Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 292, Issue -, Pages 623-632Publisher
ELSEVIER
DOI: 10.1016/j.jad.2021.05.112
Keywords
Mood disorders; Anxiety disorders; Adverse childhood experiences; Childhood maltreatment; Child sexual abuse; Child physical abuse
Categories
Funding
- Joyce and Aqueil Ahmad Endowment within the College of Arts & Sciences at the University of North Dakota
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Childhood adversity in various forms is associated with higher prevalence rates of different mood and anxiety disorders. Sexual, emotional, and physical abuse are linked to increased risk of these disorders. Interactive effects between adversities are limited, with significant impact from unitary adversities.
Background: Child abuse has been identified within the DSM-5 as a putative etiologic risk for over two dozen psychiatric disorders. Methods: This study examined associations between self-reported diagnostic histories of six Mood, Anxiety and Stress-Related Disorders and childhood adversities measured using dichotomous ACE (Adverse Childhood Experiences) counts and dimensional indices of child abuse. Results: Adversity odds ratio were all significant (p < .001) and averaged as follows: sexual abuse, ORM = 3.16; emotional abuse, ORM = 2.62; physical abuse, ORM = 2.41; maternal battering, ORM = 2.15. An effort was made to differentiate between additive and interactive adversity risks. While significant adversity interactions were found, they tended to be modest in effect sizes and scope. The combination of sexual, physical and emotional abuse was associated with a maximal odds ratio and prevalence for Major Depression (OR = 5.13, 70.8%). The large impacts of unitary adversities limited the potential for large interactive effects. Limitations: The cross-sectional analysis relied on retrospective self-reports that may not generalize fully to respondents differing in ethnicity, religion, sexual orientation, or other factors. Conclusions: Childhood adversity in four different forms was associated with higher prevalence rates for six different mood and anxiety disorders. Childhood sexual and emotional abuse appeared to account for unshared variance in all of these lifetime diagnoses. Significant high risk adversity combinations were found for Major Depression (sexual/physical/ emotional), Post-Traumatic Stress Disorder (sexual/physical & physical/maternal battering), and Generalized Anxiety Disorder (physical/emotion/maternal battering).
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