Emotional Abuse in Childhood Is a Differential Factor for the Development of Depression in Adults

Abstract

We evaluate the association between subtypes of early life stress (ELS; sexual abuse, physical abuse, emotional abuse, physical neglect, and emotional neglect) and psychiatric disorders in adults. The sample was composed of 81 adult psychiatric patients treated at the Day Hospital Unit in Brazil. The patients were assessed using the Mini International Neuropsychiatric Interview according to diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The presence of ELS was confirmed by the Childhood Trauma Questionnaire, which investigates abuse and neglect subtypes. The patients were also evaluated for the severity of psychiatric symptoms through self-report questionnaires. A total of 71.6% of the patients experienced some type of severe ELS compared with 28.4% of the patients without ELS. Of these, 55.5% reported having experienced emotional abuse; 48.1%, physical neglect; 45.7%, emotional neglect; 39.5%, physical abuse; and 27.2%, sexual abuse. Our data showed that, among the ELS subtypes, emotional abuse was positively associated with psychopathology in adults, particularly with mood disorders (p < 0.05). The patients with a history of emotional abuse had higher severity scores in all symptoms, such as depression, hopelessness, suicidal ideation, anxiety, and impulsivity. These data demonstrate the impact of ELS, especially in cases of emotional abuse, as a trigger for psychiatric disorders and indicate that the severity of ELS is associated with severity of psychiatric symptoms. Therefore, further studies are needed to assess the importance of emotional abuse as a risk factor of severe psychopathology in adults.

Childhood trauma and dimensions of depression: a specific association with the cognitive domain

“…19 Experiencing verbal abuse throughout childhood was frequently self-reported, and was significantly associated with adult psychological distress. 18 In another recent study with a sample involving distinct psychiatric disorders, Martins et al 20 found that EA, among different types of early life stresses, was positively associated with psychopathology in adulthood, especially with mood disorders. Patients with a history of EA had higher severity scores for all symptoms, such as depression, hopelessness, suicidal ideation, anxiety, and impulsivity.…”

Trauma and stressor-related disorders

“…Corroborando com os achados da literatura, a pesquisa realizada por Martins et al 57 identificou associação entre o abuso emocional infantil e ocorrência de depressão na vida adulta de pacientes em regime de semi-internação psiquiátrica. Além disso, a literatura cientifica aponta que pacientes com EP apresentam pior resposta terapêutica.…”

Do estresse precoce à depressão: avaliação da atividade do eixo Hipotálamo-Pituitária-Adrenal (HPA) e da função cognitiva

“…De acordo com estudos realizados previamente por nosso grupo de pesquisa e da literatura cerca de 70 a 80% dos pacientes com transtorno depressivo relataram a ocorrência de algum subtipo de estresse precoce (Carr, Martins, Stingel, Lemgruber, & Juruena, 2013;Martins et al 2011Martins et al , 2014Tunnard et al, 2013) Figura 3.1 -Esquema de distribuição da amostra total dos estudos realizados. …”

“…Considerando os subtipos de estresse precoce relacionados a maus tratos infantis, no nosso estudo encontramos com maior frequência casos de negligência e abuso emocional, seguidos por negligência física, abuso físico e, em último lugar, abuso sexual. Sendo assim, nossos resultados se assemelharam aos de Martins et al, 2014, que observaram maior prevalência relatos de abuso emocional, negligência física e emocional, contrastando com a menor porcentagem de maus tratos relacionados a abuso físico e abuso sexual entre pacientes psiquiátricos em regime de semi-internação. Cabe destacar que, dentre todos os subtipos de estresse precoce, identificamos uma menor prevalência de casos de abuso sexual e abuso físico entre os pacientes avaliados.…”

“…Enquanto o abuso emocional engloba várias formas de maus tratos infantis, é geralmente a agressão verbal que recebe menos atenção como uma forma específica de abuso. O estudo de Martins et al (2014) demonstrou que dentre os subtipos de maus tratos na infância, o abuso emocional foi positivamente associado com transtornos psiquiátricos na vida adulta, particularmente depressão. Além disso, essa modalidade de maus tratos na infância parece estar relacionado a maior gravidade de sintomas depressivos, ansiosos, de desesperança, ideação suicida e impulsividade .…”