New research published in the journal Nature Human Behavior suggests that a person’s subjective experience of childhood maltreatment is linked to an elevated risk of psychopathology, while the objective experience of abuse is not.
While childhood maltreatment is a known risk factor for future mental health issues, there is an emerging debate over whether it is the objective experience of abuse or a person’s construal of the abuse that leads to psychopathology. It has recently been discovered that assessments identifying adults with subjective reports of past childhood maltreatment and assessments identifying children with objective experiences of maltreatment yield disparate groups of individuals.
Study authors Andrea Danese (@andrea_danese) and Cathy Spatz Widom say that a better understanding of how subjective and objective experiences of childhood maltreatment contribute to psychopathology would greatly inform future research practices.
“Doubts on whether psychopathology is more strongly associated with documented experience or personal appraisal of childhood trauma dates back to writing by Freud,” said Danese, a professor of child and adolescent psychiatry at King’s College London.
“That was at the time when the philosophical tradition of Phenomenology was also developing, focusing on the differences between objective and subjective experience. Building on that tradition, we have recently shown that prospective measures of childhood trauma (third-person perspectives from official records or parental reports) and retrospective measures (self reports by adults) identify largely different groups of people. Therefore, we sought to test whether these different measures of childhood trauma also showed differential association with psychopathology.”
To explore this topic, the researchers obtained a sample of 908 individuals identified through official court records as victims of child abuse or neglect in 1967-1971. The researchers then gathered a comparison sample of 667 individuals with no record of abuse or neglect, who were matched to the first sample when it came to age, race, sex, and social class.
Danese and Widom tracked down both groups of individuals and were able to conduct two-hour follow-up interviews among 1,196 of these participants, who were now an average of 28 years of age. During these interviews, the participants were asked questions about their upbringing that assessed the presence of childhood maltreatment. The interviews also measured current and lifetime psychopathology, which included measures of depression, dysthymia, PTSD, generalized anxiety disorder, antisocial personality disorder, and alcohol and drug abuse/dependence.
The interviews revealed three different groups of participants: those with only objective experiences of child abuse, those with both objective and subjective experiences of abuse, and those with only subjective experiences of abuse.
The researchers found that adults with only objective experiences of child abuse — those identified by official records as having been victims of abuse but who did not retrospectively recall the experience when interviewed — showed no greater psychopathology than those with neither objective nor subjective experiences of maltreatment. On the other hand, adults who retrospectively recalled being abused as children showed an increased risk of lifetime psychopathology whether they had official records of childhood maltreatment or not.
“The subjective or ‘lived’ experience of childhood trauma is more strongly associated with psychopathology than even severe objective experiences documented from court records. This means that psychopathology is not simply triggered by what happens to children but rather how children and adults think about their experiences,” Danese told PsyPost. “This perspective offers new hope for treatments focused on cognitive interventions for trauma survivors. Overall, this evidence suggests that young people are not defined by their negative life experiences.”
This pattern of findings remained constant across gender, race, type of psychological disorder, and type of maltreatment.
“Of course,” the researchers emphasized, “our results do not diminish the significance of maltreatment in the lives of children . . . Our results also show that many children with official records and subjective appraisal of maltreatment go on to develop psychopathology.”
The researchers said that the field’s current understanding of psychopathology resulting from child abuse needs to be revised so that it acknowledges the crucial role of the subjective experience of childhood maltreatment. They added that more research is needed to better understand why some abused children go on to establish a subjective evaluation of their abuse while others do not.
“We are interested to expand our analysis to test if there are features on the traumatic events and cognitive appraisal that can help us explain the differential association of objective and subjective measures of childhood trauma with psychopathology,” Danese told PsyPost. “We are also interested in testing whether similar or different patterns can be observed for the associations with physical health outcomes. Ultimately, we will learn from this epidemiological work to inform the development of new treatments.”
The study, “Objective and subjective experiences of child maltreatment and their relationships with psychopathology“, was authored by Andrea Danese and Cathy Spatz Widom.
