European Child & Adolescent Psychiatry

, Volume 27, Issue 4, pp 481–491 | Cite as

Childhood physical maltreatment, perceived social isolation, and internalizing symptoms: a longitudinal, three-wave, population-based study

  • Mashhood Ahmed Sheikh
Original Contribution


A number of cross-sectional studies have consistently shown a correlation between childhood physical maltreatment, perceived social isolation and internalizing symptoms. Using a longitudinal, three-wave design, this study sought to assess the mediating role of perceived social isolation in adulthood in the association between childhood physical maltreatment and internalizing symptoms in adulthood. The study has a three-wave design. We used data collected from 1994 to 2008 within the framework of the Tromsø Study (N = 4530), a representative prospective cohort study of men and women. Perceived social isolation was measured at a mean age of 54.7 years, and internalizing symptoms were measured at a mean age of 61.7 years. The difference-in-coefficients method was used to assess the indirect effects and the proportion (%) of mediated effects. Childhood physical maltreatment was associated with an up to 68% [relative risk (RR) = 1.68, 95% confidence interval (CI): 1.33–2.13] higher risk of perceived social isolation in adulthood. Childhood physical maltreatment and perceived social isolation in adulthood were associated with greater levels of internalizing symptoms in adulthood (p < 0.01). A dose-response association was observed between childhood physical maltreatment and internalizing symptoms in adulthood (p < 0.001). Perceived social isolation in adulthood mediated up to 14.89% (p < 0.05) of the association between childhood physical maltreatment and internalizing symptoms in adulthood. The results of this study indicate the need to take perceived social isolation into account when considering the impact of childhood physical maltreatment on internalizing symptoms.


Psychological well-being Psychological distress Social support Anxiety Depression Childhood abuse Emotional distress Loneliness 



I am thankful to Jan Abel Olsen and Birgit Abelsen for their collaboration throughout the project that resulted in this manuscript.

Compliance with ethical standards

Conflict of interest

The author declared no conflicts of interest with respect to the authorship or the publication of this article.


This research was funded by the University of Tromsø.

Ethical approval

This investigation was carried out in accordance with the latest version of the Declaration of Helsinki. The Tromsø study has been approved by the Regional Committee for Medical and Health Research Ethics, the Data Inspectorate, and the Norwegian Directorate of Health. Written informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Health Services Research Unit, Department of Community MedicineUniversity of TromsøTromsøNorway

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