Childhood trauma associated with psychiatric disorders
Youths being treated for psychiatric disorders often have a history of childhood trauma, according to a study from Singapore.
“[Previous] studies have reported a significantly higher prevalence of childhood trauma in patients with mental disorders, emphasizing the risk of traumatic experiences in subsequent psychopathology,” said the researchers. The findings in this study were consistent with these previous ones, they said.
The population comprised 354 individuals aged 14–35 years (mean age 23.7 years, 47.7 percent male) with psychiatric disorders (mood disorders [30.2 percent], schizophrenia or other psychotic disorders [20 percent], adjustment disorder [14.3 percent], or anxiety disorder [13.4 percent]) who were treated as outpatients at the Institute of Mental Health in Singapore. They were compared with 100 healthy individuals aged 14–35 years without mental illness from the Singapore population (mean age 23.4 years, 45 percent male) who served as the control group. Information on sociodemographic and clinical characteristics were gleaned from interviews and medical records, while the Childhood Trauma Questionnaire-Short Form (CTQ-SF) was used to identify presence and severity of childhood trauma such as physical, emotional, or sexual abuse, or physical or emotional neglect.
Almost 30 percent of patients with anxiety disorder, 14.6 percent of patients with mood disorder, 21.9 percent of patients with schizophrenia or other psychotic disorders, and 33.9 percent of patients with adjustment disorder reported at least one childhood trauma compared with 28 percent of the control group. [Ann Gen Psychiatry 2019;18:15]
Of these, 24.8 percent with mood disorder, 16.5 percent with schizophrenia or other psychotic disorders, 21.5 percent with adjustment disorder, 21.3 percent with anxiety disorder, and 18 percent of the control group experienced ≥1 childhood trauma.
Individuals with psychiatric disorders had a greater prevalence of childhood trauma compared with the control group (51.4 percent vs 24.0 percent), specifically experiences with physical abuse (37.9 percent vs 16.0 percent), emotional abuse (43.2 percent vs 14.0 percent), sexual abuse (20.9 percent vs 5.00 percent, and physical neglect (48.9 percent vs 18.0 percent).
Individuals with psychiatric disorders also had significantly higher CTQ-SF scores than those in the control group (mean score, 51.9 vs 44.3; p<0.01).
Emotional neglect was a prevalent childhood trauma in individuals with psychiatric disorder, being the most frequently reported trauma in patients with adjustment disorder (52.3 percent) and anxiety disorder (44.3 percent).
Emotional abuse (59.1 percent) and physical neglect (54.0 percent) were the most common trauma in patients with mood disorder, physical and emotional neglect in psychotic disorder (52.7 and 42.9 percent, respectively), emotional neglect and abuse in adjustment disorder (52.3 and 47.7 percent, respectively), and emotional neglect, physical neglect, and emotional abuse in anxiety disorder (44.3, 34.4, and 34.4 percent, respectively).
In this study, emotional neglect occurred at a comparative rate in the patients and the control group. One explanation for this could be the difference in Asian and Western parenting styles, said the researchers.
“Parental expressivity such as acceptance and care in Asian culture are shown through instrumental support (eg, food, schooling) rather than verbal expressions (eg, hugs and praise) … the younger generation may perceive their parents’ parenting practices as devoid of emotional warmth, which could lead to the perception of emotional neglect,” they said.
The researchers acknowledged that excluding patients with childhood-diagnosed psychiatric disorders could have affected the generalizability of the findings. Furthermore, certain sociodemographic factors varied between the patients and controls.
“The present study suggests that childhood trauma needs more attention, particularly in psychiatric clinical practices and scientific research. Such information is important as it contributes to the public education on the negative impact of childhood adversity toward a child’s mental health development and the effective approaches to treatment,” they concluded.