BackgroundChildhood maltreatment is associated with depression and cardiometabolic disease in adulthood. However, the relationships with these two diseases have so far only been evaluated in... Show moreBackgroundChildhood maltreatment is associated with depression and cardiometabolic disease in adulthood. However, the relationships with these two diseases have so far only been evaluated in different samples and with different methodology. Thus, it remains unknown how the effect sizes magnitudes for depression and cardiometabolic disease compare with each other and whether childhood maltreatment is especially associated with the co-occurrence (“comorbidity”) of depression and cardiometabolic disease. This pooled analysis examined the association of childhood maltreatment with depression, cardiometabolic disease, and their comorbidity in adulthood.MethodsWe carried out an individual participant data meta-analysis on 13 international observational studies (N = 217,929). Childhood maltreatment comprised self-reports of physical, emotional, and/or sexual abuse before 18 years. Presence of depression was established with clinical interviews or validated symptom scales and presence of cardiometabolic disease with self-reported diagnoses. In included studies, binomial and multinomial logistic regressions estimated sociodemographic-adjusted associations of childhood maltreatment with depression, cardiometabolic disease, and their comorbidity. We then additionally adjusted these associations for lifestyle factors (smoking status, alcohol consumption, and physical activity). Finally, random-effects models were used to pool these estimates across studies and examined differences in associations across sex and maltreatment types.ResultsChildhood maltreatment was associated with progressively higher odds of cardiometabolic disease without depression (OR [95% CI] = 1.27 [1.18; 1.37]), depression without cardiometabolic disease (OR [95% CI] = 2.68 [2.39; 3.00]), and comorbidity between both conditions (OR [95% CI] = 3.04 [2.51; 3.68]) in adulthood. Post hoc analyses showed that the association with comorbidity was stronger than with either disease alone, and the association with depression was stronger than with cardiometabolic disease. Associations remained significant after additionally adjusting for lifestyle factors, and were present in both males and females, and for all maltreatment types.ConclusionsThis meta-analysis revealed that adults with a history of childhood maltreatment suffer more often from depression and cardiometabolic disease than their non-exposed peers. These adults are also three times more likely to have comorbid depression and cardiometabolic disease. Childhood maltreatment may therefore be a clinically relevant indicator connecting poor mental and somatic health. Future research should investigate the potential benefits of early intervention in individuals with a history of maltreatment on their distal mental and somatic health (PROSPERO CRD42021239288). Show less
Abstract Background: A dimensional approach of psychopathology focuses on features and risk factors that are shared across diagnoses. In support for this dimensional approach, studies point to a... Show moreAbstract Background: A dimensional approach of psychopathology focuses on features and risk factors that are shared across diagnoses. In support for this dimensional approach, studies point to a general psychopathology factor (GPF) associated with risk for multiple psychiatric disorders. It is, however, unknown how GPF relates to white matter integrity (WMI). In the current diffusion tensor imaging (DTI) study, we examined how GPF relates to abnormalities in a skeleton representation of white matter tracts, taking into account a trans-diagnostic risk factor: unresolved-disorganized attachment (Ud) resulting from loss or trauma. Methods: Unique associations between GPF, Ud, and WMI were examined in a combined sample of adolescents (N = 63) with childhood sexual abuse-related posttraumatic stress disorder (N = 18), anxiety and depressive disorders (N = 26) and without psychiatric disorder (N = 19). WMI was measured using DTI. Ud was measured using the Adult Attachment Interview. We controlled for puberty stage, gender, age, and IQ. Results: Controlling for GPF, Ud was associated with reduced fractional anisotropy (FA) in the splenium and inferior fronto-occipital fasciculus (IFOF). Controlling for Ud, GPF was associated with reduced FA in the genu and body of the corpus callosum. Conclusions: Decreasing WMI in the genu and body with increasing psychopathology across diagnoses suggests demyelinization in these areas and may underlie comorbidity and presence of symptoms that transcend psychopathological diagnoses. In contrast, trauma-related WMI reductions in the splenium and IFOF may account for heterogeneity within diagnostic categories as a function of childhood trauma. These findings support the importance of a dimensional approach in addition to traditional diagnostic classifications in clinical research and practice. Keywords: Adversity, Child abuse, Psychopathology, Attachment, Brain imaging Show less
In support of efforts to develop effective intervention and prevention programs to reduce (the devastating consequences of) child maltreatment, it is important to understand the origins of child... Show moreIn support of efforts to develop effective intervention and prevention programs to reduce (the devastating consequences of) child maltreatment, it is important to understand the origins of child maltreatment. Why do some parents use dysfunctional parenting strategies and others do not? Different research angles have been of guidance in tracking down the etiology of child maltreatment (e.g., stress-regulation, intergenerational transmission, attachment security). An influential line of thought is that parental responses to child behavior depend on the way parents interpret and evaluate child behavior, also known as parental attributions. Milner (1993, 2003) incorporated parental attributions as key component in the Social Information Processing (SIP) model of Child Physical Abuse (CPA). The model explains how parental cognitions (e.g., perceptions, attributions) and affective schemata based on prior experiences, guide parenting behavior. The model hypothesizes that parents who attribute more responsibility and hostile intent to child behavior, and evaluate the behavior as more wrong and blameworthy, are parents who are at risk for child abuse. In this dissertation, negative parental attributions and their interrelated components as theorized by the SIP-model, are the main focus of investigation in a quest to improve our understanding of the etiology of dysfunctional parenting, and subsequently child maltreatment. Show less
This study investigated the prevalence of child maltreatment in a cross-cultural perspective, the changes in prevalence estimates in Vietnam over time, child and family risk factors of maltreatment... Show moreThis study investigated the prevalence of child maltreatment in a cross-cultural perspective, the changes in prevalence estimates in Vietnam over time, child and family risk factors of maltreatment, and possible consequences of child maltreatment. We administered questionnaires and a working memory test to 1,851 secondary and high school students (12-17 years old) in four Northern provinces of Vietnam. We compared current Vietnamese prevalence estimates with those from the Dutch prevalence study on child maltreatment (NPM-2010) and from a prevalence study in Vietnam 10 years ago to achieve a cross-cultural and chronological comparison. We found that although there was a decrease in emotional and physical abuse over time, all types of child maltreatment were still highly prevalent, ranging from 2.6% for sexual abuse to 31.8% for emotional abuse. Most types were more common in Vietnam than in the Netherlands. Only the past year sexual abuse prevalence in Vietnam was lower. Single parenthood, being a boy, and older age were risk factors for child maltreatment. Child maltreatment was related to negative child well-being aspects with the largest effect on emotional functioning. Our study draws a clearer picture on child maltreatment in Vietnam. It highlights the importance of prompt responses to child maltreatment. Show less
Beckerman, M.; Van Berkel, S.; Mesman, J.; Alink, L.R.A. 2017
The aim of this set of studies was to provide more insight in individual characteristics that influence care-giving abilities, in particular precursors of harsh and abusive parenting. We examined... Show moreThe aim of this set of studies was to provide more insight in individual characteristics that influence care-giving abilities, in particular precursors of harsh and abusive parenting. We examined how different subtypes of childhood abuse were related to child abuse potential in adulthood. Emotional neglect in childhood was related to child abuse potential, which is in line with earlier research showing the long-lasting effects of emotional maltreatment and neglect in childhood. With regard to the effects of oxytocin on the neural basis of parenting, we used fMRI to examine how oxytocin influenced emotion recognition using pictures of both adult and infant faces, taking experiences of maternal love withdrawal into account as potential moderator. Oxytocin enhanced neural activity in regions involved in emotion processing, such as the IFG, insula and STG. Our findings regarding the moderating role of experiences of maternal love withdrawal are inconsistent for emotion recognition in adult faces and in infant faces. Lastly, a new paradigm (LISSA) to observe sensitivity in response to standardized infant cues was developed and tested. Our results show that sensitivity can be reliably assessed using this procedure, making the LISSA a promising method for future research and clinical practice. Show less
In this thesis we describe, combine and compare results of a series of meta-analyses on the prevalence of child sexual, physical, and emotional abuse and of physical and emotional neglect,... Show moreIn this thesis we describe, combine and compare results of a series of meta-analyses on the prevalence of child sexual, physical, and emotional abuse and of physical and emotional neglect, including 244 publications and 577 prevalence rates for the various types of maltreatment. Child maltreatment research seems to be dominated by research on sexual abuse, by studies in developed parts of the world, and by research using self-report measures. The overall estimated prevalence rates for self-report studies were 127/1,000 for sexual abuse (76/1,000 among boys and 180/1,000 among girls), 226/1,000 for physical abuse, 363/1,000 for emotional abuse, 163/1,000 for physical neglect, and 184/1,000 for emotional neglect. The overall estimated prevalence rates for studies using informants were 4/1,000 for sexual abuse and 3/1,000 for physical and for emotional abuse. Design and sample characteristics partly explained variation of self-reported prevalence rates. We conclude that child maltreatment is a widespread, global phenomenon affecting the lives of millions of children all over the world, which is in sharp contrast with the United Nation’s Convention on the Rights of the Child. Show less
