Saturday, December 26, 2015

Childhood Trauma and Its Relation to Chronic Depression in Adulthood

There is a large consensus indicating that childhood trauma is significantly involved in the development of depression. 

The aim of this study was to examine the prevalence of retrospectively recalled childhood trauma in chronically depressed patients and to investigate a more specific relationship between trauma type and depression. 

We further asked for the influence of multiple experiences of childhood trauma on the vulnerability to a chronic course of depression in adulthood. 349 chronically depressed patients of the German LAC Depression Study completed the Childhood Trauma Questionnaire, a self-report measure of traumatic experiences in childhood. 75.6% of the chronically depressed patients reported clinically significant histories of childhood trauma. 37% of the chronically depressed patients reported multiple childhood traumatization. 

Experiences of multiple trauma also led to significantly more severe depressive symptoms. Stepwise multiple regression analysis suggested that childhood emotional abuse and sexual abuse were significantly associated with a higher symptom severity in chronically depressed adults. Yet, expanding the regression model for multiple exposures showed that multiplicity was the only remaining significant predictor for symptom severity in chronically depressed patients. 

Clinical implications suggest a precise assessment of childhood trauma in chronically depressed patients with a focus on emotional abuse, sexual abuse, and multiple exposures to childhood trauma. This trial is registered with registration number ISRCTN91956346.

…Overall, the prevalence of childhood trauma was remarkably high with a magnitude of 75.6%. Moreover, CTQ subscale means indicated childhood trauma on the thresholds from moderate to severe exposure []. We additionally applied higher thresholds for the specific examination of clinically relevant childhood trauma []. Specific contributions of certain types of childhood trauma to the vulnerability of different forms of psychopathology were repeatedly reported. Our results show that emotional abuse was reported most frequently with 61%. Additionally, 25% of the patients reported childhood sexual abuse. Contrastingly, 15% emotional abuse and 12.6% sexual abuse were found in a representative German survey study on the prevalence of childhood trauma []. These findings show chronically depressed patients to be highly burdened by childhood adversities and supports reports of greater childhood adversity in chronic forms of depression compared to nonchronic forms []. For example, dysthymic patients were reported to have significantly poorer early parental relationships and to receive less care than patients with episodic depression []. Also, duration of depression was reported to be uniquely predicted by maternal abuse, maternal indifference, and paternal overcontrol [].

In our study, women reported significantly more frequent childhood trauma in general and emotional abuse and sexual abuse in particular. McGrath et al. [] pointed to the higher risk of victimization in women and estimated childhood abuse in women at 21.7 to 37%. Lampe's [] review on childhood trauma confirmed that women suffered more frequently from sexual abuse than men. Scher et al. [] showed that women were nearly twice as likely to report emotional abuse and four times as likely to report sexual abuse. Furthermore, our results showed that when referring to associations of trauma types and trauma groups with symptom severity, gender did not contribute significantly. Arnow et al. [] examined the moderating role of gender on the association between childhood abuse, neglect, and depression, yet they found no gender differences. However, they also identified significantly more depressed women than men reporting histories of emotional abuse and sexual abuse, which they interpreted as stemming from higher rates of victimization among women (p. 179). The lack of evidence for gender differences in the relationship of childhood adversity and depression was also substantiated by other studies reporting that among those with a history of childhood sexual abuse [] with physical [] or emotional abuse [, ] men and women were equally at risk for depression…

Full article at:

1Sigmund-Freud-Institute, 60323 Frankfurt, Germany
2University of Kassel, Psychoanalytical Psychology, 34127 Kassel, Germany
*Alexa Negele: Email: ed.tutitsni-duerf-dnumgis@elegen

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