Which is Worse – The Memory or the Maltreatment?

Many studies have linked childhood maltreatment and adversity to mental and physical health disorders later in life. Most of the studies have been retrospective in design, which inserts bias into the study and makes the results less conclusive. A new study evaluated both prospectively and retrospectively gathered information about childhood experiences and adult mental health and reports that the association is the same, no matter how the information is ascertained.

The current study, published in the British Journal of Psychiatry, used data from the New Zealand Mental Health Survey that was conducted in 2003 and 2004. Of the near-13,000 adults who participated in the study, the researchers evaluated 1413 of them between the ages of 16 and 27 years. The participants answered questions about possible mental health disorders, based on DSM-IV criteria, and recalled childhood maltreatment and adversity, such as experiencing physical or sexual abuse or witnessing parental violence. This was the “retrospective” portion of the study. The researchers also linked the findings to the database of the national child protective services agency to identify maltreatment records. This qualified as the “prospective” portion of the study.

In all, 358 of the participants retrospectively reported childhood maltreatment and 168 prospective cases were reported. Adults who had any type of report or evidence of maltreatment (retrospective or prospective) had a significant risk (2-to 4-fold) of developing drug abuse or dependence, major depressive disorder, and any anxiety disorder compared to those with no history of maltreatment. Neither assessment showed a significant link between childhood experiences and alcohol abuse or all types of depression.

The major difference between retrospective and prospective assessments was the finding that prospectively-obtained information predicted an earlier onset of mental health disorders, a longer duration of the condition, and a greater degree of impairment. The mechanism behind the association is not clear, but a neurobiological link is hypothesized. Childhood maltreatment may alter neurobiological systems and predispose adults to a myriad of chronic mental and physical disorders.

Previous retrospective studies have concluded that it is not the childhood maltreatment itself that causes mental health problems in adults, but, rather, the memory of the maltreatment. This study refutes those claims and indicates that both are harmful to the well-being of would-be adults. The authors of the current confirm the substantial impact of early maltreatment on adult health, but expect that prospective data will be used to screen for mental health disorders later in life. Targeted mental health interventions for children who experience maltreatment might reduce the burden of adult mental health disorders.

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