Summary: Researchers have identified a causal effect between childhood maltreatment and an increased risk of mental health disorders.
According to a new study led by UCL researchers, being the victim of childhood abuse or neglect can cause multiple mental health problems.
The research, published in the American Journal of Psychiatryseeks to examine the causal effects of childhood maltreatment on mental health by considering other genetic and environmental risk factors, such as a family history of mental illness and socioeconomic disadvantage.
The first research of its kind analyzed 34 quasi-experimental studies, involving more than 54,000 people.
Quasi-experimental studies can better establish cause and effect in observational data, using specialized samples (eg, identical twins) or innovative statistical techniques to rule out other risk factors. For example, in samples of identical twins, if an abused twin has mental health problems but his non-abused twin does not, the association cannot be due to genetics or the family environment shared between Twins.
Across the 34 studies, the researchers found small effects of child maltreatment on a range of mental health issues, including internalizing disorders (for example, depression, anxiety, self-harm, and attempted suicide), externalizing disorders (eg, alcohol and drug abuse, ADHD, and conduct disorder) and psychosis.
These effects were consistent regardless of the method used or how maltreatment and mental health were measured.
The results suggest that preventing eight cases of child abuse would prevent a person from developing mental health problems.
Corresponding author Dr Jessie Baldwin (UCL Psychology & Language Sciences) said:
“It is well known that child maltreatment is associated with mental health problems, but it was unclear whether this relationship is causal or better explained by other risk factors.
“This study provides rigorous evidence suggesting that childhood maltreatment has weak causal effects on mental health problems. Although small, these effects of maltreatment could have far-reaching consequences, given that mental health problems predict a range of poor outcomes, such as unemployment, physical health problems and early mortality.
“Interventions that prevent maltreatment are therefore not only essential for child well-being, but may also prevent the long-term suffering and financial costs of mental illness.”
Nevertheless, the researchers also found that part of the overall risk of mental health problems among those exposed to abuse was due to pre-existing vulnerabilities – which could include other adverse environments (e.g. socioeconomic disadvantage ) and a genetic responsibility.
Dr Baldwin said: “Our findings also suggest that to minimize the risk of mental health problems in people exposed to abuse, clinicians should address not only the experience of abuse, but also pre-existing psychiatric risk factors. “
The researchers defined child abuse as any physical, sexual, or emotional abuse or neglect before the age of 18.
The study was funded by Wellcome and is in collaboration with King’s College London, University of Lausanne, Yale University School of Medicine, University of Bristol and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust.
Each of the quasi-experimental studies analyzed may have been subject to potential bias. However, the results were consistent across studies using different quasi-experimental methods, suggesting that the results are robust.
Additionally, it was not possible to draw firm conclusions about the specific effects of different types of abuse, as it is common for different types of abuse/neglect to occur at the same time, and studies rarely take this into account. .
The lack of available data meant that it was not possible to examine the effects of the timing of abuse, the interval between abuse and mental health problems, or differences between racial or ethnic groups. Future quasi-experimental research is needed to answer these questions.
About this research on mental health and child abuse
Author: Danby Poppy
Contact: Danby Poppy – UCL
Picture: Image is in public domain
Original research: The findings will appear in American Journal of Psychiatry