Can I Leave the Past Behind? Associations between Childhood Abuse and Adult Psychopathology

Abstract

Background: Research consistently shows that abuse during childhood is related to adult psychopathology. Information regarding childhood abuse is frequently collected from either previous documentation or from participants’ self-reports. Objective: In the current study, we combined information on reports of childhood abuse from several informants (patients, treating clinicians, and independent interviewer), as well as diagnostic assessments of adult patients based on independent interviewer assessments based on structured diagnostic interviews (SCID) and clinician judgments, to better examine the association between exposure to abuse during childhood and adult psychopathology. Participants and Setting: A convenience sample of patients in community mental health and hospital-based clinics (N = 170) and their clinicians (N = 80) participated in the study. Methods: Patients and clinicians completed the Clinical Data Form. Patients also completed the Childhood Trauma Questionnaire. Independent interviewer-assessed patients and completed the Familial Experiences Interview. Clinicians completed a diagnostic assessment of their patients based on clinical judgment. Independent interviewers completed the Structured Clinical Interview (SCID). Results: Reports of exposure to physical, emotional, and sexual abuse during childhood from all informants correlated with the treating clinician’s diagnosis of borderline personality disorder (BPD; r range 0.23–0.37, p < 0.05), but not with SCID diagnosis of BPD. Clinician and SCID diagnosis of post-traumatic stress disorder (PTSD) correlated with patient and interviewer reports of childhood sexual abuse (r range 0.23–0.30, p < 0.05), but there were no correlations with treating clinician’s reports of sexual abuse. Conclusions: The association between BPD and childhood abuse is consistent across different ratings and measurements. The study raises questions of the ability of a structured interview to accurately capture BPD and highlights the connection between sexual abuse and PTSD, and the importance of treating clinicians’ examination of childhood sexual abuse among their patients.