Age of onset of child maltreatment predicts long-term mental health outcomes.

The authors tested the hypothesis that children who are maltreated earlier in life are at greater risk for poor psychological functioning in adulthood than those maltreated later in life. Age of onset of maltreatment was assessed with 3 classifications: (a) continuous (ages 0-11 years); (b) dichotomous (early [ages 0-5 years] vs. later [ages 6-11 years]); and (c) developmental (infancy [ages 0-2 years], preschool [ages 3-5 years], early school age [ages 6-8 years], and school age [ages 9-11 years]). Individuals with documented cases of physical and sexual abuse and neglect prior to age 12 (N=496) were followed up and assessed in adulthood. Results indicated that an earlier onset of maltreatment, measured dichotomously and developmentally, predicted more symptoms of anxiety and depression in adulthood, while controlling for gender, race, current age, and other abuse reports. Later onset of maltreatment, measured continuously or developmentally, was predictive of more behavioral problems in adulthood. Implications for the assessment of maltreated children, the prevention of adult psychopathology, and the classification of age of maltreatment onset are discussed.

[1]  C. Widom,et al.  Antisocial personality disorder in abused and neglected children grown up. , 1994, The American journal of psychiatry.

[2]  Philip C. Kendall,et al.  Issues and recommendations regarding use of the Beck Depression Inventory , 1987, Cognitive Therapy and Research.

[3]  Lee N. Robins,et al.  Psychiatric Disorders in America: The Epidemiologic Catchment Area Study , 1990 .

[4]  M. Everson,et al.  Defining maltreatment chronicity: are there differences in child outcomes? , 2005, Child abuse & neglect.

[5]  F. Mandel,et al.  Post-traumatic stress disorder in physically abused adolescents. , 1994, Journal of the American Academy of Child and Adolescent Psychiatry.

[6]  D. Cicchetti,et al.  Failures in the expectable environment and their impact on individual development: The case of child maltreatment: Risk, disorder, and adaptation , 1995 .

[7]  Tuppett M. Yates,et al.  The Long-Term Consequences of Maltreatment in the Early Years: A Developmental Pathway Model to Antisocial Behavior , 2002 .

[8]  C. Zahn-Waxler,et al.  Internalizing problems of childhood and adolescence: Prospects, pitfalls, and progress in understanding the development of anxiety and depression , 2000, Development and Psychopathology.

[9]  D. Cicchetti,et al.  An ecological-transactional analysis of children and contexts: The longitudinal interplay among child maltreatment, community violence, and children's symptomatology , 1998, Development and Psychopathology.

[10]  L. Radloff The CES-D Scale , 1977 .

[11]  D. Cicchetti,et al.  The effects of maltreatment on development during early childhood: Recent studies and their theoretical, clinical, and policy implications. , 1989 .

[12]  E. Erikson Childhood and Society , 1965 .

[13]  B. Gomes-Schwartz,et al.  Severity of emotional distress among sexually abused preschool, school-age, and adolescent children. , 1985, Hospital & community psychiatry.

[14]  D. Parmelee,et al.  Treatment of Child Abuse , 2001 .

[15]  D. Wolfe Child Abuse: Implications for Child Development and Psychopathology. Second Edition. Developmental Clinical Psychology and Psychiatry, Volume 10. , 1987 .

[16]  F. Putnam Dissociation in Children and Adolescents: A Developmental Perspective , 1997 .

[17]  Analogue versus clinical depression: a critical reappraisal. , 1993 .

[18]  J. J. Haugaard Implications of longitudinal research with child witnesses for developmental theory, public policy, and intervention strategies. , 2005, Monographs of the Society for Research in Child Development.

[19]  C. Widom,et al.  Alcohol abuse in abused and neglected children followed-up: are they at increased risk? , 1995, Journal of studies on alcohol.

[20]  D H Barlow,et al.  The development of anxiety: the role of control in the early environment. , 1998, Psychological bulletin.

[21]  The cycle of violence. , 1989, Science.

[22]  Glenn N Saxe,et al.  Pathways to PTSD, part II: Sexually abused children. , 2005, The American journal of psychiatry.

[23]  J. Garbarino,et al.  The maltreatment of youth. , 1997 .

[24]  B. Egeland,et al.  Developmental sequelae of maltreatment in infancy , 1981 .

[25]  J. Garbarino,et al.  Understanding Abusive Families , 1980 .

[26]  D. Cicchetti,et al.  Risk, disorder, and adaptation , 1995 .

[27]  D. Cicchetti,et al.  Organizational Perspective on Cognitive Control Functioning and Cognitive-Affective Balance in Maltreated Children , 1989 .

[28]  B. J. Casey,et al.  Developmental traumatology part II: brain development∗ ∗ See accompanying Editorial, in this issue. , 1999, Biological Psychiatry.

[29]  E. E. Maccoby Social-emotional development and response to stressors. , 1983 .

[30]  R. Agnew Foundation for a General Strain Theory of Crime and Delinquency , 1992, Crime, Inequality and the State.

[31]  C. Widom Child abuse, neglect, and adult behavior: research design and findings on criminality, violence, and child abuse. , 1989, The American journal of orthopsychiatry.

[32]  D. Cicchetti,et al.  Dimensions of child maltreatment and children's adjustment: Contributions of developmental timing and subtype , 2001, Development and Psychopathology.

[33]  M. Rutter,et al.  Stress, coping, and development in children , 1983 .

[34]  Matcheri S Keshavan,et al.  Developmental traumatology part I: biological stress systems∗ ∗ See accompanying Editorial, in this issue. , 1999, Biological Psychiatry.

[35]  C. Patterson,et al.  Pathways from child maltreatment to internalizing problems: Perceptions of control as mediators and moderators , 2001, Development and Psychopathology.

[36]  Peer relationships and self-esteem among children who have been maltreated. , 1998 .

[37]  C. A. Smith,et al.  The importance of timing: The varying impact of childhood and adolescent maltreatment on multiple problem outcomes , 2001, Development and Psychopathology.

[38]  G. Goodman,et al.  Predictors of attributions of self-blame and internalizing behavior problems in sexually abused children. , 2003, Journal of child psychology and psychiatry, and allied disciplines.

[39]  C. Adams-Tucker Proximate effects of sexual abuse in childhood: a report on 28 children. , 1982, The American journal of psychiatry.

[40]  G. S. Pettit,et al.  The timing of child physical maltreatment: A cross-domain growth analysis of impact on adolescent externalizing and internalizing problems , 2001, Development and Psychopathology.

[41]  M. Black,et al.  A follow-up study of behavior problems associated with child sexual abuse. , 1993, Child abuse & neglect.

[42]  E. A. Sirles,et al.  Psychiatric status of intrafamilial child sexual abuse victims. , 1989, Journal of the American Academy of Child and Adolescent Psychiatry.

[43]  D. Cicchetti Toward the development of a scientific nosology of child maltreatment: Personality and psychopathology , 1991 .

[44]  M. Drake Diagnostic and Statistical Manual of Mental Disorders (3rd ed. rev.) , 1988 .

[45]  J. Ogawa,et al.  Development and the fragmented self: Longitudinal study of dissociative symptomatology in a nonclinical sample , 1997, Development and Psychopathology.

[46]  D. Cicchetti,et al.  Child Maltreatment: Theory and Research on the Causes and Consequences of Child Abuse and Neglect , 1989 .

[47]  M. D. Bellis Developmental traumatology: the psychobiological development of maltreated children and its implications for research, treatment, and policy. , 2001 .

[48]  J. Coyne Self-reported distress: analog or Ersatz depression? , 1994, Psychological bulletin.

[49]  C. Widom,et al.  Childhood Victimization, Running Away, and Delinquency , 1999 .

[50]  M. Ainsworth,et al.  Origins of the Sense of Security. (Book Reviews: Patterns of Attachment. A Psychological Study of the Strange Situation) , 1978 .

[51]  A. Beck,et al.  Beck Anxiety Inventory. , 1997 .

[52]  D Cicchetti,et al.  A developmental psychopathology perspective on child abuse and neglect. , 1995, Journal of the American Academy of Child and Adolescent Psychiatry.

[53]  Sexual assault and mental disorders in a community population. , 1988 .

[54]  A. Beck,et al.  An inventory for measuring clinical anxiety: psychometric properties. , 1988, Journal of consulting and clinical psychology.

[55]  M. A. Sedney,et al.  Factors associated with a history of childhood sexual experience in a nonclinical female population. , 1984, Journal of the American Academy of Child Psychiatry.

[56]  C. Widom Posttraumatic stress disorder in abused and neglected children grown up. , 1999, The American journal of psychiatry.

[57]  J. Belsky,et al.  The Pennsylvania Infant and Family Development Project, III: The origins of individual differences in infant-mother attachment: maternal and infant contributions. , 1984, Child development.

[58]  J. Kaufman,et al.  Depressive disorders in maltreated children. , 1991, Journal of the American Academy of Child and Adolescent Psychiatry.