Steffey, S.K., Gibson, B.W. & Dula, C.S.East Tennessee State University

Childhood Issues & Adulthood Tissues:

Examining Relationships between Childhood Abuse & Adult

Depression

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

DepressionMost 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 sexesFemales 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

ParticipantsParticipants 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.

MeasuresDemographics

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 African-American/Black.

METHOD

MeasuresCTQ (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

MeasuresCESD (The Center for Epidemiologic Studies

Depression Scale) The Center for Epidemiologic Studies Depression Scale (CES-D), 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

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

CTQEA

CTQPA

CTQSA

CTQEN

CTQPN

CTQMD

CTQTOT

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 ResearchFuture 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).

REFERENCESAllen, 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-FS-child-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, 297-334.

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.