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Childhood maltreatment, juvenile disorders and adult post-traumatic stress disorder: a prospective investigation

Published online by Cambridge University Press:  29 October 2013

N. Breslau ,
K. C. Koenen ,
Z. Luo ,
J. Agnew-Blais ,
S. Swanson ,
R. M. Houts ,
R. Poulton  and
T. E. Moffitt
N. Breslau*
Affiliation:
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
K. C. Koenen
Affiliation:
Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY, USA
Z. Luo
Affiliation:
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
J. Agnew-Blais
Affiliation:
Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
S. Swanson
Affiliation:
Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
R. M. Houts
Affiliation:
Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
R. Poulton
Affiliation:
Dunedin Multidisciplinary Health and Development Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
T. E. Moffitt
Affiliation:
Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
*
* Address for correspondence: N. Breslau, Ph.D., Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA. (Email: breslau@msu.edu)
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Abstract

Background

We examine prospectively the influence of two separate but potentially inter-related factors in the etiology of post-traumatic stress disorder (PTSD): childhood maltreatment as conferring a susceptibility to the PTSD response to adult trauma and juvenile disorders as precursors of adult PTSD.

Method

The Dunedin Multidisciplinary Health and Development Study (DMHDS) is a birth cohort (n = 1037) from the general population of New Zealand's South Island, with multiple assessments up to age 38 years. DSM-IV PTSD was assessed among participants exposed to trauma at ages 26–38. Complete data were available on 928 participants.

Results

Severe maltreatment in the first decade of life, experienced by 8.5% of the sample, was associated significantly with the risk of PTSD among those exposed to adult trauma [odds ratio (OR) 2.64, 95% confidence interval (CI) 1.16–6.01], compared to no maltreatment. Moderate maltreatment, experienced by 27.2%, was not associated significantly with that risk (OR 1.55, 95% CI 0.85–2.85). However, the two estimates did not differ significantly from one another. Juvenile disorders (ages 11–15), experienced by 35% of the sample, independent of childhood maltreatment, were associated significantly with the risk of PTSD response to adult trauma (OR 2.35, 95% CI 1.32–4.18).

Conclusions

Severe maltreatment is associated with risk of PTSD response to adult trauma, compared to no maltreatment, and juvenile disorders, independent of earlier maltreatment, are associated with that risk. The role of moderate maltreatment remains unresolved. Larger longitudinal studies are needed to assess the impact of moderate maltreatment, experienced by the majority of adult trauma victims with a history of maltreatment.

Keywords

Juvenile disorderslongitudinal cohortmaltreatmentPTSD
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 9 , July 2014 , pp. 1937 - 1945
Copyright
Copyright © Cambridge University Press 2013 

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