The Relationship Between Childhood Conflicts and Adult Depression

Download Report

Transcript The Relationship Between Childhood Conflicts and Adult Depression

Childhood Issues & Adulthood Tissues:
Examining Relationships between Childhood
Abuse & Adult Depression
Steffey, S.K., Gibson, B.W. & Dula, C.S.
East Tennessee State University
ABSTRACT

Depression is considered a debilitating clinical disorder and consumes $83
billion dollars of annual healthcare costs. Depression is more common in
woman than men with a incidence ratio of 13 to 5, respectively. Research
indicates that childhood sexual abuse is associated with depression. This study
seeks to examine relationships between childhood abuse/neglect and
depression. It was hypothesized that childhood maltreatment and depression
would show a positive relationship, and that females would have significantly
higher depression scores than males. Participants included 207 students from
psychology classes within a rural Southeastern university in the United States,
via an online participant management system that ensured anonymity.
Participants received modest extra credit in courses for their time. The
Childhood Trauma Questionnaire (CTQ) measures childhood maltreatment, and
includes 28 self-report items assessing emotional, physical, and sexual abuse,
and emotional and physical neglect. The Center for Epidemiologic Studies
Depression Scale (CES-D) includes 20 self-report items used to measure
depressive symptoms. Limitations included a relatively homogenous college
sample and inherent issues with self-reported variables. Future research might
consider other variables pertaining to childhood conflicts and use of the
Diathesis-Stress Model.
INTRODUCTION
Depression
Most common adult outcome of exposure to childhood
sexual abuse (Teicher et al., 2009).
Child abuse and Neglect cases
According to the National Child Abuse and Neglect Data
System 9.3 % of confirmed child abuse and neglect cases
involved sexual abuse. (American Humane Fact Services, 2007).
Frequency between sexes
Females are diagnosed with major depressive
disorder at about 2.5 times the rate of males. (Weiss et al.,
1999).
OBJECTIVE/HYPOTHESIS
This study sought to examine relationships between
childhood maltreatment (including physical, sexual and
emotional abuse) and adult depression and the
differences between the sexes on relevant variables.
H1: There will be a significant, positive relationship
between scores on measures of various types of
childhood maltreatment and scores on a measure of
depression.
H2: Females will have significantly higher depression
scores than males.
METHOD
Participants
Participants were recruited utilizing a convenience sample from
various psychology classes from a local Southeastern university in
the U.S. via an online participant management system.
Participant are assigned ID codes to ensure anonymity.
Participation was voluntary and yielded extra course credit.
Measures
Demographics
The current study included 207 participants. A total of 55
(26.6%) were male, 152 (73.4%) were female. Ages ranged
from 17 to 62 where the mean was 21.86 and the SD = 6.72.
With regard to race/ethnicity, 86.5% of participants reported
being Caucasian/White, and 5% reported being AfricanAmerican/Black.
METHOD
Measures
CTQ (Childhood Trauma questionnaire )
Used to measure childhood maltreatment which
included a 28-item self- report that measures 5 types of
maltreatment: emotional, physical, and sexual abuse,
and emotional and physical neglect. A 5-point Likert
scale was used for the responses which range from
“Never True” to “Very Often True” (Bernstein, et.al, 1997).
Instrument reliability is reflected by high internal
consistency computed with Cronbach’s alpha (Cronbach,
1951); the current study shows a total scale alpha = .92.
METHOD
Measures
CESD (The Center for Epidemiologic Studies Depression Scale)
The Center for Epidemiologic Studies Depression Scale (CESD), a short 20-item self- report designed to measure depressive
symptoms, was used to measure depression. Participants
responded to items by choosing: “Rarely or none of the time”
(less than 1 day), “some or little of the time” (1-2 days),
“occasionally or a moderate amount of time” (3-4 days) or
“most or all of the time” (5-7 days). The current study showed
the CES-D scale had an alpha = .91.
RESULTS
An independent samples t-test was calculated to assess
differences in reporting of childhood maltreatment and
depression between females and males. There were no
significant sex differences on any study variables. See
Figure 1 for mean scores and standard deviations on all
scale scores.
RESULTS
Figure 1. Mean Scores for All Participants on All Variables
45.00
39.31
40.00
35.00
SD
=
14.77
Mean Score
30.00
25.00
20.00
15.59
15.00
10.00
5.00
9.35
9.03
SD
=
4.89
7.42
SD
=
3.35
6.45
SD
=
4.10
SD
=
4.71
SD
=
10.38
9.93
7.83
SD
=
2.86
SD
=
3.67
.00
CTQ -EA
CTQ -PA
CTQ -SA
CTQ -EN
CTQ -PN
CTQ -MD
CTQ -Tot
CESD
Note: CTQ = Childhood Trauma Questionnaire; A = Abuse, N = Neglect; Emotional = Emotional; P = Physical; S = Sexual; MD =
Minimization/Denial; CESD = Depression Measure; No significant differences existed on any scale between males and
females.
RESULTS
H1: Supported. A moderate significant relationship was
observed between all forms of childhood maltreatment
and depression.
H2: Not Supported: There was no significant differences
between depression scores for females versus males
Table 1. Correlations between Study Variables
CTQ
EA
CTQ
PA
CTQ
SA
CTQ
EN
CTQ
PN
CTQ
MD
CTQ
TOT
CESD
CTQ
EA
---
.60**
.36**
.70**
.58**
-.67**
.88**
.40**
CTQ
PA
.60**
---
.36**
.46**
.50**
-.41**
.75**
.22**
CTQ
SA
.36**
.36**
---
.28**
.32**
-.21**
.63**
.31**
CTQ
EN
.70**
.46**
.28**
---
.60**
-.78**
.84**
.46**
CTQ
PN
.58**
.50**
.32**
.60**
---
-.46**
.76**
.45**
CTQ
MD
-.67**
-.41**
-.21**
-.78**
-.46**
---
-.68**
-.45**
CTQ
TOT
.88**
.75**
.63**
.84**
.76**
-.68**
---
.50**
CESD
.40**
.22**
.31**
.46**
.45**
-.45**
.50**
---
Note: **= p < .01; CTQ = Childhood Trauma Questionnaire; A = Abuse, N = Neglect; Emotional = Emotional; P = Physical; S = Sexual; MD = Minimization/Denial; TOT = Total Score; CESD = Center
for Epidemiologic Studies -Depression Scale.
DISCUSSION
Relationships between the variables of interest were
solidly related to one another as predicted. The results
may be underestimates of the strength of the
relationships as individuals often consciously suppress or
censor their reports of traumatic events, due to feelings
of shame or fear of the consequences of disclosure (Allen, 1995;
Rogers, 1995).
Also, unconscious processes, such as dissociation or
denial, can lead to the inability to recall traumatic
experiences (Allen, 1995; Davis, 1996; Davis & Frawley, 1994; Herman, 1992; Rogers, 1995).
DISCUSSION
Limitations
Though it is plausible that childhood maltreatment causes
adulthood depression, the nature of correlational research
prohibits making such a statement. Additionally, the sample was
relatively homogenous with regard to race/ethnicity, age, and
education, meaning caution must be used in generalizing results.
Finally, there are inherent limitations in all self-reported data.
Future Research
Future studies might examine the effects of other variables such
as family conflict, parental substance abuse, and other
environmental issues, on adulthood psychopathology.
Researchers may also consider the Diathesis-Stress Model, which
posits a relationship between genetic predispositions toward
developing various types of mental disorders and life stressors
(e.g., maltreatment, trauma victimization) that may trigger such
disorders (Schumm et al., 2005).
REFERENCES
Allen, J, G. (1995). The spectrum of accuracy in memories of childhood trauma. Harvard Review of
Psychiatry, 3, 84-95.
American Humane Fact Sheet. (2007). http://americanhumane.com/assets/docs/about-us/AU-FSchild-sexual-abuse.pdf
Bernstein, D. P., Ahluvalia, T., Pogge, D., Handelsman, L. (1997). Validity of the Childhood Trauma
Questionnaire in an adolescent psychiatric population. Journal of the American Academy of Child &
Adolescent Psychiatry, 36 (3), 340-348.
Bushnell J.A., Wells J.E., Oakley-Brown M.A. (1999). Long-term effects of intrafamilial sexual abuse
in childhood. Acta Psychiatrica Scandinavica (85), 136–142.
Cronbach, L.J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297334.
Davies, J.M. & Frawley, M.G. (1994). Treating the adult survivor of childhood sexual abuse. New
York: Basic Books.
Hart, S.N., Brassard, M.R., Binggeli, N.J., & Davidson, H.A. (2002). Psychological maltreatment.
Thousand Oaks, CA.: Sage Publications, Inc.
REFERENCES
Herman, J.L. (1992). Trauma and recovery. New York: Basic Books.
Johnson, R, Kotch, J, Catellier, D, Winsor, J, Dufort, V., Hunter, W. & Amaya-Jackson, L (2002).
Adverse behavioral and emotional outcomes from child abuse and witnessed violence. Child
Maltreatment, 7(3), 179-186.
Radloff, L.S. (1977). The CES-D scale: a self-report depression scale for research in the general
population. Applied Psychology Measurenment, 1, 385-401.doi: 10.1177/0146621677001306
Schumm, J. A., Stines, L. R., Hobfoll, S. E., & Jackson, A. P. (2005). The Double-Barreled Burden of
Child Abuse and Current Stressful Circumstances on Adult Women: The Kindling Effect of Early
Traumatic Experience. Journal of Traumatic Stress, 18(5), 467-476. doi:10.1002/jts.20054
Teicher, M., Samson, J., Polcari, A., & Andersen, S. (2009). Length of time between onset of
childhood sexual abuse and emergence of depression in a young adult sample: A retrospective
clinical report. Journal of Clinical Psychiatry, 70(5), 684-691. doi:10.4088/JCP.08m04235
Weiss, E.L., Longhurst J, G., & Mazure C.M. (1999). Childhood Sexual Abuse as a Risk Factor for
Depression in Women: Psychosocial and Neurobiological Correlates. American Journal of
Psychiatry. (156), 816-828.