Skip to main content

Loneliness mediates the relationship between childhood trauma and adult psychopathology: evidence from the adult psychiatric morbidity survey

Social Psychiatry and Psychiatric Epidemiology volume 50, pages 591–601 (2015)Cite this article

Abstract

Childhood abuse (CA) has been found to be related to the development of a variety of psychiatric disorders in adulthood. Although CA is also associated with adult loneliness, few studies have investigated the role of loneliness as a mediator in the relationship between CA and adult psychopathology. Using data from a large, general population sample a mediation model was proposed and tested. Controlling for a range of background variables, the results from a series of regression analyses found that loneliness mediated the association between CA and six adult psychiatric disorders. The findings of this study highlight the importance of loneliness to the development of psychopathology. Theoretical and practical implications are discussed.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price includes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

References

  1. Pereda N, Guilera G, Forns M, Gómez-Benito J (2009) The prevalence of child sexual abuse in community and student samples: a meta-analysis. Clin Psychol Rev 29(4):328–338

  2. Kessler RC, McLaughlin KA, Green JG, Gruber MJ, Sampson NA, Zaslavsky AM, Williams DR (2010) Childhood adversities and adult psychopathology in the WHO world mental health surveys. Br J Psychiatry 197(5):378–385

    Article  PubMed Central  PubMed  Google Scholar 

  3. Radford L, Corral S, Bradley C, Fisher HL (2013) The prevalence and impact of child maltreatment and other types of victimization in the UK: findings from a population survey of caregivers, children and young people and young adults. Child Abuse Negl 37(10):801–813

    Article  PubMed  Google Scholar 

  4. Gilbert R, Widom CS, Browne K, Fergusson D, Webb E, Janson S (2009) Burden and consequences of child maltreatment in high-income countries. Lancet 373(1):68–81

    Article  PubMed  Google Scholar 

  5. Reading R (2006) The enduring effects of abuse and related adverse experiences in childhood. Child Care Health Dev 32(2):253–256

    Google Scholar 

  6. Fergusson D, Horwood L, Lynskey M (1996) Childhood sexual abuse and psychiatric disorder in young adulthood: ii. Psychiatric outcomes of childhood sexual abuse. J Am Acad Child Adolesc Psychiatry 35(10):1365–1374

    Article  CAS  PubMed  Google Scholar 

  7. Horwitz AV, Widom CS, McLaughlin J, White HR (2001) The impact of childhood abuse and neglect on adult mental health: a prospective study. J Health Soc Behav 42(2):184–201

    Article  CAS  PubMed  Google Scholar 

  8. Jonas S, Bebbington P, McManus S, Meltzer H, Jenkins R, Kuipers E, Brugha T (2011) Sexual abuse and psychiatric disorder in England: results from the 2007 adult psychiatric morbidity survey. Psychol Med 41(4):709–719

    Article  CAS  PubMed  Google Scholar 

  9. Kendall-Tackett K, Williams L, Finkelhor D (1993) Impact of sexual abuse on children: a review and synthesis of recent empirical studies. Psychol Bull 113(1):164

    Article  CAS  PubMed  Google Scholar 

  10. Molnar BE, Buka SL, Kessler RC (2001) Child sexual abuse and subsequent psychopathology: results from the national comorbidity survey. Am J Public Health 91(5):753

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Read J, Agar K, Argyle N, Aderhold V (2003) Sexual and physical abuse during childhood and adulthood as predictors of hallucinations, delusions and thought disorder. Psychol Psychother: Theory, Res Pract 76(1):1–22

    Article  Google Scholar 

  12. Read J, Perry BD, Moskowitz A, Connolly J (2001) The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model. Psychiatry: Interpers Biological Processes 64(4):319–345

    CAS  Google Scholar 

  13. Schoedl AF, Costa MC, Mari JJ, Mello MF, Tyrka AR, Carpenter LL, Price LH (2010) The clinical correlates of reported childhood sexual abuse: an association between age at trauma onset and severity of depression and ptsd in adults. J Child Sexual Abuse 19(2):156–170

    Article  Google Scholar 

  14. Shevlin M, Dorahy M, Adamson G (2007) Childhood traumas and hallucinations: an analysis of the national comorbidity survey. J Psychiatr Res 41(3):222–228

    Article  PubMed  Google Scholar 

  15. 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 Abuse Negl 31(1):517–530

    Article  PubMed Central  PubMed  Google Scholar 

  16. Sugaya L, Hasin DS, Olfson M, Lin KH, Grant BF, Blanco C (2012) Child physical abuse and adult mental health: a national study. J Trauma Stress 25(4):384–392

    Article  PubMed Central  PubMed  Google Scholar 

  17. Green JG, McLaughlin KA, Berglund PA, Gruber MJ, Sampson NA, Zaslavsky AM, Kessler RC (2010) Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. Arch Gen Psychiatry 67(2):113

    Article  PubMed Central  PubMed  Google Scholar 

  18. Hovens JG, Wiersma JE, Giltay EJ, Van Oppen P, Spinhoven P, Penninx BW, Zitman FG (2010) Childhood life events and childhood trauma in adult patients with depressive, anxiety and comorbid disorders vs. controls. Acta Psychiatr Scand 122(1):66–74

    Article  CAS  PubMed  Google Scholar 

  19. 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

    Article  CAS  PubMed  Google Scholar 

  20. Cutajar MC, Mullen PE, Ogloff JR, Thomas SD, Wells DL, Spataro J (2010) Psychopathology in a large cohort of sexually abused children followed up to 43 years. Child Abuse Negl 34(11):813–822

    Article  PubMed  Google Scholar 

  21. Friedrich WN, Urquiza AJ, Beilke RL (1986) Behavior problems in sexually abused young children. J Pediatr Psychol 11(1):47–57

    Article  CAS  PubMed  Google Scholar 

  22. Mullen PE, Martin JL, Anderson JC, Romans SE, Herbison GP (1993) Childhood sexual abuse and mental health in adult life. Br J Psychiatry 163(6):721–732

    Article  CAS  PubMed  Google Scholar 

  23. Kessler R, Davis C, Kendler K (1997) Childhood adversity and adult psychiatric disorder in the US national comorbidity survey. Psychol Med 27(5):1101–1119

    Article  CAS  PubMed  Google Scholar 

  24. Benjet C, Borges G, Medina-Mora ME (2010) Chronic childhood adversity and onset of psychopathology during three life stages: childhood, adolescence and adulthood. J Psychiatr Res 44(1):732–740

    Article  PubMed  Google Scholar 

  25. Edwards VJ, Holden GW, Felitti VJ, Anda RF (2003) Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: results from the adverse childhood experiences study. Am J Psychiatry 160(8):1453–1460

    Article  PubMed  Google Scholar 

  26. Moeller TP, Bachmann GA, Moeller JR (1993) The combined effects of physical, sexual, and emotional abuse during childhood: long-term health consequences for women. Child Abuse Negl 17(5):623–640

    Article  CAS  PubMed  Google Scholar 

  27. Schilling EA, Aseltine RH, Gore S (2008) The impact of cumulative childhood adversity on young adult mental health: measures, models, and interpretations. Soc Sci Med 66(5):1140–1151

    Article  PubMed Central  PubMed  Google Scholar 

  28. Shevlin M, Houston JE, Dorahy MJ, Adamson G (2008) Cumulative traumas and psychosis: an analysis of the national comorbidity survey and the british psychiatric morbidity survey. Schizophr Bull 34(1):193–199

    Article  PubMed Central  PubMed  Google Scholar 

  29. Clark C, Caldwell T, Power C, Stansfeld SA (2010) Does the influence of childhood adversity on psychopathology persist across the lifecourse? A 45-year prospective epidemiologic study. Ann Epidemiol 20(5):385–394

    Article  PubMed  Google Scholar 

  30. Finkelhor D, Ormrod RK, Turner HA (2007) Poly-victimization: a neglected component in child victimization. Child Abuse Negl 31(1):7–26

    Article  PubMed  Google Scholar 

  31. Turner HA, Finkelhor D, Ormrod R (2010) Poly-victimization in a national sample of children and youth. Am J Prev Med 38(3):323–330

    Article  PubMed  Google Scholar 

  32. Hawkley LC, Cacioppo JT (2010) Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med 40(2):218–227

    Article  PubMed  Google Scholar 

  33. Murphy J, Shevlin M, Adamson G, Houston JE (2013) From sexual abuse to psychosis: a pilot study exploring the social deafferentation hypothesis and the mediating role of avoidance. Psychosis 5(1):36–47

    Article  Google Scholar 

  34. Lewis G, Pelosi A (1990) Manual of the revised clinical interview schedule (CIS-R). Institute of Psychiatry, London

    Google Scholar 

  35. Cacioppo JT, Hughes ME, Waite LJ, Hawkley LC, Thisted RA (2006) Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. Psychol Aging 21(1):140–151

    Article  PubMed  Google Scholar 

  36. Jones PB (2013) Adult mental health disorders and their age at onset. Br J Psychiatry 202(54):5–10

    Article  Google Scholar 

  37. Gibson RL, Hartshorne TS (1996) Childhood sexual abuse and adult loneliness and network orientation. Child Abuse Negl 20(11):1087–1093

    Article  CAS  PubMed  Google Scholar 

  38. Lev-Wiesel R, Sternberg R (2012) Victimized at home revictimized by peers: domestic child abuse a risk factor for social rejection. Child Adolesc Soc Work J 29(3):203–220

    Article  Google Scholar 

  39. Merz EM, Jak S (2013) The long reach of childhood. Childhood experiences influence close relationships and loneliness across life. Adv Life Course Res 18(3):212–222

    Article  PubMed  Google Scholar 

  40. Heinrich LM, Gullone E (2006) The clinical significance of loneliness: a literature review. Clin Psychol Rev 26:695–718

    Article  PubMed  Google Scholar 

  41. Lasgaard M, Goossens L, Bramsen RH, Trillingsgaard T, Elklit A (2011) Different sources of loneliness are associated with different forms of psychopathology in adolescence. J Res Pers 45(2):233–237

    Article  Google Scholar 

  42. Meltzer H, Bebbington P, Dennis MS, Jenkins R, McManus S, Brugha TS (2013) Feelings of loneliness among adults with mental disorder. Soc Psychiatry Psychiatr Epidemiol 48(1):5–13

    Article  PubMed  Google Scholar 

  43. Solomon Z, Waysman M, Mikulincer M (1990) Family functioning, perceived societal support, and combat-related psychopathology: the moderating role of loneliness. J Soc Clin Psychol 9(4):456–472

    Article  Google Scholar 

  44. Cannon TD, Cadenhead K, Cornblatt B, Woods SW, Addington J, Walker E, Heinssen R (2008) Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch Gen Psychiatry 65(1):28

    Article  PubMed Central  PubMed  Google Scholar 

  45. Hoffman RE (2007) A social deafferentation hypothesis for induction of active schizophrenia. Schizophr Bull 33(5):1066–1070

    Article  PubMed Central  PubMed  Google Scholar 

  46. Hoffman RE (2008) Auditory/verbal hallucinations, speech perception neurocircuitry, and the social deafferentation hypothesis. Clinical EEG Neuroscience 39(2):87–90

    Article  PubMed  Google Scholar 

  47. Matheson SL, Vijayan H, Dickson H, Shepherd AM, Carr VJ, Laurens KR (2013) Systematic meta-analysis of childhood social withdrawal in schizophrenia, and comparison with data from at-risk children aged 9–14 years. J Psychiatr Res 47(1):1061–1068

    Article  PubMed  Google Scholar 

  48. Bartels M, Cacioppo JT, Hudziak JJ, Boomsma DI (2008) Genetic and environmental contributions to stability in loneliness throughout childhood. Am J Med Gene Part B: Neuropsy Genetics 147(3):385–391

    Article  Google Scholar 

  49. Hawkley LC, Cacioppo JT (2007) Aging and loneliness downhill quickly? Curr Dir Psychol Sci 16(4):187–191

    Article  Google Scholar 

  50. Sperry DM, Widom CS (2013) Child abuse and neglect, social support, and psychopathology in adulthood: a prospective investigation. Child Abuse Negl 37:415–425

    Article  PubMed Central  PubMed  Google Scholar 

  51. Widom CS, Czaja SJ, Dutton MA (2008) Childhood victimization and lifetime revictimization. Child Abuse Neglect 32:785–796

    Article  PubMed Central  PubMed  Google Scholar 

  52. Vranceanu A-M, Hobfoll SE, Johnson RJ (2007) Child multi-type maltreatment and associated depression and PTSD symptoms: the role of social support and stress. Child Abuse Negl 31(1):71–84

    Article  PubMed Central  PubMed  Google Scholar 

  53. Merrill LL, Thomsen CJ, Sinclair BB, Gold SR, Milner JS (2001) Predicting the impact of child sexual abuse on women: the role of abuse severity, parental support, and coping strategies. J Consult Clin Psychol 69(6):992

    Article  CAS  PubMed  Google Scholar 

  54. McManus S, Meltzer H, Brugha TS, Bebbington PE, Jenkins R (2009). Adult psychiatric morbidity in England, 2007: results of a household survey

  55. 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):465–486

    Article  CAS  PubMed  Google Scholar 

  56. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental (4th edn.) (DSM-IV), 4th edn. APA, Washington, DC

    Google Scholar 

  57. Brewin CR, Rose S, Andrews B, Green J, Tata P, McEvedy C, Foa E (2002) Brief screening instrument for post-traumatic stress disorder. Br J Psychiatry 181(2):158–162

    PubMed  Google Scholar 

  58. Bebbington P, Nayani T (1995) The psychosis screening questionnaire. Int J Met Psychiatric Res 5(1):11–19

    Google Scholar 

  59. Murphy J, Shevlin M, Houston J, Adamson G (2012) A population based analysis of subclinical psychosis and help-seeking behavior. Schizophr Bull 38(2):360–367

    Article  PubMed Central  PubMed  Google Scholar 

  60. Wing JK, Babor T, Brugha T, Burke J, Cooper JE, Giel R, Sartorius N (1990) SCAN: schedules for clinical assessment in neuropsychiatry. Arch Gen Psychiatry 47(6):589

    Article  CAS  PubMed  Google Scholar 

  61. Tyrer P, Nur U, Crawford M, Karlsen S, MacLean C, Rao B, Johnson T (2005) The social functioning questionnaire: a rapid and robust measure of perceived functioning. Int J Soc Psychiatry 51(3):265–275

    Article  PubMed  Google Scholar 

  62. Muthén LK, Muthen B (2010). Mplus 6.0. Los Angeles, CA: Muthén & Muthén

  63. Akaike H (1987) Factor analysis and AIC. Psychometrika 52(3):317–332

    Article  Google Scholar 

  64. Schwarz G (1978) Estimating the dimension of a model. Annals Statistics 6(2):461–464

    Article  Google Scholar 

  65. Sclove SL (1987) Application of model-selection criteria to some problems in multivariate analysis. Psychometrika 52(3):333–343

    Article  Google Scholar 

  66. Moylan CA, Herrenkohl TI, Sousa C, Tajima EA, Herrenkohl RC, Russo MJ (2010) The effects of child abuse and exposure to domestic violence on adolescent internalizing and externalizing behavior problems. J Family Viol 25(1):53–63

    Article  Google Scholar 

  67. Norman GJ, Hawkley L, Ball A, Berntson GG, Cacioppo JT (2013) Perceived social isolation moderates the relationship between early childhood trauma and pulse pressure in older adults. Int J Psychophysiol 88:334–338

    Article  PubMed  Google Scholar 

  68. Maxwell SE, Cole DA (2007) Bias in cross-sectional analyses of longitudinal mediation. Psychol Methods 12(1):23

    Article  PubMed  Google Scholar 

  69. Borys S, Perlman D (1985) Gender differences in loneliness. Pers Soc Psychol Bull 11(1):63–74

    Article  Google Scholar 

  70. Hardt J, Rutter M (2004) Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatry 45(2):260–273

    Article  PubMed  Google Scholar 

  71. Arseneault L, Bowes L, Shakoor S (2010) Bullying victimization in youths and mental health problems: ‘much ado about nothing’. Psychol Med 40(5):717–729

    Article  CAS  PubMed  Google Scholar 

  72. McCloskey LA, Figueredo AJ, Koss MP (1995) The effects of systemic family violence on children’s mental health. Child Dev 66(5):1239–1261

    Article  CAS  PubMed  Google Scholar 

  73. Savikko N, Routasalo P, Tilvis RS, Strandberg TE, Pitkälä KH (2005) Predictors and subjective causes of loneliness in an aged population. Arch Gerontol Geriatr 41(3):223–233

    Article  CAS  PubMed  Google Scholar 

  74. Harmer AL, Sanderson J, Mertin P (1999) Influence of negative childhood experiences on psychological functioning, social support, and parenting for mothers recovering from addiction. Child Abuse Negl 23(5):421–433

    Article  CAS  PubMed  Google Scholar 

  75. National Institute for Health and Clinical Excellence (2005) Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care. Gaskell, Leicester

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Psychology, Faculty of Life and Health Sciences, University of Ulster at Magee, Londonderry, BT48 7JL, Northern Ireland

    Mark Shevlin, Eoin McElroy & Jamie Murphy

Authors
  1. Mark Shevlin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eoin McElroy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jamie Murphy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mark Shevlin.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Shevlin, M., McElroy, E. & Murphy, J. Loneliness mediates the relationship between childhood trauma and adult psychopathology: evidence from the adult psychiatric morbidity survey. Soc Psychiatry Psychiatr Epidemiol 50, 591–601 (2015). https://doi.org/10.1007/s00127-014-0951-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-014-0951-8

Keywords

  • Loneliness
  • Childhood abuse
  • Psychopathology
  • Trauma
  • Mediation