Skip to main content
Erschienen in: European Child & Adolescent Psychiatry 7/2015

01.07.2015 | Original Contribution

Child maltreatment and psychological symptoms in a Portuguese adult community sample: the harmful effects of emotional abuse

verfasst von: Aida Dias, Luísa Sales, David J. Hessen, Rolf J. Kleber

Erschienen in: European Child & Adolescent Psychiatry | Ausgabe 7/2015

Einloggen, um Zugang zu erhalten

Abstract

Child maltreatment (CM) is associated with poor long-term health outcomes. However, knowledge about CM prevalence and related consequences is scarce among adults in South European countries. We examined the self-reported prevalence of five different forms of CM in a community sample of 1,200 Portuguese adults; we compared the results with similar samples from three other countries, using the same instrument. We also explored the relationship between CM and psychological symptoms. Cross-sectional data using the Childhood Trauma Questionnaire-Short Form and the Brief Symptom Inventory were analyzed. Moderate or severe CM exposure was self-reported by 14.7 % of the sample, and 67 % was exposed to more than one form of CM. Emotional neglect was the most endorsed experience, with women reporting greater emotional abuse and men reporting larger physical abuse. Physical and sexual abuse was less self-reported by Portuguese than by American or German subjects. CM exposure predicted 12.8 % of the psychological distress. Emotional abuse was the strongest predictor for psychological symptoms, namely for paranoid ideation, depression, and interpersonal sensitivity. Emotional abuse overlapped with the exposure to all other CM forms, and interacted with physical abuse, physical neglect, and emotional neglect to predict psychological distress. Low exposure to emotional abuse was directly associated with the effects of physical abuse, physical neglect, and emotional neglect to predict adult psychological distress. Verbal abuse experiences were frequently reported and had the highest correlations with adult psychological distress. Our results underline the potential hurtful effects of child emotional abuse among Portuguese adults in the community. They also highlight the need to improve prevention and intervention actions to reduce exposure and consequences of CM, particularly emotional abuse.
Literatur
1.
Zurück zum Zitat Krug E, Dahlberg L, Mercy JA et al (2002) World Report on Violence and Health. 346 Krug E, Dahlberg L, Mercy JA et al (2002) World Report on Violence and Health. 346
2.
Zurück zum Zitat Puras D (2011) Protection of children in European countries: analysis of the concluding observations of the UN Committee on the Rights of the Child. Eur Child Adolesc Psychiatry 20:S42–S43. doi:10.1007/s00787-011-0181-5 Puras D (2011) Protection of children in European countries: analysis of the concluding observations of the UN Committee on the Rights of the Child. Eur Child Adolesc Psychiatry 20:S42–S43. doi:10.​1007/​s00787-011-0181-5
3.
Zurück zum Zitat Gilbert R, Widom CS, Browne K et al (2009) Burden and consequences of child maltreatment in high-income countries. Lancet 373:68–81PubMedCrossRef Gilbert R, Widom CS, Browne K et al (2009) Burden and consequences of child maltreatment in high-income countries. Lancet 373:68–81PubMedCrossRef
4.
Zurück zum Zitat Chiu RG, Lutfey KE, Litman HJ et al (2013) Prevalence and overlap of childhood and adult physical, sexual, and emotional abuse: a descriptive analysis of results from the Boston Area Community Health (BACH) Survey. Violence Vict 28:381–402PubMedCentralPubMedCrossRef Chiu RG, Lutfey KE, Litman HJ et al (2013) Prevalence and overlap of childhood and adult physical, sexual, and emotional abuse: a descriptive analysis of results from the Boston Area Community Health (BACH) Survey. Violence Vict 28:381–402PubMedCentralPubMedCrossRef
5.
Zurück zum Zitat Sethi D, Bellis M, Hughes K et al (2013) European report on preventing child maltreatment. 116 Sethi D, Bellis M, Hughes K et al (2013) European report on preventing child maltreatment. 116
6.
Zurück zum Zitat Hibbard R, Barlow J, MacMillan H, The Committee on Child Abuse and Neglect and AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY CM and VC (2012) Psychological Maltreatment. Pediatr 130:372–378. doi:10.1542/peds.2012-1552 Hibbard R, Barlow J, MacMillan H, The Committee on Child Abuse and Neglect and AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY CM and VC (2012) Psychological Maltreatment. Pediatr 130:372–378. doi:10.​1542/​peds.​2012-1552
8.
Zurück zum Zitat Brewin CR, Andrews B, Gotlib IH (1993) Psychopathology and early experience: a reappraisal of retrospective reports. Psychol Bull 113:82–98PubMedCrossRef Brewin CR, Andrews B, Gotlib IH (1993) Psychopathology and early experience: a reappraisal of retrospective reports. Psychol Bull 113:82–98PubMedCrossRef
9.
Zurück zum Zitat Pereira da Silva SS, da Costa Maia  (2013) The stability of self-reported adverse experiences in childhood: a longitudinal study on obesity. J Interpers Violence 28:1989–2004. doi:10.1177/0886260512471077 Pereira da Silva SS, da Costa Maia  (2013) The stability of self-reported adverse experiences in childhood: a longitudinal study on obesity. J Interpers Violence 28:1989–2004. doi:10.​1177/​0886260512471077​
11.
13.
Zurück zum Zitat Springer KW, Sheridan J, Kuo D, Carnes M (2007) Long-term physical and mental health consequences of childhood physical abuse: results from a large population-based sample of men and women. Child Abus Negl 31:517–530CrossRef Springer KW, Sheridan J, Kuo D, Carnes M (2007) Long-term physical and mental health consequences of childhood physical abuse: results from a large population-based sample of men and women. Child Abus Negl 31:517–530CrossRef
14.
Zurück zum Zitat Wegman HL, Stetler C (2009) A meta-analytic review of the effects of childhood abuse on medical outcomes in adulthood. Psychosom Med 71:805–812PubMedCrossRef Wegman HL, Stetler C (2009) A meta-analytic review of the effects of childhood abuse on medical outcomes in adulthood. Psychosom Med 71:805–812PubMedCrossRef
15.
Zurück zum Zitat MacMillan HL, Fleming JE, Streiner DL et al (2001) Childhood abuse and lifetime psychopathology in a community sample. Am J Psychiatry 158:1878–1883PubMedCrossRef MacMillan HL, Fleming JE, Streiner DL et al (2001) Childhood abuse and lifetime psychopathology in a community sample. Am J Psychiatry 158:1878–1883PubMedCrossRef
16.
Zurück zum Zitat Kaplan SJ, Pelcovitz D, Labruna V (1999) Child and adolescent abuse and neglect research: a review of the past 10 years. Part I: physical and emotional abuse and neglect. J Am Acad Child Adolesc Psychiatry 38:1214–1222. doi:10.1097/00004583-199910000-00009 Kaplan SJ, Pelcovitz D, Labruna V (1999) Child and adolescent abuse and neglect research: a review of the past 10 years. Part I: physical and emotional abuse and neglect. J Am Acad Child Adolesc Psychiatry 38:1214–1222. doi:10.​1097/​00004583-199910000-00009
17.
Zurück zum Zitat Briere J, Runtz M (1990) Differential adult symptomatology associated with three types of child abuse histories. Child Abus Negl 14:357–364CrossRef Briere J, Runtz M (1990) Differential adult symptomatology associated with three types of child abuse histories. Child Abus Negl 14:357–364CrossRef
18.
Zurück zum Zitat Gauthier L, Stollak G, Messé L, Aronoff J (1996) Recall of childhood neglect and physical abuse as differential predictors of current psychological functioning. Child Abuse Negl 20:549–559. doi:10.1016/0145-2134(96)00043-9 Gauthier L, Stollak G, Messé L, Aronoff J (1996) Recall of childhood neglect and physical abuse as differential predictors of current psychological functioning. Child Abuse Negl 20:549–559. doi:10.​1016/​0145-2134(96)00043-9
19.
Zurück zum Zitat Irving SM, Ferraro KF (2006) Reports of abusive experiences during childhood and adult health ratings: personal control as a pathway?. J Aging Heal 18:458–485. doi:10.1177/0898264305280994 Irving SM, Ferraro KF (2006) Reports of abusive experiences during childhood and adult health ratings: personal control as a pathway?. J Aging Heal 18:458–485. doi:10.​1177/​0898264305280994​
20.
Zurück zum Zitat Spertus IL, Yehuda R, Wong CM et al (2003) Childhood emotional abuse and neglect as predictors of psychological and physical symptoms in women presenting to a primary care practice. Child Abus Negl 27:1247–1258CrossRef Spertus IL, Yehuda R, Wong CM et al (2003) Childhood emotional abuse and neglect as predictors of psychological and physical symptoms in women presenting to a primary care practice. Child Abus Negl 27:1247–1258CrossRef
21.
Zurück zum Zitat Riggs SA, Kaminski P (2010) Childhood emotional abuse, adult attachment, and depression as predictors of relational adjustment and psychological aggression. J Aggress Maltreat Trauma 19:75–104. doi:10.1080/10926770903475976 CrossRef Riggs SA, Kaminski P (2010) Childhood emotional abuse, adult attachment, and depression as predictors of relational adjustment and psychological aggression. J Aggress Maltreat Trauma 19:75–104. doi:10.​1080/​1092677090347597​6 CrossRef
22.
Zurück zum Zitat Teicher MH, Samson JA, Polcari A, McGreenery CE (2006) Sticks, stones, and hurtful words: relative effects of various forms of childhood maltreatment. Am J Psychiatry 163:993–1000PubMedCrossRef Teicher MH, Samson JA, Polcari A, McGreenery CE (2006) Sticks, stones, and hurtful words: relative effects of various forms of childhood maltreatment. Am J Psychiatry 163:993–1000PubMedCrossRef
23.
24.
Zurück zum Zitat Wright MO, Crawford E, Del Castillo D (2009) Childhood emotional maltreatment and later psychological distress among college students: The mediating role of maladaptive schemas. Child Abuse Negl 33:59–68. doi:10.1016/j.chiabu.2008.12.007 Wright MO, Crawford E, Del Castillo D (2009) Childhood emotional maltreatment and later psychological distress among college students: The mediating role of maladaptive schemas. Child Abuse Negl 33:59–68. doi:10.​1016/​j.​chiabu.​2008.​12.​007
25.
Zurück zum Zitat Teicher MH, Samson JA (2013) Childhood maltreatment and psychopathology: a case for ecophenotypic variants as clinically and neurobiologically distinct subtypes. Am J Psychiatry 170:1114–1133PubMedCentralPubMedCrossRef Teicher MH, Samson JA (2013) Childhood maltreatment and psychopathology: a case for ecophenotypic variants as clinically and neurobiologically distinct subtypes. Am J Psychiatry 170:1114–1133PubMedCentralPubMedCrossRef
26.
Zurück zum Zitat Leenarts LW, Diehle J, Doreleijers TH et al (2013) Evidence-based treatments for children with trauma-related psychopathology as a result of childhood maltreatment: a systematic review. Eur Child Adolesc Psychiatry 22:269–283. doi:10.1007/s00787-012-0367-5 PubMedCrossRef Leenarts LW, Diehle J, Doreleijers TH et al (2013) Evidence-based treatments for children with trauma-related psychopathology as a result of childhood maltreatment: a systematic review. Eur Child Adolesc Psychiatry 22:269–283. doi:10.​1007/​s00787-012-0367-5 PubMedCrossRef
27.
Zurück zum Zitat Dorrepaal E, Thomaes K, Smit JH et al (2010) Stabilizing group treatment for complex posttraumatic stress disorder related to childhood abuse based on psycho-education and cognitive behavioral therapy: a pilot study. Child Abuse Negl 34:284–288. doi:10.1016/j.chiabu.2009.07.003 Dorrepaal E, Thomaes K, Smit JH et al (2010) Stabilizing group treatment for complex posttraumatic stress disorder related to childhood abuse based on psycho-education and cognitive behavioral therapy: a pilot study. Child Abuse Negl 34:284–288. doi:10.​1016/​j.​chiabu.​2009.​07.​003
28.
29.
Zurück zum Zitat Unicef (2003) A league table of child maltreatment in rich nations. 36 Unicef (2003) A league table of child maltreatment in rich nations. 36
30.
Zurück zum Zitat Eurostat (2010) Europe in figures—Eurostat yearbook. 650 Eurostat (2010) Europe in figures—Eurostat yearbook. 650
31.
Zurück zum Zitat Paulo I (2010) Portugal é o país da Europa com mais doentes mentais. [Portugal is the European country with the highest rates of mental health problems]. Expresso Paulo I (2010) Portugal é o país da Europa com mais doentes mentais. [Portugal is the European country with the highest rates of mental health problems]. Expresso
32.
Zurück zum Zitat Caldas de Almeida JM (2009) Portuguese National Mental Health Plan (2007–2016) Executive Summary. Ment Health Fam Med 6:233–244 Caldas de Almeida JM (2009) Portuguese National Mental Health Plan (2007–2016) Executive Summary. Ment Health Fam Med 6:233–244
33.
Zurück zum Zitat Figueiredo B, Bifulco A, Paiva C et al (2004) History of childhood abuse in Portuguese parents. Child Abus Negl 28:669–682CrossRef Figueiredo B, Bifulco A, Paiva C et al (2004) History of childhood abuse in Portuguese parents. Child Abus Negl 28:669–682CrossRef
34.
Zurück zum Zitat Machado C, Gonçalves M, Matos M, Dias AR (2007) Child and partner abuse: self-reported prevalence and attitudes in the north of Portugal. Child Abus Negl 31:657–670CrossRef Machado C, Gonçalves M, Matos M, Dias AR (2007) Child and partner abuse: self-reported prevalence and attitudes in the north of Portugal. Child Abus Negl 31:657–670CrossRef
35.
Zurück zum Zitat Comissão Nacional de Protecção de Crianças e Jovens em Risco (2012) Relatório Anual de Avaliação da Atividade das Comissões de Proteção de Crianças e Jovens [Annual report of activities assessment of the Comissions for children and youth protection]. 184 Comissão Nacional de Protecção de Crianças e Jovens em Risco (2012) Relatório Anual de Avaliação da Atividade das Comissões de Proteção de Crianças e Jovens [Annual report of activities assessment of the Comissions for children and youth protection]. 184
37.
Zurück zum Zitat Bernstein DP, Stein JA, Newcomb MD et al (2003) Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abus Negl 27:169–190CrossRef Bernstein DP, Stein JA, Newcomb MD et al (2003) Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abus Negl 27:169–190CrossRef
38.
Zurück zum Zitat Derogatis LR, Melisaratos N (1983) The brief symptom inventory: an introductory report. Psychol Med 13:595–605PubMedCrossRef Derogatis LR, Melisaratos N (1983) The brief symptom inventory: an introductory report. Psychol Med 13:595–605PubMedCrossRef
40.
Zurück zum Zitat Hernandez A, Gallardo-Pujol D, Pereda N et al (2012) Initial validation of the spanish childhood trauma questionnaire-short form: factor structure, reliability and association with parenting. J Interpers Violence. doi:10.1177/0886260512468240 PubMed Hernandez A, Gallardo-Pujol D, Pereda N et al (2012) Initial validation of the spanish childhood trauma questionnaire-short form: factor structure, reliability and association with parenting. J Interpers Violence. doi:10.​1177/​0886260512468240​ PubMed
41.
Zurück zum Zitat Scher CD, Stein MB, Asmundson GJ et al (2001) The childhood trauma questionnaire in a community sample: psychometric properties and normative data. J Trauma Stress 14:843–857PubMedCrossRef Scher CD, Stein MB, Asmundson GJ et al (2001) The childhood trauma questionnaire in a community sample: psychometric properties and normative data. J Trauma Stress 14:843–857PubMedCrossRef
42.
Zurück zum Zitat Roy CA, Perry JC (2004) Instruments for the assessment of childhood trauma in adults. J Nerv Ment Dis 192:343–351PubMedCrossRef Roy CA, Perry JC (2004) Instruments for the assessment of childhood trauma in adults. J Nerv Ment Dis 192:343–351PubMedCrossRef
43.
Zurück zum Zitat Dias A, Sales L, Carvalho A et al (2013) Estudo de propriedades psicométricas do Questionário de Trauma de Infância—Versão breve numa amostra portuguesa não clínica (Study of psychometric properties of the Childhood Trauma Questionnaire-Short Version in a Portuguese community sample). Laboratório Psicol 11:103–120 Dias A, Sales L, Carvalho A et al (2013) Estudo de propriedades psicométricas do Questionário de Trauma de Infância—Versão breve numa amostra portuguesa não clínica (Study of psychometric properties of the Childhood Trauma Questionnaire-Short Version in a Portuguese community sample). Laboratório Psicol 11:103–120
44.
Zurück zum Zitat Bernstein DP, Ahluvalia T, Pogge D, Handelsman L (1997) Validity of the Childhood Trauma Questionnaire in an adolescent psychiatric population. J Am Acad Child Adolesc Psychiatry 36:340–348PubMedCrossRef Bernstein DP, Ahluvalia T, Pogge D, Handelsman L (1997) Validity of the Childhood Trauma Questionnaire in an adolescent psychiatric population. J Am Acad Child Adolesc Psychiatry 36:340–348PubMedCrossRef
45.
Zurück zum Zitat Canavarro MC (1999) Inventário de Sintomas Psicopatológicos—BSI. In: Simões MR, Gonçalves M, Almeida LS (eds) SHO-Apport, Braga, pp 87–109 Canavarro MC (1999) Inventário de Sintomas Psicopatológicos—BSI. In: Simões MR, Gonçalves M, Almeida LS (eds) SHO-Apport, Braga, pp 87–109
46.
Zurück zum Zitat De Beurs E, Zitman FG (2006) De Brief Symptom Inventory (BSI): De betrouwbaarheid en validiteit van een handzaam alternatief voor de SCL-90. Maandbl. Geestelijke Volksgezond. 61 De Beurs E, Zitman FG (2006) De Brief Symptom Inventory (BSI): De betrouwbaarheid en validiteit van een handzaam alternatief voor de SCL-90. Maandbl. Geestelijke Volksgezond. 61
47.
Zurück zum Zitat Thombs BD, Bernstein DP, Lobbestael J, Arntz A (2009) A validation study of the Dutch Childhood Trauma Questionnaire-Short Form: factor structure, reliability, and known-groups validity. Child Abus Negl 33:518–523CrossRef Thombs BD, Bernstein DP, Lobbestael J, Arntz A (2009) A validation study of the Dutch Childhood Trauma Questionnaire-Short Form: factor structure, reliability, and known-groups validity. Child Abus Negl 33:518–523CrossRef
48.
Zurück zum Zitat Klinitzke G, Romppel M, Hauser W et al (2012) The German Version of the Childhood Trauma Questionnaire (CTQ): psychometric characteristics in a representative sample of the general population. Psychother Psychosom Med Psychol 62:47–51. doi:10.1055/s-0031-1295495 PubMedCrossRef Klinitzke G, Romppel M, Hauser W et al (2012) The German Version of the Childhood Trauma Questionnaire (CTQ): psychometric characteristics in a representative sample of the general population. Psychother Psychosom Med Psychol 62:47–51. doi:10.​1055/​s-0031-1295495 PubMedCrossRef
49.
Zurück zum Zitat Tabachnick BG, Fidell LS (2007) Using multivariate statistics, 5th edn. p 980 Tabachnick BG, Fidell LS (2007) Using multivariate statistics, 5th edn. p 980
50.
Zurück zum Zitat Teicher MH, Samson JA, Sheu Y-S et al (2010) Hurtful words: association of exposure to peer verbal abuse with elevated psychiatric symptom scores and corpus callosum abnormalities. Am J Psychiatry 167:1464–1471PubMedCentralPubMedCrossRef Teicher MH, Samson JA, Sheu Y-S et al (2010) Hurtful words: association of exposure to peer verbal abuse with elevated psychiatric symptom scores and corpus callosum abnormalities. Am J Psychiatry 167:1464–1471PubMedCentralPubMedCrossRef
Metadaten
Titel
Child maltreatment and psychological symptoms in a Portuguese adult community sample: the harmful effects of emotional abuse
verfasst von
Aida Dias
Luísa Sales
David J. Hessen
Rolf J. Kleber
Publikationsdatum
01.07.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
European Child & Adolescent Psychiatry / Ausgabe 7/2015
Print ISSN: 1018-8827
Elektronische ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-014-0621-0

Weitere Artikel der Ausgabe 7/2015

European Child & Adolescent Psychiatry 7/2015 Zur Ausgabe

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

22.04.2024 DGIM 2024 Kongressbericht

Die Kombination aus Medikamenten und Psychotherapie gilt als effektivster Ansatz bei Depressionen. Das ist bei betagten Menschen nicht anders, trotz Besonderheiten.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.