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 on 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 neurobiological effects of child maltreatment 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.

Reduced hippocampal and amygdala volume as a mechanism underlying stress sensitization to depression following childhood trauma

“…Second, higher levels of depression have the potential to bias retrospective recall of violence exposure. However, these concerns are reduced by the high level of agreement between child and parent reports of violence exposure in this sample, and recent work suggests that recall bias does not explain associations between retrospective reports of childhood trauma and psychopathology (Danese & Widom, 2020).…”

Adversity in childhood is linked to mental and physical health throughout life

“…Effects mediated indirectly might include changing the quality of the care giving environment (eg, less responsive care 3 ) or the surrounding distal environment (eg, neighbourhood violence, which in turn will affect child development across several levels 53 ); or building dysfunctional cognitions about the self and the world. 25 54 55 The effects of food insecurity (leading to undernutrition or malnutrition) and unsafe or substandard housing (resulting in exposure to asthmagens or environmental toxicants such as lead) can lead to social disparities in health. 4 Distal effects of adversity include the early adoption of health damaging behaviors (eg, smoking, poor food choices) that later in life lead to diabetes, heart disease, and metabolic syndrome.…”

“…Furthermore, it can lead to the development of dysfunctional cognition about self and others. 54 The interplay of these different mediation mechanisms remains largely unclear.…”

“…Subjective experience is particularly important for psychopathology, over and above objective experience. 54 …”

Kaleidoscope

“…Danese & Spatz Widom compared court-documented evidence of maltreatment of children with individuals' subjective recall of events and psychiatric histories as adults. 2 The authors accessed a unique sample of just over 900 official records from the USA to find that individuals' perceptions were far more important: the risk of subsequent psychopathology was minimal, even in the presence of severe objective reports of trauma, without confirmatory subjective accounts. Conversely, the risk of psychopathology was high in subjective recall of significant events, whatever the objective data showed.…”