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Annals of General Psychiatry
Published in: Annals of General Psychiatry 1/2019

Open Access 01-12-2019 | Schizophrenia | Primary research

The prevalence of childhood trauma in psychiatric outpatients

Authors: Fiona Devi, Shazana Shahwan, Wen Lin Teh, Rajeswari Sambasivam, Yun Jue Zhang, Ying Wen Lau, Say How Ong, Daniel Fung, Bhanu Gupta, Siow Ann Chong, Mythily Subramaniam

Published in: Annals of General Psychiatry | Issue 1/2019

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Abstract

Background

The aim of this present study was to compare the prevalence and type of trauma experienced by community sample with the outpatient sample with mental disorders.

Methods

A total of 354 outpatients, aged 14–35 years old, with mood disorders, schizophrenia and other psychotic disorders, adjustment disorder and anxiety disorder were recruited from a tertiary psychiatric hospital. A total of 100 healthy controls were recruited from the Singapore general population by snowballing. The Childhood Trauma Questionnaire-Short Form (CTQ-SF) designed to measure childhood trauma and the severity (e.g., physical abuse, emotional abuse, sexual abuse, physical neglect and emotional neglect) was administered to participants. Socio-demographic and clinical characteristics were obtained from interviews with the participants and from outpatients’ medical records, respectively. Independent sample t tests and Chi-square tests were used to investigate the differences between the outpatient and community samples.

Results

Overall the CTQ-SF total and domain scores indicated that outpatient sample experienced higher rate of traumatic life events in childhood than community sample. Two most reported trauma types were emotional abuse (n = 81, 59.1%) and physical neglect (n = 74, 54%) reported by the mood disorder group. In the community sample, emotional neglect (n = 46, 46%) and physical neglect (n = 18, 18%) were the most commonly reported trauma type. Overall outpatient sample (n = 80, 22.6%) and community sample (n = 28, 28%) reported at least one type of trauma.

Conclusion

The findings indicate higher rates of CTQ-SF total and domain scores in outpatient sample demonstrating a higher rate of traumatic life events in childhood compared to community sample. Further research in childhood trauma is needed to improve the knowledge in psychiatric clinic practices.
Literature
1.
Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C, et al. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health. 2017;2(8):e356–66.PubMedCrossRef
2.
Busso DS, McLaughlin KA, Brueck S, Peverill M, Gold AL, Sheridan MA. Child abuse, neural structure, and adolescent psychopathology: a longitudinal study. J Am Acad Child Adolesc Psychiatry. 2017;56(4):321–328.e1.PubMedPubMedCentralCrossRef
3.
Kessler RC, McLaughlin KA, Green JG, Gruber MJ, Sampson NA, Zaslavsky AM, et al. Childhood adversities and adult psychopathology in the WHO World Mental. Br J Psychiatry. 2010;197(5):378–85.PubMedPubMedCentralCrossRef
4.
Bellis MA, Hughes K, Hardcastle K, Ashton K, Ford K, Quigg Z, et al. The impact of adverse childhood experiences on health service use across the life course using a retrospective cohort study. J Health Serv Res Policy. 2017;22(3):168–77.PubMedCentralCrossRef
5.
6.
Pechtel P, Pizzagalli DA. Effects of early life stress on cognitive and affective function: an integrated review of human literature. Psychopharmacology. 2011;214(1):55–70.PubMedCrossRef
7.
Behere AP, Basnet P, Campbell P. Effects of family structure on mental health of children: a preliminary study. Indian J Psychol Med. 2017;39(4):457–63.PubMedPubMedCentralCrossRef
8.
Teicher MH, Samson JA, Anderson CM, Ohashi K. The effects of childhood maltreatment on brain structure, function and connectivity. Nat Rev Neurosci. 2016;17(10):652–66.PubMedCrossRef
9.
Bellis MA, Hughes K, Leckenby N, Perkins C, Lowey H. National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviors in England. BMC Med. 2014;12:72.PubMedPubMedCentralCrossRef
10.
Bellis MA, Hughes K, Leckenby N, Jones L, Baban A, Kachaeva M, et al. Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries. Bull World Health Organ. 2014;92(9):641–55.PubMedPubMedCentralCrossRef
11.
DeRosse P, Nitzburg GC, Kompancaril B, Malhotra AK. The relation between childhood maltreatment and psychosis in patients with schizophrenia and non-psychiatric controls. Schizophr Res. 2014;155:66–71.PubMedPubMedCentralCrossRef
12.
Bellis MA, Hughes K, Leckenby N, Hardcastle KA, Perkins C, Lowey H. Measuring mortality and the burden of adult disease associated with adverse childhood experiences in England: a national survey. J Public Health. 2015;37(3):445–54.CrossRef
13.
Larsson S, Andreassen OA, Aas M, Rossberg JI, Mork E, Steen NE, et al. High prevalence of childhood trauma in patients with schizophrenia spectrum and affective disorder. Compr Psychiatry. 2013;54(2):123–7.PubMedCrossRef
14.
Liu Y, Croft JB, Chapman DP, Perry GS, Greenlund KJ, Zhao G, et al. Relationship between adverse childhood experiences and unemployment among adults from five US states. Soc Psychiatry Psychiatr Epidemiol. 2013;48(3):357–69.PubMedCrossRef
15.
Weber K, Rockstroh B, Borgelt J, Awiszus B, Popov T, Hoffmann K, et al. Stress load during childhood affects psychopathology in psychiatric patients. BMC Psychiatry. 2008;8(1):63.PubMedPubMedCentralCrossRef
16.
Negele A, Kaufhold J, Kallenbach L, Leuzinger-Bohleber M. Childhood trauma and its relation to chronic depression in adulthood. Depress Res Treat. 2015;2015:11.
17.
Xie P, Wu K, Zheng Y, Guo Y, Yang Y, He J, et al. Prevalence of childhood trauma and correlations between childhood trauma, suicidal ideation, and social support in patients with depression, bipolar disorder, and schizophrenia in southern China. J Affect Disord. 2018;228:41–8.PubMedCrossRef
18.
Reeder FD, Husain N, Rhouma A, Haddad PM, Munshi T, Naeem F, et al. The relationship between childhood trauma and adult psychosis in a UK early intervention service: results of a retrospective case note study. Neuropsychiatr Dis Treat. 2017;13:269–73.PubMedPubMedCentralCrossRef
19.
Duhig M, Patterson S, Connell M, Foley S, Capra C, Dark F, et al. The prevalence and correlates of childhood trauma in patients with early psychosis. Aust N Z J Psychiatry. 2015;49(7):651–9.PubMedCrossRef
20.
Aas M, Andreassen OA, Aminoff SR, Færden A, Romm KL, Nesvåg R, et al. A history of childhood trauma is associated with slower improvement rates: findings from a one-year follow-up study of patients with a first-episode psychosis. BMC Psychiatry. 2016;16:126.PubMedPubMedCentralCrossRef
21.
Thompson AD, Nelson B, Yuen HP, Lin A, Amminger GP, McGorry PD, et al. Sexual trauma increases the risk of developing psychosis in an ultra high-risk “prodromal” population. Schizophr Bull. 2014;40(3):697–706.PubMedCrossRef
22.
Read J, van Os J, Morrison AP, Ross CA. Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatr Scand. 2005;112(5):330–50.PubMedCrossRef
23.
Cutajar MC, Mullen PE, Ogloff JP, Thomas SD, Wells DL, Spataro J. Schizophrenia and other psychotic disorders in a cohort of sexually abused children. Arch Gen Psychiatry. 2010;67(11):1114–9.PubMedCrossRef
24.
Ucok A, Bikmaz S. The effects of childhood trauma in patients with first-episode schizophrenia. Acta Psychiatr Scand. 2007;116(5):371–7.PubMedCrossRef
25.
Cardno AG, Marshall EJ, Coid B, Macdonald AM, Ribchester TR, Davies NJ, et al. Heritability estimates for psychotic disorders: the Maudsley twin psychosis series. Arch Gen Psychiatry. 1999;56(2):162–8.PubMedCrossRef
26.
Kim JS, Lee SH. Influence of interactions between genes and childhood trauma on refractoriness in psychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry. 2016;70:162–9.PubMedCrossRef
27.
Garno JL, Gunawardane N, Goldberg JF. Predictors of trait aggression in bipolar disorder. Bipolar Disord. 2008;10(2):285–92.PubMedCrossRef
28.
Leverich GS, Altshuler LL, Frye MA, Suppes T, Keck PE Jr, McElroy SL, et al. Factors associated with suicide attempts in 648 patients with bipolar disorder in the Stanley Foundation Bipolar Network. J Clin Psychiatry. 2003;64(5):506–15.PubMedCrossRef
29.
Garno JL, Goldberg JF, Ramirez PM, Ritzler BA. Impact of childhood abuse on the clinical course of bipolar disorder. Br J Psychiatry. 2005;186:121–5.PubMedCrossRef
30.
Hyun M, Friedman SD, Dunner DL. Relationship of childhood physical and sexual abuse to adult bipolar disorder. Bipolar Disord. 2000;2(2):131–5.PubMedCrossRef
31.
Luby JL, Gaffrey MS, Tillman R, April LM, Belden AC. Trajectories of preschool disorders to full DSM depression at school age and early adolescence: continuity of preschool depression. Am J Psychiatry. 2014;171(7):768–76.PubMedPubMedCentralCrossRef
32.
Etain B, Aas M, Andreassen OA, Lorentzen S, Dieset I, Gard S, et al. Childhood trauma is associated with severe clinical characteristics of bipolar disorders. J Clin Psychiatry. 2013;74(10):991–8.PubMedCrossRef
33.
Huh HJ, Kim S-Y, Yu JJ, Chae J-H. Childhood trauma and adult interpersonal relationship problems in patients with depression and anxiety disorders. Ann Gen Psychiatry. 2014;13(1):26.PubMedPubMedCentralCrossRef
34.
Liu RT. Childhood adversities and depression in adulthood: current findings and future directions. Clin Psychol Sci Pract. 2017;24(2):140–53.CrossRef
35.
Mason O, Platts H, Tyson M. Early maladaptive schemas and adult attachment in a UK clinical population. Psychol Psychother Theory Res Pract. 2005;78(4):549–64.CrossRef
36.
Davis JL, Petretic-Jackson PA, Ting L. Intimacy dysfunction and trauma symptomatology: long-term correlates of different types of child abuse. J Trauma Stress. 2001;14(1):63–79.CrossRef
37.
Ducharme J, Koverola C, Battle P. Intimacy development: the influence of abuse and gender. J Interpers Violence. 1997;12(4):590–9.CrossRef
38.
Huh HJ, Kim S-Y, Yu JJ, Chae J-H. Childhood trauma and adult interpersonal relationship problems in patients with depression and anxiety disorders. Ann Gen Psychiatry. 2014;13:26.PubMedPubMedCentralCrossRef
39.
Kendler KS, Bulik CM, Silberg J, Hettema JM, Myers J, Prescott CA. Childhood sexual abuse and adult psychiatric and substance use disorders in women: an epidemiological and cotwin control analysis. Arch Gen Psychiatry. 2000;57(10):953–9.PubMedCrossRef
40.
Weinberger MI, Sirey JA, Bruce ML, Heo M, Papademetriou E, Meyers BS. Predictors of major depression six months after admission for outpatient treatment. Psychiatr Serv. 2008;59(10):1211–5.PubMedPubMedCentralCrossRef
41.
Teicher MH, Samson JA, Polcari A, Andersen SL. Length of time between onset of childhood sexual abuse and emergence of depression in a young adult sample. J Clin Psychiatry. 2009;70(5):684–91.PubMedPubMedCentralCrossRef
42.
Wiersma JE, Hovens JG, van Oppen P, Giltay EJ, van Schaik DJ, Beekman AT, et al. The importance of childhood trauma and childhood life events for chronicity of depression in adults. J Clin Psychiatry. 2009;70(7):983–9.PubMedCrossRef
43.
Withers AC, Tarasoff JM, Stewart JW. Is depression with atypical features associated with trauma history? J Clin Psychiatry. 2013;74(5):500–6.PubMedCrossRef
44.
Singapore DoS. Populations trends 2018. Department of Statistics MoTI, Republic of Singapore; 2018. Report No. ISSN 2591-8028.
45.
Tong CK, Elliott MJ, Tan MEHP. Public perceptions of child abuse and neglect in Singapore. Singapore: Singapore Children’s Society; 2019.
46.
Chu CM, Thomas SDM, Ng VPY. Childhood abuse and delinquency: a descriptive study of institutionalized female youth in Singapore. Psychiatry Psychol Law. 2009;16(sup1):S64–73.CrossRef
47.
Tong CK, Elliott JM, Tan P. Public perceptions of child abuse and neglect in Singapore. Singapore: Singapore Children’s Society; 1996.
48.
Back SE, Jackson JL, Fitzgerald M, Shaffer A, Salstrom S, Osman MM. Child sexual and physical abuse among college students in Singapore and the United States. Child Abuse Negl. 2003;27(11):1259–75.PubMedCrossRef
49.
Children And Young Persons Act (Chapter 38). Singapore statutes online PLUS; 1993.
50.
51.
Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, et al. Development and validation of a brief screening version of the childhood trauma questionnaire. Child Abuse Negl. 2003;27(2):169–90.PubMedCrossRef
52.
Jansen K, Cardoso TA, Fries GR, Branco JC, Silva RA, Kauer-Sant’Anna M, et al. Childhood trauma, family history, and their association with mood disorders in early adulthood. Acta Psychiatr Scand. 2016;134(4):281–6.PubMedCrossRef
53.
Karos K, Niederstrasser N, Abidi L, Bernstein DP, Bader K. Factor structure, reliability, and known groups validity of the German version of the childhood trauma questionnaire (short-form) in Swiss patients and nonpatients. J Child Sex Abuse. 2014;23(4):418–30.CrossRef
54.
Kim D, Bae H, Han C, Oh HY, Macdonald K. Psychometric properties of the childhood trauma questionnaire-short form (CTQ-SF) in Korean patients with schizophrenia. Schizophr Res. 2013;144(1–3):93–8.PubMedCrossRef
55.
Garrusi B, Nakhaee N. Validity and reliability of a Persian version of the childhood trauma questionnaire. Psychol Rep. 2009;104:509–16.PubMedCrossRef
56.
Bonoldi I, Simeone E, Rocchetti M, Codjoe L, Rossi G, Gambi F, et al. Prevalence of self-reported childhood abuse in psychosis: a meta-analysis of retrospective studies. Psychiatry Res. 2013;210(1):8–15.PubMedCrossRef
57.
Fisher HL, Jones PB, Fearon P, Craig TK, Dazzan P, Morgan K, et al. The varying impact of type, timing and frequency of exposure to childhood adversity on its association with adult psychotic disorder. Psychol Med. 2010;40(12):1967–78.PubMedPubMedCentralCrossRef
58.
Church C, Andreassen OA, Lorentzen S, Melle I, Aas M. Childhood trauma and minimization/denial in people with and without a severe mental disorder. Front Psychol. 2017;8:1276.PubMedPubMedCentralCrossRef
59.
Alvarez M-J, Roura P, Osés A, Foguet-Boreu Q, Solà J, Arrufat F. Prevalence and clinical impact of childhood trauma in patients with severe mental disorders. J Nerv Ment Disord. 2011;199:156–61.CrossRef
60.
Mills R, Scott J, Alati R, O’Callaghan M, Najman J, Strathearn L. Child maltreatment and adolescent mental health problems in a large birth cohort. Child Abuse Negl. 2013;37(5):292–302.PubMedPubMedCentralCrossRef
61.
Carr C, Martins C, Stingel A, Braga Lemgruber V, Juruena M. The role of early life stress in adult psychiatric disorders: a systematic review according to childhood trauma subtypes. J Nerv Ment Disord. 2013;201:1007–20.CrossRef
62.
Glaser D. The effects of child maltreatment on the developing brain. Med Leg J. 2014;82(3):97–111.PubMedCrossRef
63.
Molnar BE, Buka SL, Kessler RC. Child sexual abuse and subsequent psychopathology: results from the national comorbidity survey. Am J Public Health. 2001;91(5):753–60.PubMedPubMedCentralCrossRef
64.
Rössler W, Ajdacic-Gross V, Haker H, Rodgers S, Müller M, Hengartner M. Subclinical psychosis syndromes in the general population: results from a large-scale epidemiological survey among residents of the canton of Zurich, Switzerland. Epidemiol Psychiatr Sci. 2015;24:69–77.PubMedCrossRef
65.
Sahin S, Yuksel C, Guler J, Karadayi G, Akturan E, Gode E, et al. The history of childhood trauma among individuals with ultra high risk for psychosis is as common as among patients with first-episode schizophrenia. Early Interv Psychiatry. 2013;7(4):414–20.PubMedCrossRef
66.
Bebbington PE, Bhugra D, Brugha T, Singleton N, Farrell M, Jenkins R, et al. Psychosis, victimisation and childhood disadvantage: evidence from the second British national survey of psychiatric morbidity. Br J Psychiatry. 2004;185:220–6.PubMedCrossRef
67.
Molnar BE, Berkman LF, Buka SL. Psychopathology, childhood sexual abuse and other childhood adversities: relative links to subsequent suicidal behaviour in the US. Psychol Med. 2001;31(6):965–77.PubMedCrossRef
68.
Ren L, Pope Edwards C. Pathways of influence: Chinese parents’ expectations, parenting styles, and child social competence. Early Child Dev Care. 2015;185(4):614–30.CrossRef
69.
Institute FM. Cultural differences in parenting practices: what Asian American families can teach us. Frances McClelland Institute; 2010. Contract No. 1.
70.
Ang R, Goh D. Authoritarian parenting style in Asian societies: a cluster-analytic investigation. Contemp Fam Ther. 2006;28(1):131–51.CrossRef
71.
Choi Y, Kim YS, Kim SY, Park IK. Is Asian American parenting controlling and harsh? Empirical testing of relationships between Korean American and Western parenting measures. Asian Am J Psychol. 2013;4(1):19–29.PubMedPubMedCentralCrossRef
72.
Xing X, Zhang H, Shao S, Wang M. Child negative emotionality and parental harsh discipline in Chinese preschoolers: the different mediating roles of maternal and paternal anxiety. Front Psychol. 2017;8:339.PubMedPubMedCentralCrossRef
73.
74.
Mousavi SE, Low WY, Hashim AH. Perceived parenting styles and cultural influences in adolescent’s anxiety: a cross-cultural comparison. J Child Fam Stud. 2016;25(7):2102–10.CrossRef
75.
Norman RE, Byambaa M, De R, Butchart A, Scott J, Vos T. The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLoS Med. 2012;9(11):e1001349.PubMedPubMedCentralCrossRef
76.
Widom CS, DuMont K, Czaja SJ. A prospective investigation of major depressive disorder and comorbidity in abused and neglected children grown up. Arch Gen Psychiatry. 2007;64(1):49–56.PubMedCrossRef
Metadata
Title
The prevalence of childhood trauma in psychiatric outpatients
Authors
Fiona Devi
Shazana Shahwan
Wen Lin Teh
Rajeswari Sambasivam
Yun Jue Zhang
Ying Wen Lau
Say How Ong
Daniel Fung
Bhanu Gupta
Siow Ann Chong
Mythily Subramaniam
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Annals of General Psychiatry / Issue 1/2019
Electronic ISSN: 1744-859X
DOI
https://doi.org/10.1186/s12991-019-0239-1

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