Childhood Adversity and Perceived Need for Mental Health Care

Abstract

Previous community surveys have demonstrated that individuals with self-perceived need for mental health treatment in combination with meeting DSM-III-R criteria display the greatest levels of impairment in the community and have a higher likelihood of reporting parental psychopathology. The current investigation aims to replicate and extend these findings by examining the association between a wide range of childhood adversities with self-perceived need for mental health treatment and DSM-III-R diagnosis in a Canadian community sample (N = 8116). All respondents were questioned about their childhood experiences (physical and sexual abuse, emotional neglect, parental discord/separation, parental death, and parental psychopathology). After controlling for covariates in a multiple logistic regression, we found that emotional neglect (OR = 2.07), physical abuse (OR = 2.16), sexual abuse (OR = 2.39), paternal psychopathology (OR = 2.41), and maternal psychopathology (OR = 2.70) were independently and significantly associated with respondents meeting DSM criteria for a mental disorder and perceiving a need for treatment. These findings underscore the importance of future longitudinal studies considering the influence of a wide range of early childhood adversities on adult psychopathology and perceived need for treatment.

Common Mental Disorder Diagnosis and Need for Treatment are Not the Same: Findings from the NEMESIS Study

“…There has been notable debate regarding this issue with some researchers argue that meeting diagnosis nonetheless is suggestive of at least mild levels of distress and early interventions will likely result in briefer and more cost-effective treatments (Kessler et al 2003), while many other experts suggest that merely meeting the diagnostic criteria for a mental disorder is a poor indicator of treatment need (Hedden and Gfroerer 2011;Mechanic 2003;Narrow et al 2002;Regier et al 1998;Sareen et al 2013). A handful of studies have demonstrated that people who do not meet diagnostic criteria for a mental disorder may have legitimate reasons for seeking care, such as having subthreshold symptoms, life stressors, and treatment maintenance (Druss et al 2007;Pagura et al 2011;Sareen et al 2005b). In addition, many people who meet criteria for a mental disorder do not seek treatment or do not perceive a need for any intervention (Sareen et al 2005a).…”

Perceived Need for Mental Health Treatment in a Nationally Representative Canadian Sample

“…First, the prevalence of perceived need for mental health treatment is much lower than the prevalence of meeting criteria for a mental disorder diagnosis (12,26,30). Second, self-perceived need for treatment, independent of meeting criteria for a mental disorder assessed in the survey, was found to be associated with increased distress and disability (28,30).…”

“…Increased attention has also recently been paid to selfperceived need for mental health treatment in the community (12,(24)(25)(26)(27)(28). This concept takes into account theoretical models of HS.…”

Physical Punishment and Mental Disorders: Results From a Nationally Representative US Sample

“…5 It is well established that child maltreatment (ie, physical abuse, sexual abuse, emotional maltreatment, physical and emotional neglect) is associated with adult Axis I and II mental disorders. [6][7][8][9][10][11][12][13][14][15][16][17] Evidence about the negative long-term outcomes associated with child maltreatment could provide insights into understanding why physical punishment is associated with impairment and provides the theoretical perspective for the current study. 18 Although only a few representative studies have been conducted on the relationship between physical punishment and specific mental disorders, theoretically similar associations found in the child maltreatment literature would be expected for physical punishment because physical punishment and child maltreatment are not separate and unrelated dichotomies but rather varying degrees of physical force used on children found along a continuum of increasing severity ranging from no physical acts to severe child maltreatment.…”