Mental health articles

OF mental health care and mentally ill

Mental health of adults with childhood abuse or adversity

Information about the long-term mental health problems of adults with experiences of child maltreatment or childhood exposure to household dysfunction is abundant. Some relevant studies include the Adverse Childhood Experiences Study (ACE). This key study documented a strong association between child abuse (l, and sexual abuse) or adversity (substance abuse, mental illness, family violence, and criminal behavior) and increased prevalence of and risk for depressed mood, suicide attempts, alcoholism, and substance abuse in adulthood. Later studies on the ACE database have confirmed a close response relation between the number of types of abuse experiences or adversities during childhood (ACE scores) and later adult mental health; a higher number of reported childhood abuse categories associates to lower mental health scores in adulthood. After observing the graded link between the ACE score and the risk for long-term disturbances and impairments on 18 mental health ot increases in the ACE score correspond to the child’s accumulative brain stress responses, with resulting impairments on the affective, somatic, substance abuse, memory, sexual, and aggression brain functions. Other studies linked increases in the ACE scores to (a) the long-term risk for suicide attempts by both men and women; (b) the prevalence and risk for adult panic reactions, depressed affect, anxiety, hallucinations, substance use and abuse, uncontrolled anger, intimate partner violence, and comorbid disturbances; and (c) the increased rate of antidepressant, anxiolytic, antipsychotic, and mood stabilizing prescriptions.

Besides the ACE studies, documented the association of childhood physical, emotional, and sexual abuse with increased rates of psychopathology, sexual difficulties, low self-esteem, and interpersonal problems in adulthood for a sample community of women. Wofp also observed an increased lifetime risk for posttraumatic stress disorder (PTSD) for those with experiences of childhood abuse. The odds of developing PTSD were 1.75 timeser for those abused as children relative to the matched comparison group. The longitudinal study indicated that relative to matched control groups, both women and men with child abuse experiences reported more symptoms of dysthymia, antisocial personality, and lifetime symptoms of alcohol abuse or dependence. When controlling for lifetime stressors, alcohol abuse or dependence for men was significant, so mental health measures of these adults related strongly to lifetime stressors. In 2004, documented that the risk for psychotic symptoms increased with the frequency of reported experiences of child abuse. Those in the sample who reported the highest frequency of child abuse experiences were estimated to have a 30 times greater chance of having a psychotic diagnosis than those not exposed to child abuse. We confirmed that among individuals affected by schizophrenia, adverse events in childhood cumulatively predicted worse psychiatric problems, including PTSD, suicidal ideation, and alcohol and drug use disorders. Childhood adversities were prevalent for 96% of the sample; only 18% reported one adverse event, while 46% reported three or more. Using data from the Wisconsin Longitudinal Study, found a positive graded association between childhood physical abuse and adult depression, anxiety, anger, and physical problems for a sample of middle-aged participants.Some reported that women who had experienced physical and sexual abuse showed an increased prevalence of depression (1.85 prevalence ratio), including severe depression (PR, 2.40). Child abuse and adversity were also associated with adoptees’ long-term internalization and externalization of psychiatric problems. In this study, severity of child maltreatment, and the number of placements before adoption, related to the trajectories of psychiatric problems from childhood into adolescence and to adulthood up to 20 years postadoption. In a follow-up report, Some documented an increased risk for anxiety, mood, and substance abuse and dependence disorders for adults with severe and multiple adversities in early childhood who were adopted. The researchers concluded that the impact of early childhood abuse and adversity persists into adulthood even when children are placed in improved social contexts.

In 2010, reported on the association of childhood abuse (physical, emotional, and sexual) and DMS-IV internalizing disorders for adults in their late 60s. Child abuse experiences predicted long-term psychiatric disorders in adulthood, and the number of abuse experiences in childhood correlated with the number of internalizing disorders presented both at baseline and 3 years after. Self-esteem predicted also internalizing disorders, but contrary to findings with younger adults, self-esteem was not correlated to childhood abuse for this older sample. The researchers concluded that self-esteem moderates the relationship between abuse and internalizing DMS-IV disorders, with increased negative impact on those with low self-esteem.

With regards to child sexual abuse, women with experiences of childhood incest were reported to present symptoms fitting PTSD many years after the abuse ended. The women in the study ranged from 24 to 44 years of age, and all met criteria for chronic and/or delayed PTSD diagnosis 17 years (average) after the abuse ended. The researchers concluded that PTSD is a long-term effect of childhood incest. Childhood sexual abuse was also observed to be a strong factor of disordered interpersonal behaviors and functioning among adult patients with borderline personality disorders. Abuse duration, specifically repetitive sexual abuse in childhood, was the most frequent significant predictor linked to the functioning of borderline patients pointing also to the severity of the disorder. Some reported significant positive associations between child sexual abuse and mental health problems, domestic violence, rape, sexual problems, and low self-esteem. Some documented that victims of child sexual abuse were almost 3 times more likely to have at least one depressive episode in their lifetimes than those with no such experiences. Adding to this, Some reported that dysregulation of the hypothalamic–pituitary–adrenal axis function may predispose both men and women for adult depression after sexual abuse as children. Some not only observed association between child sexual abuse and adult psychiatric disorders (e.g., bulimia, alcohol and drug dependency), but linked the type of abuse to specific disorders. Nongenital sexual abuse was associated with alcohol and other drug dependency problems. Genital sexual abuse was associated with every disorder except panic disorders and bulimia, and abuse that included intercourse related to all psychiatric disorders tested.

Both physical and sexual abuse increased the likelihood of lifelong psychiatric disorders for both males and females. However, associations between child abuse and adult psychiatric illness were stronger for women, and women with sexual abuse experiences that included intercourse. Child sexual abuse has been associated with increased childhood and adulthood mental disorders. In Denmark, documented women who experienced sexual abuse as children and sought mental health services in adulthood presented serious psychiatric and social problems, including personality and adjustment disorders. Half of the women in the study had more than one suicide attempts, 35% reported substance abuse, 21% had impatient psychiatric admissions, and 62% had received in and/or outpatient psychological or psychiatric services. Sexual abuse experiences that included penetration correlated to prior inpatient psychiatric experiences. Recently, documented that relative to a community sample, men with histories of sexual abuse in childhood had increased clinical psychopathology, including a rate of PTSD 10 times that of the general population.

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