Abstract:Little is known about the influence of particular characteristics of childhood maltreatment, such as developmental stage, relationship to the perpetrator and nature of the trauma, on adult psychopathology. The effects of childhood maltreatment were assessed in adult psychiatric patients (N=287) using self-rating scales and diagnostic checklists. Maltreatment was strongly associated with dissociation. This relationship was observed for all childhood developmental stages and was strongest when the perpetrator was outside the family. Dissociation was more strongly correlated with childhood emotional abuse and sexual harassment, than with sexual or physical abuse. Childhood sexual abuse was found to be associated with symptoms of posttraumatic stress. Findings suggest that dissociation is a relatively specific consequence of childhood maltreatment that is largely independent of the familial relationship to the perpetrator or the child's developmental stage.
Keywords: Dissociation, Child Abuse, Posttraumatic Stress Disorder 3The World Health Organization defines child maltreatment as "all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child's health, survival, development or dignity in the context of a relationship of responsibility, trust or power" (World Health Organization, 1999). Dissociation, mood disorders, anxiety and posttraumatic stress symptoms are believed to constitute potential sequelae of childhood trauma (Fairbank et al, 2007;Heim et al, 2001;Spertus et al, 2003;Van der Hart et al, 2006). However, it is not clear what aspects of childhood maltreatment influence the development and nature of trauma-related symptoms.Dissociation related to trauma may involve disruptions or breakdowns of memory, awareness, identity and/or perception ("psychoform dissociation") as well as losses or distortion of sensory, perceptual, affective or motor functions ("somatoform dissociation") ( Van der Hart et al, 2004). Current theories about the development of severe dissociation emphasize the role of early onset chronic abuse and neglect from primary caregivers in childhood (Liotti, 2006;Van der Hart et al, 2006). There is ample evidence supporting the strong association between childhood maltreatment and dissociative psychopathology (Chu et al, 1999;Draijer et al, 1999;Nijenhuis et al, 1998;Ogawa et al, 1997;. Not all traumatized children develop dissociative symptoms and other factors, such as severity of abuse, numbers of perpetrators, the victim's coping style and affect modulation capacities, may moderate its relationship with maltreatment (Briere, 2006;Lange et al, 1999). This also holds true for the relationship between posttraumatic stress symptoms, depression and childhood maltreatment; victims of child abuse are at increased risk for developing posttraumatic stress disorder and depressive disorder, but childhood victimization alone is not sufficient to cause these disorders (Ch...