History of Childhood Maltreatment, Trauma Symptoms, and Go/No-Go Task Performance in College Students

Hurt and complex trauma resulting from childhood maltreatment has serious consequences for the lifespan development of the survivor (Kezelman, Hossack, Stavropoulos, & Burley, 2015; van der Kolk, 2014). Child abuse and neglect involves a betrayal of trust, care and protection within the very relationships upon which the child relies upon for care (Courtois & Ford, 2013). Psychological trauma arising from child abuse and neglect is referred to as complex, or developmental, trauma (Ford et al., 2013). This accounts for the impact of the trauma on the ongoing development of the child into adulthood. Intergenerational continuity research suggests parents’ childhood experiences and current psychosocial functioning are expressed in their parenting behaviour (K. Kim, Trickett, & Putnam, 2010). Further to this is the idea that unresolved childhood experiences of loss and trauma are repeated in the next generation (Bowlby, 2005; Egeland & Susman-Stillman, 1996). Childhood maltreatment research into intergenerational functioning and relationship outcomes in adults, however, is lacking. This thesis comprised a pilot and three studies investigating retrospective reports of childhood experiences and self-reports of current adult functioning outcomes. Participants’ categorical responses to four items on childhood sexual and physical abuse, and physical and emotional neglect, were used to identify any-abused and not-abused groups. Study 1, Experiences of Individuals investigated the relationship and functioning experiences of individuals between groups with, and without, a history of childhood abuse or neglect. Compared to participants without a history of childhood abuse and neglect, any-abused participants had poorer adult functioning outcomes including higher separation-individuation disturbances, lower perceived current social support, higher psychopathology and higher current trauma symptoms. An effect of cumulative harm was demonstrated in participants who reported more than one category of abuse or neglect. There was a link between accessing psychotherapy and poorer adult functioning outcomes. Multiple predictor variables, including adult functioning outcomes and childhood experiences of psychological abuse, physical neglect and sexual abuse were associated with current trauma symptoms. The findings of Study 1 add to the body of research in which poorer adult functioning and relationship outcomes are found in participants reporting a history of childhood abuse and neglect. Study 2, Intergenerational Continuity, examined intergenerational continuity and discontinuity in the relating and functioning of parent–child participant-dyads, with and without a history of child abuse. An intergenerational impact of the effects of childhood abuse and neglect was supported. Regardless of the participant’s own child maltreatment history, participants with a maltreated parent had, on average, poorer adult functioning outcomes, compared to participants whose parent was not maltreated. Participants who reported a history of child abuse or neglect in both generations had poorer adult functioning outcomes, compared to those in which neither generation reported a history of childhood abuse or neglect. In this research, children with an abused or neglected parent had more trauma symptoms themselves, than children with a not-abused parent. A qualitative third study, Survivors’ Experiences of their Parent, focussed on survivors’ lived experiences of their parent. Survivors’ experiences of their caregiving relationship were explored with a focus on the terms trust, hurt and healing. Interpretative Phenomenological Analysis (IPA) (Smith, Flowers & Larkin, 2009) provided a forum for survivors to give voice to their experience and explore their understanding of it. Themes included: a) permanent and generalised distrust and disconnection, b) continued expectation of hurt and anticipation of punishment, c) impact of abuse and neglect on memory, relationships, mental health, adult functioning and self-concept, d) self-protective or protective behaviour, e) slow and difficult healing, f) significant relationships with the other parent and siblings, and g) resilience. Several child abuse survivors wrote that they valued being heard. Being heard and having trauma acknowledged, they felt, may support the healing of other survivors. The lived experience of survivors informs us that, even as adults, their relationship experiences with their parent continue to impact on their relationships with themselves and with others. The current research shows that intergenerational functioning outcomes hold similar implications to outcomes for individuals, and yet has been absent from inclusion in the way we respond, treat and consider complex trauma. The global significance of this research is to shift the focus from the individual effects of childhood maltreatment to a broader understanding of the potential intergenerational effects.

A Prospective Examination of Service Use by Abused and Neglected Children Followed Up Into Adulthood

Current literature suggests that women with a history of childhood maltreatment are troubled by multiple, varied, and vague physical symptoms. The purpose of this study was to test a causal theoretical model that identifies the relationships among childhood maltreatment, chronic stress, and the health status of women seeking primary care. Survey design was used with a sample of 159 women, ages 18–88, who were seeking primary health care. Subjects completed four measures of childhood trauma and health. Forty-seven percent of the women reported a history of moderate or severe childhood maltreatment. Structural equation modeling was used to examine the hypothesized relationships among the variables. Emotional abuse predicted physical abuse, sexual abuse, and current trauma symptoms. Current trauma symptoms, in turn, were moderately predictive of perceived general health and strongly predictive of perceived mental health and physical symptoms. Subjects who experienced physical neglect or emotional ne...

Using objective measures, the authors found a high rate of childhood sexual and physical abuse in a sample of 66 female psychiatric inpatients. Childhood abuse experiences were correlated with severity of adult psychiatric symptoms. The authors explore the usefulness of adult psychological symptoms, diagnoses, and prescribed medications as factors in the identification of patients who have histories of early sexual and physical abuse.

Objective: The primary goals of this study were to (a) provide the first estimate of prevalence of self-reported history of having been emotionally, physically, and/or sexually abused for men with a substance use disorder in Sweden and (b) identify, for men with a substance use disorder, mental health, substance use, and criminal justice characteristics associated with having a history of abuse. Methods: Assessment interviews for a substance use disorder were conducted in 50 out of 300 Swedish counties for the time period 2003 to 2008. Participants were a nationally representative sample of 9,571 Swedish men interviewed in county welfare offices. The Addiction Severity Index (ASI) was used as an assessment tool in these counties. From the ASI, answers to questions asking about lifetime history of emotional, physical, and sexual abuse were analyzed to provide this initial measure on history of abuse. Bivariate statistical analysis and multivariate logistic regression methods were used to explore the relationships between substance use severity, level of mental health problems reported, criminal justice history, and history of being abused. Results: Overall, 47.9% of the men in this sample reported having experienced abuse; specifically, 26.9% of clients reported a history of physical abuse, 4.5% reported a history of sexual abuse, and 40.7% reported a history of emotional abuse. Results from logistic regression modeling identified that higher ASI mental health symptomology scores were associated with 13 times higher likelihood of having experienced any abuse. Further, results from logistic regression models identified that scoring higher on the ASI mental health symptoms core was associated with an 8 times higher likelihood of having experienced physical abuse,14 times higher likelihood of having experienced sexual abuse, and 13 times higher likelihood of having experienced emotional abuse. Conclusions: Both the high prevalence of reporting a history of abuse among men with substance use disorders and the strong association between reporting more mental health symptoms and history of abuse indicate a need for Swedish substance use disorder treatment programs to start using more comprehensive and clinically appropriate trauma assessment tools and to provide empirically supported trauma treatments.

Do trauma symptoms mediate the relationship between childhood physical abuse and adult child abuse risk?

Home visiting is an effective preventive intervention that can improve parenting outcomes for at-risk, new mothers, thereby optimizing subsequent child development. A history of maltreatment in childhood is common in mothers participating in home visiting, yet the extent to which such a history is related to parenting outcomes during home visiting is unknown. The current study evaluated whether mothers with a history of maltreatment in childhood respond less favorably to home visiting by examining the direct and indirect pathways to subsequent parenting stress, a key parenting outcome affecting child development. First-time mothers (N = 220; age range = 16-42) participating in one of two home visiting programs, Healthy Families America or Nurse Family Partnership, were evaluated at enrollment and again at 9-and 18-month post-enrollment assessments. Researchers administered measures of maternal history of maltreatment in childhood, depressive symptoms, social support, and parenting stress. Maternal history of maltreatment in childhood predicted worsening parenting stress at the 18-month assessment. Mediation modeling identified two indirect pathways, one involving social support at enrollment and one involving persistent depressive symptoms during home visiting, that explained the relation between a history of maltreatment in childhood and parenting stress at the 18-month assessment. Ways to improve the preventive effects of home visiting for mothers with a history of maltreatment in childhood through the identification of relevant intervention targets and their ideal time of administration are discussed.

BackgroundLimited information is known about the impact of childhood maltreatment on lifetime risk of violent death. This study aimed to compare manner of death, demographics, age at time of death, and the presence of a mental health or substance use disorder among decedents of violent deaths with a history of child maltreatment to those without.MethodsThis cross-sectional study compared characteristics of pediatric and adult violent deaths with and without a history of child maltreatment that were captured in the National Violent Death Reporting System from 2014 through 2018.ResultsDecedents who were male, multiracial, and had adulthood substance or mental health disorders were more likely to have a history of maltreatment. All-age decedents with a history of maltreatment were more likely to die by homicide. Adult decedents with a history of maltreatment were more likely to die by suicide. Maltreated decedents died significantly younger than non-maltreated decedents.ConclusionsAmong victims of violent deaths, an identified history of child maltreatment was associated with increased risk of homicide across the lifespan, adult suicide, and earlier death. A history of child maltreatment was also associated with mental health and substance use disorders, which may reflect one of the pathways through which the child maltreatment-to-death association functions.

Previous studies have found that those with a history of childhood abuse are more likely to smoke cigarettes than those without a history of abuse. Mechanisms underlying this greater prevalence are unclear. We examined whether current smokers with a history of childhood abuse reported greater levels of nicotine dependence and more severe nicotine withdrawal symptoms. We analyzed data from a 2-wave, national, random-digit-dial survey of adult cigarette smokers (n = 751). We examined whether childhood physical, emotional, and sexual abuse were associated with greater levels of nicotine dependence. Among those who made a quit attempt (n = 368), we examined whether abuse was associated with more severe withdrawal symptoms recalled during the 14 months between surveys. For both dependence and withdrawal, we tested a mediation pathway through current serious mental illness (SMI). All 3 types of childhood abuse were associated with more severe withdrawal symptoms. These associations were partially mediated by SMI. Sexual abuse and physical abuse were directly associated with dependence, whereas emotional abuse was indirectly associated with dependence through SMI. All 3 forms of childhood abuse were associated with both dependence and withdrawal. The greater prevalence of smoking found among those with a history of childhood abuse may be explained by heightened vulnerability to nicotine dependence and withdrawal and may be partially due to comorbid mental illness.

Is Epigenetic Stress the Link Between Childhood Maltreatment and Borderline Personality Disorder?

To determine the prevalence of a history of sexual and physical abuse in women seen in a referral-based gastroenterology practice, to determine whether patients with functional gastrointestinal disorders report greater frequencies of abuse than do patients with organic gastrointestinal diseases, and to determine whether a history of abuse is associated with more symptom reporting and health care utilization. A consecutive sample of women seen in a university-based gastroenterology practice over a 2-month period was asked to complete a brief questionnaire. The self-administered questionnaire requested information about demographics, symptoms, health care utilization, and history of abuse. Physicians indicated the primary diagnosis for each patient and whether she had ever discussed having been sexually or physically abused. Of 206 patients, 89 (44%) reported a history of sexual or physical abuse in childhood or later in life; all but 1 of the physically abused patients had been sexually abused. Almost one third of the abused patients had never discussed their experiences with anyone; only 17% had informed their doctors. Patients with functional disorders were more likely than those with organic disease diagnoses to report a history of forced intercourse (odds ratio, 2.08; 95% CI, 1.03 to 4.21) and frequent physical abuse (odds ratio, 11.39; CI, 2.22 to 58.48), chronic or recurrent abdominal pain (odds ratio, 2.06; CI, 1.03 to 4.12), and more lifetime surgeries (2.7 compared with 2.0 surgeries; P less than 0.03). Abused patients were more likely than nonabused patients to report pelvic pain (odds ratio, 4.05; CI, 1.41 to 11.69), multiple somatic symptoms (7.1 compared with 5.8 symptoms; P less than 0.001), and more lifetime surgeries (2.8 compared with 2.0 surgeries; P less than 0.01). We found that a history of sexual and physical abuse is a frequent, yet hidden, experience in women seen in referral-based gastroenterology practice and is particularly common in those with functional gastrointestinal disorders. A history of abuse, regardless of diagnosis, is associated with greater risk for symptom reporting and lifetime surgeries.

Attachment style and history of childhood abuse in suicide attempters

For bariatric surgery candidates, history of child abuse and PTSD may be under-recognized or under-reported at pre-surgical evaluation. On a range of clinically relevant factors, we studied 3045 candidates for bariatric surgery: (1) those with a history of childhood abuse compared to those without such history; and (2) among candidates with a history of abuse, those with a lifetime diagnosis of PTSD compared to those without that diagnosis. We compared them on current and lifetime eating disorders, physical health problems, health behaviors, physical functioning, psychosocial functioning, psychiatric disorders, emotional wellness, body satisfaction, and self-esteem. We hypothesized that patients with a history of childhood abuse, and within that group, those with a lifetime PTSD diagnosis, would display greater overall impairment. Patients were interviewed with semi-structured interviews and completed self-report questionnaires. Results showed that (1) patients with a history of childhood abuse exhibited significantly greater impairment than those without abuse; and (2) among candidates with a history of abuse, those with a lifetime history of PTSD displayed significantly greater impairment than those without a PTSD diagnosis. The findings suggest that a history of both childhood abuse and lifetime PTSD should be thoroughly assessed for at pre-surgical evaluation, and that greater attention be paid to the experience of PTSD symptoms in abuse survivors presenting for bariatric surgery.

BackgroundChild maltreatment exerts lasting effects on emotion regulation, which in turn accounts for adult’s risk for psychopathology such as depression. In this vulnerable population, deficits in emotion regulation of negative affect are well established and include reliance on emotional suppression and rumination strategies. In contrast, alterations in the regulation of positive affect associated with child maltreatment history are less understood. We examined the role of positive rumination and dampening of positive affect, two emotion regulation strategies that may be impaired by the experience of child maltreatment and are associated with depression risk. We hypothesized that alterations in positive rumination and dampening would explain the association between women’s childmaltreatment history and heightened risk for current depressive symptoms. To determine if positive affect regulation accounts for unique variance between child maltreatment history and depression risk we controlled for brooding rumination.MethodsUndergraduate women (n = 122) completed surveys on child maltreatment, depressive symptoms, and their tendency to dampen or engage in positive rumination in response to positive affect, reflecting cross-sectional data. The PROCESS macro, model 4 was run in SPSS to examine the extent to which emotion regulation strategies accounted for the association between child maltreatment history and current depressive symptoms.ResultsChild maltreatment history was associated with a higher tendency to dampen positive affect but was not linked with positive rumination. Dampening partially explained the link between child maltreatment and women’s current depressive symptoms. Dampening and brooding rumination each accounted for unique variance in the association between child maltreatment and depressive symptoms.ConclusionsResults suggest that emotion suppression strategies among child maltreatment survivors may also extend to positive affect, with impairments in specific regulation strategies. Currently dysphoric women with a history of child maltreatment tend to dampen their positive moods and reactions to events as well as ruminate on their dysphoric moods, both tendencies accounted for unique variance in current depression risk. Longitudinal research is warranted to clarify the role of alterations in positive emotion regulations strategies in understanding how child maltreatment fosters risk for psychopathology such as depression.

Background: Dissociation has been recognized as a relevant factor within the context of traumatization. Since childhood maltreatment as well as child birth can be regarded as a potential trauma, this study examined dissociation in a sample of 58 young mothers with a history of abuse in comparison to a control group. Methods: All women with newborn children were contacted by mail and presented with the Childhood Trauma Questionnaire. Women who reached a cutoff for moderate or severe sexual and/or physical abuse and whose children were term babies with Apgar scores >7 were included in the study to form the index group (n = 58); the control group was formed by matching mothers with no reported experiences of physical and/or sexual abuse (n = 61). Dissociative experiences were assessed by the Scale of Dissociative Experiences (German version of the Dissociative Experiences Scale). Results: The results show that mothers with a history of physical or sexual abuse – matched for infant gender, maternal education, marital status, number of infants and birth weight – had significantly more dissociative experiences. Conclusions: Maternal history of abuse significantly increases maternal dissociative experiences, which has frequently been postulated but never empirically shown in a prospective design in a sample of young mothers. As maternal psychopathology has been found to have a profound impact on child development, specifically in the first year of life, these data are of immediate relevance for preventive efforts when targeting at-risk mother-infant dyads.