Child Abuse Increases Risk of PTSD in Young Adults

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Researchers in New Zealand have found a link between childhood abuse and mental disorders in young adults. The article by Drs. Scott, Smith, and Ellis was published in the July issue of the Archives of General Psychiatry. The authors analyzed data from a nationally representative community survey of 2144 New Zealanders ages 16 to 27. The survey assessed a variety of anxiety, mood, and substance use disorders during the previous year and in the person's lifetime. National child protection agency records were used to identify the 221 young adults who received services as children due to abuse or neglect (child maltreatment). As is standard for this type of study, the results of the analyses were adjusted for demographic and socioeconomic factors (age, sex, ethnicity, education, & income).

The first set of analyses compared adults with and without child protection service records. Those with a history of child maltreatment had a significantly higher risk of having one or more mental disorders both in the previous year and in their lifetimes. The risk of a mental disorder was highest for Posttraumatic Stress Disorder (PTSD) in the previous year. Those with a history of child maltreatment were 5.12 times more likely to have PTSD. They were also 2.41 times more likely to have an anxiety disorder, a mood disorder (1.86), or a substance use disorder (1.71).

The researchers then repeated their analyses after removing people from the comparison group who reported a history of childhood maltreatment in the survey. The risk of developing a mental disorder went up for most of the disorders, but the greatest increase was in the risk for PTSD in the previous year. Those with a history of child maltreatment were nearly 11 times more likely to have PTSD than the comparison group (10.92). To get a sense of how high that is, compare it to the following statistic from the American Heart Association: "People who smoke a pack of cigarettes a day have more than twice the risk of heart attack than people who’ve never smoked."

Most studies of the effects of child maltreatment and adult mental illness use retrospective reports of child abuse by adults. Retrospective reports may be unreliable for several reasons including memory issues and reluctance to disclose abuse. This study avoids that issue by using prospective records of child abuse and neglect. The authors were also able to show that excluding individuals who retrospectively report abuse (without corroborating records) actually strengthened the relationship between child abuse and later mental illness.

Not surprisingly, the authors conclude that there is a need to provide mental health interventions for maltreated children to prevent or reduce the risk of later mental illness. Their results demonstrate the long-term negative effects of child abuse and neglect on mental health. Consistent with the results of other research with children, and retrospective research with adults, their results show that abused children are at high risk for having PTSD in adulthood.

Scott, K., Smith, D., & Ellis, P. (2010). Prospectively Ascertained Child Maltreatment and Its Association With DSM-IV Mental Disorders in Young Adults Archives of General Psychiatry, 67 (7), 712-719 DOI: 10.1001/archgenpsychiatry.2010.71