Abstract
Childhood maltreatment is a common phenomenon in various psychiatric disorders. Accordingly, patients with disorders from the schizophrenia spectrum (SSD) appear to have high prevalence rates of childhood maltreatment. However, the interpretation and comparability of prevalence rates is impeded by methodological weaknesses and differences such as measures and thresholds used in previous studies. Therefore, we aimed to provide and compare systematically captured data on prevalence rates of all common types of childhood maltreatment in patients with SSD using a standardized and well-established questionnaire and the most frequently used thresholds. The sample consisted of 48 patients with a primary diagnosis of SSD. 58.3–77.1% of the sample experienced at least one type of childhood maltreatment. Prevalence rates for physical abuse, physical neglect, and emotional abuse were dependent on the thresholds used, while equal rates were found for emotional neglect and sexual abuse. Physical neglect (46–67%), and emotional abuse (44–48%) were most commonly reported, followed by emotional neglect (38%), physical abuse (25–38%), and sexual abuse (25%). Additionally, high levels of peer victimization were reported by SSD patients. It appears that childhood maltreatment is a common phenomenon in SSD, even though methodological details, especially cut-off scores, have a substantial impact on the prevalence rates that are determined. Therefore, the methodology of studies should be closely examined when drawing conclusions from presented prevalence rates.
Highlights
One of the most important challenges worldwide is childhood maltreatment [1]
Out of the sample of 48 SSD patients, we found 37 participants (77.1%) meeting cut-off scores according to Walker et al [40] and 28 patients (58.3%) meeting the “moderate to severe” thresholds established by Bernstein and Fink [41] for at least one type of childhood abuse or neglect, as measured by the Childhood Trauma Questionnaire (CTQ) subscales [41]
With this study we aimed at presenting and comparing prevalence rates of childhood maltreatment in a sample of patients with SSD based on both the original “moderate to severe” severity ratings established by Bernstein and Fink [41] and the empirically determined and validated cut-off scores established by Walker et al [40]. 58.3% of the sample reached threshold for at least one type of childhood maltreatment using “moderate to severe” thresholds established by Bernstein and Fink [41], while 77.1% of the sample reached cut-off score according to Walker et al [40] for at least one type of maltreatment
Summary
One of the most important challenges worldwide is childhood maltreatment [1]. Childhood maltreatment refers to all forms of physical, emotional, or sexual abuse, neglect, or transgressions resulting in actual or potential harm to the child’s health, survival, or development [2]. Experiences of childhood maltreatment appear to be an important risk factor for mental health. Individuals who have experienced childhood maltreatment present with an earlier onset of symptomatology, a greater symptom severity, more hospitalizations and more suicide attempts [6,7,8,9,10,11]. In line with findings in other psychiatric disorders, SSD patients who have experienced childhood maltreatment exhibited higher symptom severity, more comorbid disorders, greater cognitive impairment, an earlier age at first hospitalization, more hospitalizations, and more suicide attempts than SSD patients without childhood maltreatment experiences [8, 10, 17]. Childhood maltreatment is a common phenomenon in SSD and appears to be associated with a less favorable course of disease
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