Collishaw Et Al. (2007)
Collishaw Et Al. (2007)
Collishaw Et Al. (2007)
004
Copyright © 2007 Elsevier Ltd All rights reserved.
Abstract
Objective
Methods
Results
Ten percent of individuals reported repeated or severe
physical or sexual abuse in childhood. Prospective measures
revealed increased rates of adolescent psychiatric disorders
in this group. Rates of adult psychopathology were also high.
A substantial minority of abused individuals reported no
mental health problems in adult life. Resilience of this kind
was related to perceived parental care, adolescent peer
relationships, the quality of adult love relationships, and
personality style.
Conclusion
Article Outline
Introduction
Aims and hypotheses
Method
Sample and design
The Isle of Wight study—adolescence (1968)
The Isle of Wight follow-up study (1998–2000)
Prospective measures collected in adolescence
Psychopathology
Peer relationships
Family functioning and demographics
Retrospective measures collected in adulthood
Childhood abuse
Adult psychopathology
Parental care
The Adult Personality Functioning Assessment (APFA)
Relationship history
Personality
Crime
Self-rated health
“Quality of relationships” index (adolescent/adult composite)
Analysis strategy
Results
Cumulative incidence and characteristics of reported abuse in
childhood
Adolescent correlates of child abuse
Adult psychopathology
Resilience in the abused group
Predictors of resilience to adult psychopathology (abused group
only)
General or abuse-specific predictors of adult psychopathology
Discussion
Main findings
Strengths and limitations
Extent of resilience to adult psychopathology
Predictors of resilience to adult psychopathology
Individual characteristics
Adolescent family adversity
Adolescent psychiatric impairment
Interpersonal relationships
Acknowledgements
References
Introduction
Child abuse is a serious and common risk that affects the long-
term mental health of individuals in profound ways. However, a
growing body of evidence indicates that the mental health of a
substantial minority of abused individuals appears relatively
unaffected (McGloin & Widom, 2001). Gaining a fuller
understanding of the factors and processes involved in
positive adaptation is important for several reasons.
Theoretically, models of resilience have the potential to enhance
the understanding of the mechanisms by which abuse affects
psychosocial development. Clinically, some protective factors may
be amenable to external manipulation and could thus present a
potential focus for future treatments and interventions. The present
study uses longitudinal data from a general population sample
studied first in adolescence and again at mid-life to examine
correlates and outcomes of childhood abuse, the extent of
resilience for adult psychopathology, and the factors that best
predict such resilience.
Current evidence also makes clear, however, that not all abused
children go on to experience mental health problems later in life. A
number of reviews have estimated that around a third of individuals
who have experienced sexual abuse will not exhibit adult
psychiatric problems (e.g., Fergusson & Mullen, 1999; Stevenson,
1999). McGloin and Widom (2001) found that 48% of children with
documented histories of abuse or neglect did not meet criteria for
adult psychiatric disorders including depression, anxiety, PTSD
and ASPD, while 38% had not had a diagnosis for substance
abuse. Examining successful functioning over a broad range of
domains of adult psychosocial functioning, 22% were classified as
“resilient.”
Method
Psychopathology
Peer relationships
Childhood abuse
Adult psychopathology
Parental care
Relationship history
Personality
Crime
Self-rated health
Analysis strategy
Data
Adolescent at Reporting Reporti
study (N) follow abuse (N) abuse (
up (N)
a
Total cumulative incidence of abuse estimated as
236/2291 = 10.3%.
b
16 children with severe retardation excluded.
Results
Table 2.
No
Abuse
abuse OR [CI]a p
a (%)a
(%)
No
Abuse
abuse OR [CI]a p
(%)a
(%)a
Prospectively ascertained
Socio-economic factors
Social class (semi- or unskilled) 33.1 32.1 1.04 [.4–3.1] Ns
Rented accommodation 47.6 77.4 3.77 [1.1–13.4] .04
Family size (4+ siblings) 23.2 27.6 1.26 [.4–4.0] Ns
Family functioning
Parental divorce/separation 15.3 41.5 3.91 [1.2–12.4] .02
3+ separations from mother 11.3 47.0 6.97 [2.1–23.3] .002
Parental discord 3.4 22.5 8.16 [1.7–40.3] .01
Maternal psychopathology 8.9 30.7 4.56 [1.2–17.2] .03
Service use (2+ in past year) 13.6 31.7 2.95 [.8–10.4] .09
Retrospectively ascertained
Parental care
Low care—mother 21.1 58.8 5.33 [1.8–15.5] .002
Low care—father 29.2 57.8 3.29 [1.1–9.8] .03
Low care—both 10.3 44.4 6.81 [2.2–21.5] .001
a
Proportions and analyses weighted to account for study design
and attrition.
Table 3 summarizes associations between reported abuse and
assessments of adolescent psychopathology and peer
relationships. Abused individuals were considerably more likely to
have suffered from adolescent minor depression or anxiety
disorder than non-abused study members, and had increased
odds for adolescent suicidal ideation and marginally elevated rates
of adolescent conduct disorder. Abuse was also significantly
associated with dysfunctional adolescent peer relationships.
Table 3.
No
Abuse
abuse OR [CI]a p
(%)a
(%)a
a
Proportions and analyses weighted to account for study design
and attrition; all analyses controlled for gender.
Adult psychopathology
Table 4.
No
Abuse
abuse OR [CI]a p
(%)a
(%)a
Table 5.
N w/o % N %
factor Resilient w/factor Resilient
Table 6.
N w/o % N
factor Resilient w/factor R
Individual characteristics
Gender (male) 24 33.3 20 3
IQ > 100 15 46.7 28 2
Neuroticism (top quartile) 23 47.8 18 1
Adolescent factors
Family adversity index (2+) 23 43.5 21 1
Maternal psychiatric disorder 22 31.8 12 2
Adolescent psychiatric disorder 20 50.0 23 1
Normal peer relationships 23 13.0 19 5
Either parent rated as caring (PBI—retrospective) 30 20.0 13 6
Adult relationships
Supportive first partner 22 18.2 20 4
Stable relationship history 27 18.5 17 5
Friendships (good APFA rating) 17 11.8 27 4
a
Logistic regression analyses with screen status as covariate to
control for study design.
b
Continuous IQ and EPQ neuroticism scale scores used as
predictors in logistic regression analyses of resilience.
Discussion
Main findings
Individual characteristics
Interpersonal relationships
Our design did not allow us to test the direction of these effects. It
is possible, and indeed likely, that psychiatric problems will
undermine individuals’ relationship competence (e.g., Rao et al.,
1995), just as chronic problems in interpersonal relationships may
elevate the risk of future mental illness (e.g., Brown, Bifulco, &
Andrews, 1990). Our findings suggest that understanding the
processes whereby relationship competencies are developed and
maintained constitutes an important goal for future research on
resilience in individuals exposed to abusive experiences, and may
be a core target for clinical interventions.
Acknowledgements
References
Bulik et al., 2001 C.M. Bulik, C.A. Prescott and K.S. Kendler,
Features of childhood sexual abuse and the development of
psychiatric and substance use disorders, British Journal of
Psychiatry 179 (2001), pp. 444–449. Full Text via CrossRef | View
Record in Scopus |
Caspi et al., 2002 A. Caspi, J. McClay, T.E. Moffitt, J. Mill, J.
Martin, I.W. Craig, A. Taylor and R. Poulton, Role of genotype in
the cycle of violence in maltreated children, Science 297 (2002),
pp. 851–854. Full Text via CrossRef | View Record in Scopus |
Cited By in Scopus
Dodge et al., 1990 K.A. Dodge, J.E. Bates and G.S. Pettit,
Mechanisms in the cycle of violence, Science 250 (1990), pp.
1678–1683. View Record in Scopus |
Dodge et al., 1994 K.A. Dodge, G.S. Pettit and J.E. Bates, Effects
of physical maltreatment on the development of peer relations,
Development and Psychopathology 6 (1994), pp. 43–55.
Glaser, 2000 D. Glaser, Child abuse and neglect and the brain—a
review, Journal of Child Psychology and Psychiatry 41 (2000), pp.
97–116. Full Text via CrossRef | View Record in Scopus | Cited
By in Scopus
Heller et al., 1999 S.S. Heller, J.A. Larrieu, R. D’Imperio and N.W.
Boris, Research on resilience to child maltreatment: Empirical
considerations, Child Abuse & Neglect 23 (1999), pp. 321–338.
Hill, 2003 J. Hill, Childhood trauma and depression, Current
Opinion in Psychiatry 16 (2003), pp. 3–6. Full Text via CrossRef |
View Record in Scopus | Cited By in Scopus
Keiley et al., 2001 M.K. Keiley, T.R. Howe, K.A. Dodge, J.E. Bates
and G.S. Pettit, The timing of child physical maltreatment. A cross-
domain growth analysis of impact on adolescent externalising and
internalising problems, Development and Psychopathology 13
(2001), pp. 891–912. View Record in Scopus | Cited By in Scopus
Lansford et al., 2002 J.E. Lansford, K.A. Dodge, G.S. Pettit, J.E.
Bates, J. Crozier and J. Kaplow, A 12-year prospective study of the
long-term effects of early child physical maltreatment on
psychological, behavioral, and academic problems in adolescence,
Archives of Pediatrics and Adolescent Medicine 156 (2002), pp.
824–830. View Record in Scopus | Cited By in Scopus
Manly et al., 2001 J.T. Manly, J.E. Kim, F.A. Rogosch and D.
Cicchetti, Dimensions of child maltreatment and children's
adjustment: Contributions of developmental timing and subtype,
Development and Psychopathology 13 (2001), pp. 759–782. View
Record in Scopus | Cited By in Scopus
Rao et al., 1995 U. Rao, N.D. Ryan, B. Birmaher, R.E. Dahl, D.E.
Williamson, J. Kaufman, R. Rao and B. Nelson, Unipolar
depression in adolescents—clinical outcome in adulthood, Journal
of the American Academy of Child and Adolescent Psychiatry 34
(1995), pp. 566–578. View Record in Scopus | Cited By in Scopus
Todd et al., 1994 A.L. Todd, P.M. Boyce, A.C. Heath and N.G.
Martin, Shortened versions of the interpersonal sensitivity
measure, parental bonding instrument and intimate bond measure,
Personality and Individual Differences 16 (1994), pp. 323–329.
Abstract | Abstract + References | PDF (693 K)
Werner and Smith, 2001 E.E. Werner and R.S. Smith, Journeys
from childhood to midlife: Risk, resilience and recovery, Cornell
University Press, Ithaca, NY (2001).