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International Journal of Public Health

, Volume 59, Issue 2, pp 359–372 | Cite as

Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: systematic review and meta-analysis

  • Jutta Lindert
  • Ondine S. von Ehrenstein
  • Rachel Grashow
  • Gilad Gal
  • Elmar Braehler
  • Marc G. Weisskopf
Review

Abstract

Objectives

To determine whether depression and anxiety in adulthood are associated with abuse exposure in childhood.

Methods

A search of PUBMED, EMBASE and PSYCHINFO databases (2002–2012) was supplemented by hand searches of bibliographies of articles and reviews. We included studies contrasting abuse exposure vs. no-abuse exposure before age 16 years to depression and anxiety after age 16 years. Data on sample and exposure and outcome instruments, covariates and odds ratios (ORs) with the respective 95 % confidence intervals (CI) were extracted. Combined ORs and 95 % CI were calculated using random effects models. Heterogeneity was quantified using the I 2 test.

Results

Inclusion criteria were met by 19 studies with 115,579 study participants, for assessing depression (n = 14) and anxiety (n = 13). The combined ORs for depression were 2.04 (95 % CI: 1.65–2.53) for sexual abuse and 1.49 (95 % CI: 1.29–1.72) for physical abuse. The combined ORs for anxiety were 2.52 (95 % CI: 2.12–2.98) for sexual abuse and 1.70 (95 % CI: 1.33–2.18) for physical abuse.

Conclusions

High levels of depression, anxiety and distress are reported in adults exposed to childhood sexual and physical abuse. These findings require increased awareness for the potential needs of adults exposed to child abuse and public health interventions to prevent child abuse.

Keywords

Meta-analysis Child abuse Depression Anxiety Life course 

References

  1. Afifi TO, Boman J, Fleisher W, Sareen J (2009) The relationship between child abuse, parental divorce, and lifetime mental disorders and suicidality in a nationally representative adult sample. Child Abuse Negl 33(3):139–147PubMedCrossRefGoogle Scholar
  2. American Psychiatric Association (APA), Composite International Diagnostic Interview 1.1. (CIDI) (1994) Researchers manual. APA, WashingtonGoogle Scholar
  3. Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD et al (2006) The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatr Clin Neurosci 256(3):174–186CrossRefGoogle Scholar
  4. Barth J, Bermetz L, Heim E, Trelle S, Tonia T (2012) The current prevalence of child sexual abuse worldwide: a systematic review and meta-analysis. Int J Public Health 58(3):460–483Google Scholar
  5. Bebbington P, Jonas S, Kuipers E, King M, Cooper C, Brugha T et al (2011) Childhood sexual abuse and psychosis: data from a cross-sectional national psychiatric survey in England. Br J Psychiatr 199:29–37CrossRefGoogle Scholar
  6. Benjet C (2010) Childhood adversities of populations living in low-income countries: prevalence, characteristics, and mental health consequences. Curr Opin Psychiatr 23(4):356–362CrossRefGoogle Scholar
  7. Benjet C, Borges G, Medina-Mora ME, Zambrano J, Cru C, Mendez E (2009) Descriptive epidemiology of chronic childhood adversity in Mexican adolescents. J Adolesc Health 45(5):483–489PubMedCrossRefGoogle Scholar
  8. Benjet C, Thompson RJ, Gotlib IH (2010) 5-HTTLPR moderates the effect of relational peer victimization on depressive symptoms in adolescent girls. J Child Psychol Psychiatr 51(2):173–179CrossRefGoogle Scholar
  9. Bremner JD (2006) Traumatic stress: effects on the brain. Dialogues Clin Neurosci 8(4):445–461PubMedCentralPubMedGoogle Scholar
  10. Centers for Disease Control and Prevention (2005) Centers for disease control and prevention, Department of Health and Human Services. Adverse childhood experiences study. http://www.cdc/nccdph/ACE/questionnaire.htm2008
  11. Chartier MJ, Walker JR, Naimark B (2010) Separate and cumulative effects of adverse childhood experiences in predicting adult health and health care utilization. Child Abuse Negl 34(6):454–464PubMedCrossRefGoogle Scholar
  12. Comijs HC, Beekman AT, Smit F, Bremmer M, van Tilburg T, Deeg DJ (2007) Childhood adversity, recent life events and depression in late life. J Affect Disord 103(1–3):243–246PubMedCrossRefGoogle Scholar
  13. Cougle JR, Timpano KR, Sachs-Ericsson N, Keough ME, Riccardi CJ (2010) Examining the unique relationships between anxiety disorders and childhood physical and sexual abuse in the National Comorbidity Survey-Replication. Psychiatry Res 177(1–2):150–155PubMedCrossRefGoogle Scholar
  14. Cunningham H (1995) Children and childhood in Western society since 1500. Longman, LondonGoogle Scholar
  15. Draper B, Pfaff JJ, Pirkis J, Snowdon J, Lautenschlager NT, Wilson I et al (2008) Long-term effects of childhood abuse on the quality of life and health of older people: results from the depression and early prevention of suicide in general practice project. J Am Geriatr Soc 56(2):262–271PubMedCrossRefGoogle Scholar
  16. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V et al (1998) Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) study. Am J Prev Med 14(4):245–258PubMedCrossRefGoogle Scholar
  17. Friedman SH, Loue S, Goldman Heaphy EL, Mendez N (2011) Intimate partner violence victimization and perpetration by Puerto Rican women with severe mental illnesses. Community Ment Health J 47(2):156–163PubMedCrossRefGoogle Scholar
  18. Fujiwara T, Kawakami N (2011) Association of childhood adversities with the first onset of mental disorders in Japan: results from the World Mental Health Japan, 2002–2004. J Psychiatr Res 45(4):481–487PubMedCrossRefGoogle Scholar
  19. Gal G, Levav I, Gross R (2011) Psychopathology among adults abused during childhood or adolescence: results from the Israel-based World Mental Health survey. J Nerv Ment Dis 199(4):222–229PubMedCrossRefGoogle Scholar
  20. Garner AS, Shonkoff JP (2012) Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health. Pediatrics 129(1):224–231CrossRefGoogle Scholar
  21. Gilbert R, Fluke J, O’Donnell M, Gonzalez-Izquierdo A, Brownell M, Gulliver P et al (2012) Child maltreatment: variation in trends and policies in six developed countries. Lancet 379(9817):758–772PubMedCrossRefGoogle Scholar
  22. Higgins JPT, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21(11):1539–1558PubMedCrossRefGoogle Scholar
  23. Hussey JM, Chang JJ, Kotch JB (2006) Child maltreatment in the United States: prevalence, risk factors, and adolescent health consequences. Pediatrics 118(3):933–942PubMedCrossRefGoogle Scholar
  24. Ishida K, Stupp P, Melian M, Serbanescu F, Goodwin M (2010) Exploring the associations between intimate partner violence and women’s mental health: evidence from a population-based study in Paraguay. Soc Sci Med 71(9):1653–1661PubMedCrossRefGoogle Scholar
  25. Janssen I, Krabbendam L, Bak M, Hanssen M, Vollebergh W, de Graaf R et al (2004) Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatr Scand 109(1):38–45PubMedCrossRefGoogle Scholar
  26. Jirapramukpitak T, Harpham T, Prince M (2011) Family violence and its ‘adversity package’: a community survey of family violence and adverse mental outcomes among young people. Soc Psychiatry Psychiatr Epidemiol 46(9):825–831PubMedCentralPubMedCrossRefGoogle Scholar
  27. Kelly-Irving M, Mabile L, Grosclaude P, Lang T, Delpierre C (2013) The embodiment of adverse childhood experiences and cancer development: potential biological mechanisms and pathways across the life course. Int J Public Health 58:3–11PubMedCrossRefGoogle Scholar
  28. Kempe CH, Silverman FN, Steele BF, Droegemueller W, Silver HK (1962) The battered-child syndrome. JAMA 181:17–24PubMedCrossRefGoogle Scholar
  29. Kendler KS, Bulik CM, Silberg J, Hettema JM, Myers J, Prescott CA (2000) Childhood sexual abuse and adult psychiatric and substance use disorders in women: an epidemiological and cotwin control analysis. Arch Gen Psychiatry 57(10):953–959PubMedCrossRefGoogle Scholar
  30. Kendler KS, Kuhn JW, Prescott CA (2004) Childhood sexual abuse, stressful life events and risk for major depression in women. Psychol Med 34(8):1475–1482PubMedCrossRefGoogle Scholar
  31. Kessler RC, Abelson J, Demler O, Escobar JI, Gibbon M, Guyer ME et al (2004) Clinical calibration of DSM-IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMHCIDI). Int J Methods Psychiatry Res 13(2):122–139CrossRefGoogle Scholar
  32. Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J et al (2009) The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiologia Psichiatria Sociale 18(1):23–33CrossRefGoogle Scholar
  33. Kessler RC, McLaughlin KA, Green JG, Gruber MJ, Sampson NA, Zaslavsky AM et al (2010) Childhood adversities and adult psychopathology in the WHO World Mental Health surveys. Br J Psychiatry 197(5):378–385PubMedCentralPubMedCrossRefGoogle Scholar
  34. Knapman A, Kaltwasser SF, Martins-de-Souza D, Holsboer F, Landgraf R, Turck CW et al (2012) Increased stress reactivity is associated with reduced hippocampal activity and neuronal integrity along with changes in energy metabolism. Eur J Neurosci 35(3):412–422Google Scholar
  35. Lee S, Guo WJ, Tsang A, He YL, Huang YQ, Zhang MY et al (2011) The prevalence of family childhood adversities and their association with first onset of DSM-IV disorders in metropolitan China. Psychol Med 41(1):85–96PubMedCentralPubMedCrossRefGoogle Scholar
  36. Lewis G, Pelosi AJ, Araya R, Dunn G (1992) Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychol Med 22(2):465–486PubMedCrossRefGoogle Scholar
  37. Libby AM, Orton HD, Novins DK, Beals J, Manson SM (2005) Childhood physical and sexual abuse and subsequent depressive and anxiety disorders for two American Indian tribes. Psychol Med 35(3):329–340PubMedCrossRefGoogle Scholar
  38. Lipsey M, Lipsey M, Wilson DB (2000) Practical meta-analysis. Sage, Thousand OaksGoogle Scholar
  39. Lovibond SH, Lovibond PF (1995) Manual for the Depression Anxiety Stress Scales. University of New South Wales, New South WalesGoogle Scholar
  40. Luo Y, Parish WL, Laumann EO (2008) A population-based study of childhood sexual contact in China: prevalence and long-term consequences. Child Abuse Negl 32(7):721–731PubMedCentralPubMedCrossRefGoogle Scholar
  41. Maier T, Mohler-Kuo M, Landolt MA, Schnyder U, Jud A (2013) The tip of the iceberg. Incidence of disclosed cases of child sexual abuse in Switzerland: results from a nationwide agency agency survey. Int J Public Health doi: 10.1007/s00038-013-0498-6
  42. Martinez J, Hosek SG, Carleton RA (2009) Screening and assessing violence and mental health disorders in a cohort of inner city HIV-positive youth between 1998–2006. AIDS Patient Care STDs 23(6):469–475PubMedCentralPubMedCrossRefGoogle Scholar
  43. McEwen BS (2003) Early life influences on life-long patterns of behavior and health. Ment Retard Develop Disabil Res Rev 9(3):149–154Google Scholar
  44. McEwen BS, Eiland L, Hunter RG, Miller MM (2012) Stress and anxiety: structural plasticity and epigenetic regulation as a consequence of stress. Neuropharmacology 62(1):3–12PubMedCentralPubMedCrossRefGoogle Scholar
  45. Moffitt TE, Caspi A, Harrington H, Milne BJ, Melchior M, Goldberg D et al (2007) Generalized anxiety disorder and depression: childhood risk factors in a birth cohort followed to age 32. Psychol Med 37(3):441–452PubMedCrossRefGoogle Scholar
  46. Mulvihill D (2005) The health impact of childhood trauma: an interdisciplinary review, 1997–2003. Issues Compr Pediatr Nurs 28(2):115–136PubMedCrossRefGoogle Scholar
  47. Nalavany BA, Ryan SD, Hinterlong J (2009) Externalizing behavior among adopted boys with preadoptive histories of child sexual abuse. J Child Sexual Abuse 18(5):553–573CrossRefGoogle Scholar
  48. Panter-Brick C, Goodman A, Tol W, Eggerman M (2011) Mental health and childhood adversities: a longitudinal study in Kabul, Afghanistan. J Am Acad Child Psychiatry 50(4):349–363CrossRefGoogle Scholar
  49. Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401CrossRefGoogle Scholar
  50. Ramiro LS, Madrid BJ, Brown DW (2010) Adverse childhood experiences (ACE) and health-risk behaviors among adults in a developing country setting. Child Abuse Negl 34(11):842–855PubMedCrossRefGoogle Scholar
  51. Rind B, Tromovitch P, Bauserman R (1998) A meta-analytic examination of assumed properties of child sexual abuse using college samples. Psychol Bull 124(1):22–53PubMedCrossRefGoogle Scholar
  52. Schafer I, Langeland W, Hissbach J, Luedecke C, Ohlmeier MD, Chodzinski C et al (2010) Childhood trauma and dissociation in patients with alcohol dependence, drug dependence, or both—a multi-center study. Drug Alcohol Depend 109(1–3):84–89PubMedCrossRefGoogle Scholar
  53. Shonkoff JP, Garner AS (2012) The lifelong effects of early childhood adversity and toxic stress. Pediatrics 129(1):232–246CrossRefGoogle Scholar
  54. Slopen N, Williams DR, Seedat S, Moomal H, Herman A, Stein DJ (2010) Adversities in childhood and adult psychopathology in the South Africa stress and health study: associations with first-onset DSM-IV disorders. Soc Sci Med 71(10):1847–1854PubMedCentralPubMedCrossRefGoogle Scholar
  55. Spitzer RL, Williams JBW (1985) Structured clinical interview for DSM-III-R (SCID). NY Biometrics Research Dept. New York State Psychiatric Institute, New YorkGoogle Scholar
  56. Spitzer RL, Kroenke K, Williams JB (1999) Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient health questionnaire. JAMA 282(18):1737–1744PubMedCrossRefGoogle Scholar
  57. Stewart AJ, Steiman M, Cauce AM, Cochran BN, Whitbeck LB, Hoyt DR (2004) Victimization and posttraumatic stress disorder among homeless adolescents. J Am Acad Child Adolesc Psychiatry 43(3):325–331PubMedCrossRefGoogle Scholar
  58. Stoltenborgh M, van Ijzendoorn MH, Euser EM, Bakermans-Kranenburg MJ (2011) A global perspective on child sexual abuse: meta-analysis of prevalence around the world. Child Maltreat 16(2):79–101PubMedCrossRefGoogle Scholar
  59. Straus MA (1979) Measuring intra family conflict and violence: the Conflict Tactics Scale. J Marriage Fam 41:75–88CrossRefGoogle Scholar
  60. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA 283(15):2008–2012PubMedCrossRefGoogle Scholar
  61. Szyf M (2012) The early-life social environment and DNA methylation. Clin Genet 81(4):341–349PubMedCrossRefGoogle Scholar
  62. Thompson MP, Kingree JB, Desai S (2004) Gender differences in long-term health consequences of physical abuse of children: data from a nationally representative survey. Am J Public Health 94(4):599–604PubMedCentralPubMedCrossRefGoogle Scholar
  63. Tonmyr L, Williams G, Hovdestad WE, Draca J (2011) Anxiety and/or depression in 10-15-year-olds investigated by child welfare in Canada. J Adolesc Health 48(5):493–498Google Scholar
  64. Van der Vegt EJ, Tieman W, van der Ende J, Ferdinand RF, Verhulst FC, Tiemeier H (2009) Impact of early childhood adversities on adult psychiatric disorders: a study of international adoptees. Soc Psychiatry Psychiatr Epidemiol 44(9):724–731PubMedCrossRefGoogle Scholar
  65. Widom CS, DuMont K, Czaja SJ (2007) A prospective investigation of major depressive disorder and comorbidity in abused and neglected children grown up. Arch Gen Psychiatry 64(1):49–56PubMedCrossRefGoogle Scholar
  66. Wilczynski NL, Haynes RB (2003) Developing optimal search strategies for detecting clinically sound causation studies in MEDLINE. In: AMIA annual symposium proceedings, pp 719–723Google Scholar
  67. Wing JK, Babor T, Brugha T, Burke J, Cooper JE, Giel R et al (1990) SCAN. Schedules for clinical assessment in neuropsychiatry. Arch Gen Psychiatry 47(6):589–593PubMedCrossRefGoogle Scholar
  68. Wingo AP, Wrenn G, Pelletier T, Gutman AR, Bradley B, Ressler KJ (2010) Moderating effects of resilience on depression in individuals with a history of childhood abuse or trauma exposure. J Affect Disord 126(3):411–414PubMedCentralPubMedCrossRefGoogle Scholar
  69. World Health Organization (1990) Composite International Diagnostic Interview (CIDI). http://www3.who.int/cidi. Accessed 13 Jan 2011
  70. World Health Organisation (1994) A user guide to the self reproting questionnaire (SRQ). World Health Organization Press, GenevaGoogle Scholar
  71. World Health Organization (2001) The world health report 2001—mental health: new understanding, new hope. World Health Organization Press, GenevaGoogle Scholar
  72. Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67(6):361–370PubMedCrossRefGoogle Scholar
  73. Zung WW (1965) A self-rating depression scale. Arch Gen Psychiatry 12:63–70PubMedCrossRefGoogle Scholar

Copyright information

© Swiss School of Public Health 2013

Authors and Affiliations

  • Jutta Lindert
    • 1
    • 2
    • 3
  • Ondine S. von Ehrenstein
    • 4
  • Rachel Grashow
    • 3
  • Gilad Gal
    • 5
  • Elmar Braehler
    • 2
  • Marc G. Weisskopf
    • 3
    • 6
  1. 1.Department of Public HealthProtestant University of LudwigsburgLudwigsburgGermany
  2. 2.Department for Medical Psychology and Medical Sociology, Faculty of MedicineUniversity of LeipzigLeipzigGermany
  3. 3.Department of Environmental HealthHarvard School of Public HealthBostonUSA
  4. 4.Fielding School of Public HealthUniversity of California Los AngelesLos AngelesUSA
  5. 5.School of Behavioral SciencesThe Academic College Tel Aviv-YaffoTel AvivIsrael
  6. 6.Department of EpidemiologyHarvard School of Public HealthBostonUSA

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