Childhood Issues & Adulthood Tissues:
Examining Relationships between Childhood Abuse & Adult Depression
Steffey, S.K., Gibson, B.W. & Dula, C.S.
APPLIED PSYCHOLOGY LABORATORY
East Tennessee State University
http://www.etsu.edu/apl/
Johnson City, Tennessee
ABSTRACT
METHOD
• Depression is considered a debilitating clinical disorder and consumes $83
billion dollars of annual healthcare costs. Depression is more common in
woman than men with a incidence ratio of 13 to 5, respectively. Research
indicates that childhood sexual abuse is associated with depression. This
study seeks to examine relationships between childhood abuse/neglect and
depression. It was hypothesized that childhood maltreatment and depression
would show a positive relationship, and that females would have
significantly higher depression scores than males. Participants included 207
students from psychology classes within a rural Southeastern university in
the United States, via an online participant management system that ensured
anonymity. Participants received modest extra credit in courses for their
time. The Childhood Trauma Questionnaire (CTQ) measures childhood
maltreatment, and includes 28 self-report items assessing emotional,
physical, and sexual abuse, and emotional and physical neglect. The Center
for Epidemiologic Studies Depression Scale (CES-D) includes 20 selfreport items used to measure depressive symptoms. Limitations included a
relatively homogenous college sample and inherent issues with selfreported variables. Future research might consider other variables pertaining
to childhood conflicts and use of the Diathesis-Stress Model.
Procedure
INTRODUCTION
• Research states depression is the most common adult outcome of exposure
to childhood sexual abuse (Teicher et al., 2009).
• According to the National Child Abuse and Neglect Data System, 9.3% of
confirmed child abuse and neglect cases involved sexual abuse (American
Humane Fact Services, 2007).
• According to Heim et al., (2000) the victim’s perception of the seriousness
of the abuse may differ by sex.
• Research indicates that childhood sexual abuse is associated with adult
depression, where depression is reported with a greater frequency by
females versus males; females are diagnosed with major depressive
disorder at about 2.5 times the rate of males (Weiss et al., 1999).
• It is reported that 20.7% of women with a history of childhood sexual abuse
met lifetime diagnostic criteria for an adult psychiatric disorder; mostly
depression (Bushnell et al., 1999).
• Studies show that children who have been physically abused or witnessed
such violence had a higher rate of depression, anger, and anxiety in
adulthood (Johnson et al., 2002).
RESULTS (CONT.)
• Participants were recruited utilizing a convenience sample from various
psychology classes from a local Southeastern university in the U.S. via an online
participant management system. Participant are assigned ID codes to ensure
anonymity. Participation was voluntary and yielded extra course credit.
• The current study included 207 participants. A total of 55 (26.6%) were male,
152 (73.4%) were female. Ages ranged from 17 to 62 where the mean was 21.86
and the SD = 6.72. With regard to race/ethnicity, 86.5% of participants reported
being Caucasian/White, and 5% reported being African-American/Black.
Measures
• A demographic questionnaire was used to gather self-reported information on
age, sex, and race/ethnicity.
• The Childhood Trauma Questionnaire (CTQ) short-form was used to measure
childhood maltreatment which included a 28-item self- report that measures 5
types of maltreatment: emotional, physical, and sexual abuse, and emotional and
physical neglect. A 5-point Likert scale was used for the responses which range
from “Never True” to “Very Often True” (Bernstein, et.al, 1997). Instrument
reliability is reflected by high internal consistency computed with Cronbach’s
alpha (Cronbach, 1951); the current study shows a total scale alpha = .92.
• The Center for Epidemiologic Studies Depression Scale (CES-D), a short 20item self- report designed to measure depressive symptoms, was used to measure
depression. Participants responded to items by choosing: “Rarely or none of the
time” (less than 1 day), “some or little of the time” (1-2 days), “occasionally or a
moderate amount of time” (3-4 days) or “most or all of the time” (5-7 days). The
current study showed the CES-D scale had an alpha = .91.
RESULTS
• An independent samples t-test was calculated to assess differences in reporting
of childhood maltreatment and depression between females and males. There
were no significant sex differences on any study variables. See Figure 1 for
mean scores and standard deviations on all scale scores.
• H1: Supported. A moderate significant relationship was observed between all
forms of childhood maltreatment and depression.
• H2: Not Supported: There was no significant differences between depression
scores for females versus males.
Figure 1. Mean Scores for All Participants on Study Variables
45.00
39.31
40.00
SD
=
14.77
35.00
OBJECTIVE / HYPOTHESIS
Mean Score
• This study sought to examine relationships between childhood
maltreatment (including physical, sexual and emotional abuse) and adult
depression and the differences between the sexes on relevant variables.
Hypotheses
• H1: There will be a significant, positive relationship between scores on
measures of various types of childhood maltreatment and scores on a
measure of depression.
• H2: Females will have significantly higher depression scores than males.
25.00
20.00
15.59
15.00
10.00
5.00
9.03
SD
=
4.89
7.42
SD
=
3.35
9.35
6.45
SD
=
4.10
SD
=
4.71
SD
=
10.38
9.93
7.83
SD
=
2.86
SD
=
3.67
.00
CTQ -EA CTQ -PA CTQ -SA CTQ -EN CTQ -PN CTQ -MD CTQ -Tot
CTQ
EA
CTQ
PA
CTQ
SA
CTQ
EN
CTQ
PN
CTQ
MD
CTQ
TOT
CESD
CTQ
EA
---
.60**
.36**
.70**
.58**
-.67**
.88**
.40**
CTQ
PA
.60**
---
.36**
.46**
.50**
-.41**
.75**
.22**
CTQ
SA
.36**
.36**
---
.28**
.32**
-.21**
.63**
.31**
CTQ
EN
.70**
.46**
.28**
---
.60**
-.78**
.84**
.46**
CTQ
PN
.58**
.50**
.32**
.60**
---
-.46**
.76**
.45**
CTQ
MD
-.67**
-.41**
-.21**
-.78**
-.46**
---
-.68**
-.45**
CTQ
TOT
.88**
.75**
.63**
.84**
.76**
-.68**
---
.50**
CESD
.40**
.22**
.31**
.46**
.45**
-.45**
.50**
---
Note: **= p < .01; CTQ = Childhood Trauma Questionnaire; A = Abuse, N = Neglect; Emotional = Emotional; P = Physical; S = Sexual; MD
= Minimization/Denial; TOT = Total Score; CESD = Center for Epidemiologic Studies -Depression Scale.
DISCUSSION
• Relationships between the variables of interest were solidly related to one another as predicted.
The results may be underestimates of the strength of the relationships as individuals often
consciously suppress or censor their reports of traumatic events, due to feelings of shame or
fear of the consequences of disclosure (Allen, 1995; Rogers, 1995). Also, unconscious
processes, such as dissociation or denial, can lead to the inability to recall traumatic
experiences (Allen, 1995; Davis, 1996; Davis & Frawley, 1994; Herman, 1992; Rogers, 1995).
Limitations
• Though it is plausible that childhood maltreatment causes adulthood depression, the nature of
correlational research prohibits making such a statement. Additionally, the sample was
relatively homogenous with regard to race/ethnicity, age, and education, meaning caution must
be used in generalizing results. Finally, there are inherent limitations in all self-reported data.
Future Research
• Future studies might examine the effects of other variables such as family conflict, parental
substance abuse, and other environmental issues, on adulthood psychopathology. Researchers
may also consider the Diathesis-Stress Model, which posits a relationship between genetic
predispositions toward developing various types of mental disorders and life stressors (e.g.,
maltreatment, trauma victimization) that may trigger such disorders (Schumm et al., 2005).
30.00
Objectives
Table 1. Correlations between Study Variables
CESD
Note: CTQ = Childhood Trauma Questionnaire; A = Abuse, N = Neglect; Emotional = Emotional; P = Physical; S = Sexual; MD =
Minimization/Denial; CESD = Depression Measure; No significant differences existed on any scale between males and females.
REFERENCES
Allen, J, G. (1995). The spectrum of accuracy in memories of childhood trauma. Harvard Review of Psychiatry, 3, 84-95.
American Humane Fact Sheet. (2007). http://americanhumane.com/assets/docs/about-us/AU-FS-child-sexual-abuse.pdf
Bernstein, D. P., Ahluvalia, T., Pogge, D., Handelsman, L. (1997). Validity of the Childhood Trauma Questionnaire in an adolescent psychiatric population. Journal of the American Academy of Child & Adolescent Psychiatry,
36 (3), 340-348.
Bushnell J.A., Wells J.E., Oakley-Brown M.A. (1999). Long-term effects of intrafamilial sexual abuse in childhood. Acta Psychiatrica Scandinavica (85), 136–142.
Cronbach, L.J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297-334.
Davies, J.M. & Frawley, M.G. (1994). Treating the adult survivor of childhood sexual abuse. New York: Basic Books.
Hart, S.N., Brassard, M.R., Binggeli, N.J., & Davidson, H.A. (2002). Psychological maltreatment. Thousand Oaks, CA.: Sage Publications, Inc.
Herman, J.L. (1992). Trauma and recovery. New York: Basic Books.
Johnson, R, Kotch, J, Catellier, D, Winsor, J, Dufort, V., Hunter, W. & Amaya-Jackson, L (2002). Adverse behavioral and emotional outcomes from child abuse and witnessed violence. Child Maltreatment, 7(3), 179-186.
Radloff, L.S. (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychology Measurenment, 1, 385-401.doi: 10.1177/0146621677001306
Teicher, M., Samson, J., Polcari, A., & Andersen, S. (2009). Length of time between onset of childhood sexual abuse and emergence of depression in a young adult sample: A retrospective clinical report. Journal of Clinical
Psychiatry, 70(5), 684-691. doi:10.4088/JCP.08m04235
Weiss, E.L., Longhurst J, G., & Mazure C.M. (1999). Childhood Sexual Abuse as a Risk Factor for Depression in Women: Psychosocial and Neurobiological Correlates. American Journal of Psychiatry. (156), 816-828.
CONTACT: Susan Steffey steffeys@goldmail.etsu.edu, Ben Gibson zbwg5@goldmail.etsu.edu, or Chris S. Dula dulac@etsu.edu