Physical abuse and later depression
Oct 6, 2012
POST UPDATED -- SEE November 4
This post is motivated by a recent examination of what search phrases people have been using to find my site: childhood physical abuse and current depression being one of them. I suppose I should write an article reviewing the effects of different types of abuse and different outcomes. However, two factors stand in the way -- most forms of abuse or adversity occur together -- if you suffer physical abuse, you're also likely to suffer emotional abuse, say, as well as such things as parental chronic illness, parental criminality, exposure to domestic violence, et cetera; and most studies of the effects of abuse conclude that it is the "severity" of the abuse, and the number of incidents of abuse, that are the primary determining factors for later problems, rather than specific type of abuse -- see Pears, Kim & Fisher (2008) [LINK] for example; and Liu et al (2012) [LINK]. Note, that some specific relationships have for anxiety disorders [LINK]. Cougle et al (2010) found, after controlling for depression, other anxiety disorders, and demographic variables, unique relationships between childhood sexual abuse and social anxiety disorder (SAD), panic disorder (PD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD); in contrast, physical abuse was only associated with PTSD and specific phobia (SP). Further, among women, analyses revealed that physical abuse was uniquely associated with PTSD and SP, while sexual abuse was associated with SAD, PD, and PTSD. Among men, both sexual and physical abuse were uniquely associated with SAD and PTSD. Findings provide further evidence of the severe consequences of childhood abuse and help inform etiological accounts of anxiety disorders.
However, in a recent study Gonzalez et al (2012) [LINK] used data from the Ontario Child Health Study, a prospective, population-based study of 3294 children (ages 4-16) enrolled in 1983 and meeting inclusion criteria at follow-up in 2001 (N = 1475; ages 21-35 years) to examine the association between individual (school performance, childhood physical and sexual abuse) and family risk variables (socioeconomic status, parental mental health, medical condition, and functional limitation) with depression only, chronic pain conditions (back pain and headaches) or other CPCs (respiratory, cardiovascular and digestive disorders, and diabetes) and the comorbidity of either CPC category with depression assessed in early adulthood. Controlling for sex and age, childhood history of physical abuse was associated with most outcomes. Parental mental health, childhood functional limitation, childhood history of sexual abuse and family functioning were all related to comorbid depression and chronic pain conditions. Parental mental health was also related to increased risk of other CPCs. It was found that the greatest disease risk (comorbid depression and chronic pain conditions) was related to the greatest number of childhood risk factors. Although there was some evidence of specificity, there was overlap in childhood physical abuse predicting almost all outcomes. The researchers argue that efforts targeting the prevention and treatment of childhood maltreatment are critical in order to prevent the long lasting impact of childhood adversity on both mental and physical outcomes in early adulthood. Thus, these results substantially support both the earlier work of such as Pears, Kim, and Fisher; and Liu et al, and the work of Kate Scott from the Dunedin longterm developmental study looking at predictors of chronic physical conditions [LINK].