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Objective and subjective experiences of child maltreatment and their relationships with psychopathology

Abstract

Does psychopathology develop as a function of the objective or subjective experience of childhood maltreatment? To address this question, we studied a unique cohort of 1,196 children with both objective, court-documented evidence of maltreatment and subjective reports of their childhood maltreatment histories made once they reached adulthood, along with extensive psychiatric assessment. We found that, even for severe cases of childhood maltreatment identified through court records, risk of psychopathology linked to objective measures was minimal in the absence of subjective reports. In contrast, risk of psychopathology linked to subjective reports of childhood maltreatment was high, whether or not the reports were consistent with objective measures. These findings have important implications for how we study the mechanisms through which child maltreatment affects mental health and how we prevent or treat maltreatment-related psychopathology. Interventions for psychopathology associated with childhood maltreatment can benefit from deeper understanding of the subjective experience.

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Fig. 1: Prevalence of psychopathology in participants with objective and/or subjective measures of child maltreatment.
Fig. 2: Prevalence of individual diagnoses in participants with objective and/or subjective measures of child maltreatment.
Fig. 3: Prevalence of a history of psychopathology in participants with objective and/or subjective measures of child maltreatment in the subsample without current psychopathology at the time of subjective measure assessment.

Data availability

The data reported in the current article are not publicly available because they contain extremely sensitive information that could compromise research participant privacy and confidentiality. We cannot provide individual level data from this project because our confidentiality agreement with the participants in this study precludes this. The data are available on request from C.S.W. by qualified scientists. Requests require a concept paper describing the purpose of data access, ethical approval at the applicant’s university in writing and provision for secure data access.

Code availability

The data analysis script is available from A.D. upon request.

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Acknowledgements

This research was supported in part by grants from the National Institute of Justice (NIJ nos. 86-IJ-CX-0033, 89-IJ-CX-0007 and 2011-WG-BX-0013), the National Institute of Mental Health (NIMH nos. MH49467 and MH58386), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD no. HD40774), the National Institute on Drug Abuse (NIDA nos. DA17842 and DA10060), the National Institute on Alcohol Abuse and Alcoholism (NIAAA nos. AA09238 and AA11108), the National Institute on Aging (NIA no. AG058683) and the Doris Duke Charitable Foundation to C.S.W. The opinions, findings and conclusions or recommendations expressed are those of the authors and do not necessarily reflect those of the US Department of Justice. A.D. received funding from the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London and is supported by the Medical Research Council grant no. P005918. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NHS, the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

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A.D. and C.S.W. contributed to the conception and design of the work, interpretation of the data, revision of the work and both approved the final manuscript. A.D. was involved in data analysis and drafting of the work. C.S.W. was involved in acquisition of the data.

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Correspondence to Andrea Danese or Cathy Spatz Widom.

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Danese, A., Widom, C.S. Objective and subjective experiences of child maltreatment and their relationships with psychopathology. Nat Hum Behav 4, 811–818 (2020). https://doi.org/10.1038/s41562-020-0880-3

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