Abstract
Does psychopathology develop as a function of the objective or subjective experience of childhood maltreatment? To address this question, we studied a unique cohort of 1,196 children with both objective, court-documented evidence of maltreatment and subjective reports of their childhood maltreatment histories made once they reached adulthood, along with extensive psychiatric assessment. We found that, even for severe cases of childhood maltreatment identified through court records, risk of psychopathology linked to objective measures was minimal in the absence of subjective reports. In contrast, risk of psychopathology linked to subjective reports of childhood maltreatment was high, whether or not the reports were consistent with objective measures. These findings have important implications for how we study the mechanisms through which child maltreatment affects mental health and how we prevent or treat maltreatment-related psychopathology. Interventions for psychopathology associated with childhood maltreatment can benefit from deeper understanding of the subjective experience.
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Data availability
The data reported in the current article are not publicly available because they contain extremely sensitive information that could compromise research participant privacy and confidentiality. We cannot provide individual level data from this project because our confidentiality agreement with the participants in this study precludes this. The data are available on request from C.S.W. by qualified scientists. Requests require a concept paper describing the purpose of data access, ethical approval at the applicant’s university in writing and provision for secure data access.
Code availability
The data analysis script is available from A.D. upon request.
References
Freud, S. The Aetiology of Hysteria. Wiener Klinischen Rundschau X, 22-26 (1896). [translated from German in the Complete Psychological Works of Sigmund Freud, Vol. III]
Freud, S. Three Essays on the Theory of Sexuality (1905). Franz Deuticke [translated from German in the Complete Psychological Works of Sigmund Freud, Vol. VII]
Susser, E. & Widom, C. S. Still searching for lost truths about the bitter sorrows of childhood. Schizophr. Bull. 38, 672–675 (2012).
Baldwin, J. R., Reuben, A., Newbury, J. B. & Danese, A. Agreement between prospective and retrospective measures of childhood victimization: a systematic review and meta-analysis. JAMA Psychiatry 76, 584–593 (2019).
Child Welfare Information Gateway Working with the Courts in Child Protection (US Department of Health and Human Services, Children’s Bureau, 2006).
Widom, C. S. The cycle of violence. Science 244, 160–166 (1989).
Widom, C. S., Czaja, S. J. & DuMont, K. A. Intergenerational transmission of child abuse and neglect: real or detection bias? Science 347, 1480–1485 (2015).
Caspi, A. et al. The p factor: one general psychopathology factor in the structure of psychiatric disorders? Clin. Psychol. Sci. 2, 119–137 (2014).
Dalgleish, T. & Werner-Seidler, A. Disruptions in autobiographical memory processing in depression and the emergence of memory therapeutics. Trends Cogn. Sci. 18, 596–604 (2014).
Monroe, S. M. Modern approaches to conceptualizing and measuring human life stress. Annu. Rev. Clin. Psychol. 4, 33–52 (2008).
Widom, C. S., Weiler, B. L. & Cottler, L. B. Childhood victimization and drug abuse: a comparison of prospective and retrospective findings. J. Consult. Clin. Psychol. 67, 867–880 (1999).
Gilbert, R. et al. Burden and consequences of child maltreatment in high-income countries. Lancet 373, 68–81 (2009).
Nanni, V., Uher, R. & Danese, A. Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression: a meta-analysis. Am. J. Psychiatry 169, 141–151 (2012).
Agnew-Blais, J. & Danese, A. Childhood maltreatment and unfavourable clinical outcomes in bipolar disorder: a systematic review and meta-analysis. Lancet Psychiatry 3, 342–349 (2016).
Macmillan, H. L. et al. Interventions to prevent child maltreatment and associated impairment. Lancet 373, 250–266 (2009).
McGee, R. A., Wolfe, D. A., Yuen, S. A., Wilson, S. K. & Carnochan, J. The measurement of maltreatment: a comparison of approaches. Child Abuse Negl. 19, 233–249 (1995).
Shaffer, A., Huston, L. & Egeland, B. Identification of child maltreatment using prospective and self-report methodologies: a comparison of maltreatment incidence and relation to later psychopathology. Child Abuse Negl. 32, 682–692 (2008).
Negriff, S., Schneiderman, J. U. & Trickett, P. K. Concordance between self-reported childhood maltreatment versus case record reviews for child welfare-affiliated adolescents. Child Maltreatment 22, 34–44 (2017).
Reuben, A. et al. Lest we forget: comparing retrospective and prospective assessments of adverse childhood experiences in the prediction of adult health. J. Child Psychol. Psychiatry 57, 1103–1112 (2016).
Newbury, J. B. et al. Measuring childhood maltreatment to predict early-adult psychopathology: comparison of prospective informant-reports and retrospective self-reports. J. Psychiatr. Res. 96, 57–64 (2018).
Lazarus, R. S. & Folkman, S. Stress, Appraisal, and Coping (Springer-Verlag, 1984).
Ehlers, A. & Clark, D. M. A cognitive model of posttraumatic stress disorder. Behav. Res. Ther. 38, 319–345 (2000).
Meiser-Stedman, R., Dalgleish, T., Glucksman, E., Yule, W. & Smith, P. Maladaptive cognitive appraisals mediate the evolution of posttraumatic stress reactions: a 6-month follow-up of child and adolescent assault and motor vehicle accident survivors. J. Abnorm. Psychol. 118, 778–787 (2009).
Danese, A. & McEwen, B. S. Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiol. Behav. 106, 29–39 (2012).
Shonkoff, J. P. et al. The lifelong effects of early childhood adversity and toxic stress. Pediatrics 129, e232–e246 (2012).
Chen, Y. & Baram, T. Z. Toward understanding how early-life stress reprograms cognitive and emotional brain networks. Neuropsychopharmacology 41, 197–206 (2016).
Loftus, E. Our changeable memories: legal and practical implications. Nat. Rev. Neurosci. 4, 231–234 (2003).
Schacter, D. L. & Slotnick, S. D. The cognitive neuroscience of memory distortion. Neuron 44, 149–160 (2004).
Danese, A. Annual Research Review: Rethinking childhood trauma—new research directions for measurement, study design and analytical strategies. J. Child Psychol. Psychiatry 61, 236–250 (2020).
Widom, C. S., Fisher, J. H., Nagin, D. S. & Piquero, A. R. A prospective examination of criminal career trajectories in abused and neglected males and females followed up into middle adulthood. J. Quant. Criminol. 34, 831–852 (2018).
Widom, C. S. Child abuse, neglect, and adult behaviour. Am. J. Orthopsychiatry 59, 355–367 (1989).
Nikulina, V. & Widom, C. S. Higher levels of intelligence and executive functioning protect maltreated children against adult arrests: a prospective study. Child Maltreatment 24, 3–16 (2019).
Widom, C. S., Marmorstein, N. R. & White, H. R. Childhood victimization and illicit drug use in middle adulthood. Psychol. Addict. Behav. 20, 394–403 (2006).
Watt, N. F. Longitudinal changes in the social behavior of children hospitalized for schizophrenia as adults. J. Nerv. Ment. Dis. 155, 42–54 (1972).
Shadish, W. R., Cook, T. D. & Campbell, D. T. Experimental and Quasi-Experimental Designs for Generalized Causal Inference (Houghton-Mifflin, 2002).
Leventhal, J. M. Research strategies and methodologic standards in studies of risk factors for child abuse. Child Abuse Negl. 6, 113–123 (1982).
Schulsinger, F., Mednick, S. A. & Knop, J. Longitudinal Research: Methods and Uses in Behavioral Sciences (Martinus Nijhoff Publishers, 1981).
Widom, C. S., DuMont, K. & Czaja, S. J. A prospective investigation of major depressive disorder and comorbidity in abused and neglected children grown up. Arch. Gen. Psychiatry 64, 49–56 (2007).
Stouthamer-Loeber, M., Loeber, R., Homish, D. L. & Wei, E. Maltreatment of boys and the development of disruptive and delinquent behavior. Dev. Psychopathol. 13, 941–955 (2001).
Lansford, J. E. et al. A 12-year prospective study of the long-term effects of early child physical maltreatment on psychological, behavioral, and academic problems in adolescence. Arch. Pediatr. Adolesc. Med. 156, 824–830 (2002).
Kim-Cohen, J. et al. MAOA, maltreatment, and gene–environment interaction predicting children’s mental health: new evidence and a meta-analysis. Mol. Psychiatry 11, 903–913 (2006).
Thornberry, T. P., Knight, K. E. & Lovegrove, P. J. Does maltreatment beget maltreatment? A systematic review of the intergenerational literature. Trauma Violence Abuse 13, 135–152 (2012).
Finkelhor, D. Sexually Victimized Children (Free Press, 1979).
Finkelhor, D. Sourcebook on Child Sexual Abuse (Sage Publications, 1986).
Russell, D. E. The incidence and prevalence of intrafamilial and extrafamilial sexual abuse of female children. Child Abuse Negl. 7, 133–146 (1983).
Widom, C. S. & Morris, S. Accuracy of adult recollections of childhood victimization: Part II. Childhood sexual abuse. Psychol. Assess. 9, 34–46 (1997).
Straus, M. A., Hamby, S. L., Finkelhor, D., Moore, D. W. & Runyan, D. Identification of child maltreatment with the parent–child conflict tactics scales: development and psychometric data for a national sample of American parents. Child Abuse Negl. 22, 249–270 (1998).
Widom, C. S. & Shepard, R. L. Accuracy of adult recollections of childhood victimization: Part I. Childhood physical abuse. Psychol. Assess. 8, 412–421 (1996).
Bernstein, D. P. & Fink, L. Childhood Trauma Questionnaire: A Retrospective Self-Report Manual (The Psychological Corporation, 1998).
American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders: DSM-III-R 3rd edn, revised (American Psychiatric Press, 1987).
Robins, L. N., Helzer, J. E., Goldring, E. & Ratcliff, K. S. National Institute of Mental Health Diagnostic Interview Schedule, Version III Revised (DIS-III-R) 1981/04/01 edn (Washington University, 1989).
Eaton, W. W., Regier, D. A., Locke, B. Z. & Taube, C. A. The Epidemiologic Catchment Area Program of the National Institute of Mental Health. Public Health Rep. 96, 319–325 (1981).
Helzer, J. E. et al. A comparison of clinical and diagnostic interview schedule diagnoses: physician reexamination of lay-interviewed cases in the general population. Arch. Gen. Psychiatry 42, 657–666 (1985).
Widom, C. S. Posttraumatic stress disorder in abused and neglected children grown up. Am. J. Psychiatry 156, 1223–1229 (1999).
StataCorp. Stata statistical software: release 15. (StataCorp LLC, 2017).
R Foundation for Statistical Computing. R: a language and environment for statistical computing. (R Foundation for Statistical Computing, 2020).
Acknowledgements
This research was supported in part by grants from the National Institute of Justice (NIJ nos. 86-IJ-CX-0033, 89-IJ-CX-0007 and 2011-WG-BX-0013), the National Institute of Mental Health (NIMH nos. MH49467 and MH58386), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD no. HD40774), the National Institute on Drug Abuse (NIDA nos. DA17842 and DA10060), the National Institute on Alcohol Abuse and Alcoholism (NIAAA nos. AA09238 and AA11108), the National Institute on Aging (NIA no. AG058683) and the Doris Duke Charitable Foundation to C.S.W. The opinions, findings and conclusions or recommendations expressed are those of the authors and do not necessarily reflect those of the US Department of Justice. A.D. received funding from the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London and is supported by the Medical Research Council grant no. P005918. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NHS, the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
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A.D. and C.S.W. contributed to the conception and design of the work, interpretation of the data, revision of the work and both approved the final manuscript. A.D. was involved in data analysis and drafting of the work. C.S.W. was involved in acquisition of the data.
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Danese, A., Widom, C.S. Objective and subjective experiences of child maltreatment and their relationships with psychopathology. Nat Hum Behav 4, 811–818 (2020). https://doi.org/10.1038/s41562-020-0880-3
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DOI: https://doi.org/10.1038/s41562-020-0880-3
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