The relationship between anxiety, depression, and dissociative symptoms on the basis of childhood traumas

Objective: Although several studies have shown that childhood traumas play an important role in the etiology and maintenance of depressive, anxiety, and dissociative disorders, little is known about the relative specificity of several types of childhood abuse and neglect. The aim of this study is to evaluate the impact of specific childhood traumas on the relationship between depression, anxiety, and dissociative symptomatology. Methods: Fifty female and fifty male patients with unipolar depression have been enrolled. All patients were administered sociodemographic data form, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), and Dissociative Experiences Scale (DES). Experiences of childhood abuse and neglect were assessed by Childhood Trauma Questionnaire (CTQ-28). Results: Our results suggested that there were many similarity and gender-specific differences among the patients with traumatic experiences in terms of relationship between depression, anxiety, and dissociation symptoms. Firstly, female patients with childhood traumas have a moderate association between depression-anxiety and anxiety-dissociation symptoms whereas male patients have a high grade association between depression and dissociative symptoms directly. Secondly, in case of exposure of all abuse and neglect types, except emotional abuse, we found a positive association between depression and anxiety symptoms. Interestingly, except for emotional abuse, depression-dissociation relationship was evident in depressive patients with no maltreatment history. And finally, we found a positive relationship between anxiety and dissociation symptoms in all types of maltreatment exposure, except for sexual abuse. Conclusions: Information about childhood trauma history and gender-specific differences among symptoms would additionally help to identify individual's risk for depressive, anxiety or dissociative disorders and/or predict response to treatment. Future studies should focus on prospective examinations of potential predictors and mediators in this area.