with a history of childhood sexual abuse. Child Abuse and Neglect 24, 547556.Google Scholar
Finkelhor, D (1994). Current information on the scope and nature of child sexual abuse. The Future of Children 4, 3153.Google Scholar
Finkelhor, DP (1986). Sourcebook on Child Sexual Abuse. Sage Publications Inc: Newbury Park.Google Scholar
Finkelhor, D, Ormrod, RK, Turner, HA (2007). Polyvictimization and trauma in a national longitudinal cohort. Developmental Psychopathology 19, 149166.Google Scholar
First, MB, Gibbon, M, Spitzer, R, Williams, JBW, Benjamin, LS (1997). User's Guide for the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). American Psychiatric Press: Arlington: Washington, DC.Google Scholar
Fitzpatrick, M, Carr, A, Dooley, B, Flanagan-Howard, R, Flanagan, E, Tierney, K, White, M, Daly, M, Shevlin, M, Egan, J (2010). Profiles of adult survivors of severe sexual, physical and emotional institutional abuse in Ireland. Child Abuse Review 19, 387404.CrossRefGoogle Scholar
Fossati, A, Maffei, C, Bagnato, M, Battaglia, M, Donati, D, Donini, M, et al. (2000). Patterns of covariation of DSM-IV personality disorders in a mixed psychiatric sample. Comprehensive Psychiatry 41, 206215.CrossRefGoogle Scholar
Goldberg, RT (1994). Childhood abuse, depression, and chronic pain. Clinical Journal of Pain 10, 277281.Google Scholar
Gould, D, Stevens, N, Ward, N, Carlin, A, Sowell, H, Gustafson, B (1994). Self-reported childhood abuse in an adult population in a primary care setting. Prevalence, correlates, and associated suicide attempts. Archives of Family Medicine 3, 252256.Google Scholar
Grover, K, Carpenter, L, Price, L, Gagne, G, Mello, A, Mello, M, Tyrka, A (2007). The relationship between childhood abuse and adult personality disorder symptoms. Journal of Personality Disorders 21, 442447.Google Scholar
Hardt, J, Rutter, M (2004). Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. Journal of Child Psychology and Psychiatry 45, 260273.Google Scholar
Holmes, G, Offen, L, Waller, G (1997). See no evil, hear no evil, speak no evil: why do relatively few male victims of childhood sexual abuse receive help for abuse-related issues in adulthood? Clinical Psychology Review 17, 6988.Google Scholar
Horwitz, AV, Widom, C, McLaughlin, J, White, H (2001). The impact of childhood abuse and neglect on adult mental health: a prospective study. Journal of Health and Social Behavior 42, 184201.Google Scholar
Huang, J, Yang, Y, Wu, J, Napolitano, L, Xi, Y, Cui, Y (2012). Childhood abuse in Chinese patients with borderline personality disorder. Journal of Personality Disorders 26, 238254.Google Scholar
Joyce, PR, McKenzie, J, Luty, S, Mulder, R, Carter, J, Sullivan, P, Cloninger, C (2003). Temperamtent, childhood environment and psychopathology as risk factors for avoidant and borderline personality disorders. Australian and New Zealand Journal of Psychiatry 37, 756765.CrossRefGoogle ScholarPubMed
Kelleher, I, Harley, M, Lynch, F, Arseneault, L, Fitzpatrick, C, Cannon, M (2008). Associations between childhood trauma, bullying, and psychotic symptoms among a school-based adolescent sample. British Journal of Psychiatry 193, 378382.Google Scholar
Kelleher, I, Keeley, H, Corcoran, P, Ramsey, H, Wasserman, C, Carli, V, Sarchiapone, M, Hoven, C, Wasserman, D, Canon, M (2013). Childhod trauma and psychosis in a prospective cohort study: cause, effect, and directionality. American Journal of Psychiatry 170, 734741.Google Scholar
Kendall-Tackett, K, Williams, L, Finkelhor, D (1993). Impact of sexual abuse on children: a review and synthesis of recent empirical studies. Psychological Bulletin 113, 164180.Google Scholar
Khalily, MT, Hallahan, B (2010). Psychological assessment through performance-based techinques and self-reports: a case study of a sexually abused girl at preschool age. Journal of Child Sexual Abuse 20, 338353.Google Scholar
Kinard, EM (1995). Mother and teacher assessments of behavior problems in abused children. Journal of the American Academy of Child and Adolescent Psychiatry 34, 10431053.Google Scholar
Knutson, JF (1995). Psychological characteristics of maltreated children: putative risk factors and consequences. Annual Review of Psychology 46, 401431.CrossRefGoogle ScholarPubMed
Lindsay, M, Pitzer, K, Fingerman, L (2010). Psychosocial resources and associations between childhood physical abuse and adult well-being. Journal of Gerontology 65B, 425433.Google Scholar
Lown, EA, Nayak, MB, Korcha, RA, Greenfield, TK (2011). Child physical and sexual abuse: a comprehensive look at alcohol consumption patterns, consequences, and dependence from the national alcohol survey. Alcoholism: Clinical and Experimental Research 35, 317325.Google Scholar
Luntz, B, Widom, C (1994). Antisocial personality disorder in abused and neglected children grown up. American Journal of Psychiatry 151, 670674.Google Scholar
Malinosky-Rummel, R, Hansen, DJ (1993). Long-term consequences of childhood physical abuse. Psychological Bulletin 114, 6879.CrossRefGoogle Scholar
McGee, H, Garavan, R, Byrne, J, O'Higgins, M, Conroy, RM (2011). Secular trends in child and adult sexual violence-one decreasing and the other increasing: a population survey in Ireland. European Journal of Public Health 21, 98103.Google Scholar
Min, MO, Farkas, K, Minnes, S, Singer, LT ( 2007). Impact of childhood abuse and neglect on substance abuse and psychological distress in adulthood. Journal of Traumatic Stress 20, 833844.Google Scholar
Min, MO, Minnes, S, Kim, H, Singer, LT (2013). Pathways linking childhood maltreatment and adult physical health. Child Abuse and Neglect 37, 361373.CrossRefGoogle ScholarPubMed
Murphy, J, Houston, JE, Shevlin, M, Adamson, G (2013). Childhood sexual trauma, cannabis use and psychosis: statistically controlling for pre-trauma psychosis and psychopathology. Social Psychiatry and Psychiatric Epidemiology 48, 853861.CrossRefGoogle ScholarPubMed
Paris, J, Zweig-Frank, H, Guzder, J (1994). Psychological risk factors for borderline personality disorder in female patients. Comprehensive Psychiatry 35, 301305.Google Scholar
Patton, JH, Stanford, MS, Barratt, ES (1995). Factor structure of the Barratt Impulsiveness Scale. Journal of Clinical Psychology 51, 768774.Google Scholar
Radford, R, Corral, S, Bradley, C, Fisher, H, Bassett, C, Howat, N, Collishaw, S (2011). Child Abuse and Neglect in the UK Today. NSPCC: London.Google Scholar
Read, J, Goodman, L, Morrison, A, Ross, C, Aderhold, V (2004). Childhood trauma, loss and stress. In Models of Madness (ed. J. Read, L. Mosher and R. Bentall), pp. 223252. Brunner-Routledge: Hove, England.Google Scholar
Reigstad, B, Jorgensen, K, Wichstrom, L (2006). Diagnosed and self-reported childhood abuse in national and regional samples of child and adolescent psychiatric patients: prevalences and correlates. Nordic Journal of Psychiatry 60, 5866.Google Scholar
Roy, A (2005). Childhood trauma and impulsivity. Possible relevance to suicidal behavior. Archives of Suicide Research 9, 147151.Google Scholar
Rush, JA (2000). Handbook of Psychiatric Measures. American Psychiatric Association: Arlington: Washington, DC.Google Scholar
Saunders, BE, Villeponteaux, LA, Lipovsky, JA, Kilpatrick, D, Veronen, L (1992). Child sexual assault as a risk factor for mental disorders among women: a community survey. Journal of Interpersonal Violence 7, 189204.Google Scholar
Silk, K, Lee, S, Hill, EM, Lohr, N (1995). Borderline personality disorder symptoms and severity of sexual abuse. American Journal of Psychiatry 152, 10591064.Google ScholarPubMed
Simon, N, Herlands, N, Marks, E, Mancini, C, Letamendi, A, Li, Z, Pollack, MH, Van Ameringen, M, Stein, MB (2009). Childhood maltreatment linked to greater symptom severity and poorer quality of life and function in social anxiety disorder. Depression and Anxiety 26, 10271032.Google Scholar
Springer, K, Sheridan, J, Kuo, D, Carnes, M (2003). The long-term health outcomes of childhood abuse. Journal of General Internal Medicine 18, 864870.Google Scholar
Swett, C, Halpert, M (1993). Reported history of physical abuse and sexual abuse in relation to dissociation and other symptomatology in women psychiatric inpatients (1993). Journal of Interpersonal Violence 8, 545555.CrossRefGoogle Scholar
Tonmyr, L, Jamieson, E, Mery, L, MacMillan, H (2005). The relation between childhood adverse experiences and disability due to mental health problems in a community sample of women. Canadian Journal of Psychiatry 50, 778783.Google Scholar
Van Winkel, R, Van Nierop, M, Myin-Germeys, I, Van Os, J (2013). Childhood trauma as a cause of psychosis: linking genes, psychology, and biology. Canadian Journal of Psychiatry 58, 4451.Google Scholar
Widom, CS, Czaja, SJ, Paris, J (2009). A prospective investigation of borderline disorder in abused and neglected children followed up into adulthood. Journal of Personality Disorders 23, 433446.Google Scholar
Wu, SW, Schairer, LC, Dellor, E, Grella, C (2010). Childhood trauma and health outcomes in adults with comorbid substance abuse and mental health disorders. Addictive Behaviors 35, 6871.Google Scholar
Zimmerman, M, Rothschild, L, Chelminski, I (2005). The prevalence of DSM-IV personality disorders in psychiatric outpatients. American Journal of Psychiatry 162, 19111918.Google Scholar
Zlotnicka, C, Johnson, J, Kohn, R, Vicente, B, Rioseco, P, Saldivia, S (2008). Childhood trauma, trauma in adulthood, and psychiatric diagnoses: results from community sample. Comprehensive Psychiatry 49, 163169.Google Scholar