The impact of childhood maltreatment on depressive and anxiety disorders: Examining personal characteristics, childhood maltreatment domains, and remission

Date Published: 

Hovens, J.G., Giltay, E.J., van Hemert, A.M., & Penninx, B.W. (2016). Childhood maltreatment and the course of depressive and anxiety disorders: The contribution of personality characteristics. Depression and Anxiety, 33(1), 27-34.

Reviewed by: 
David Blatt
Tara Black
Barbara Fallon

The purpose of this study was to explore the relationship between childhood maltreatment and personality characteristics in order to determine the chance of remission of depressive and anxiety disorders in adults. Data was gathered from a longitudinal cohort study (Netherlands Study of Depression and Anxiety) that included 2,981 participants, aged 18–65 years. The study reports data from baseline, 2-year, and 4-year follow-up assessments of adults who had a depressive and/or anxiety disorder within the past 6 months (the response rate was 49.4%; n=1,474).

At baseline, the lifetime presence of depressive and/or anxiety disorders were diagnosed using the Composite International Diagnostic Interview (CIDI). The Life Chart Interview (LCI) was used to determine the time to remission of depressive and/or anxiety disorders. At the 2- and 4-year follow-up assessments, the CIDI and LCI were repeated to determine if participants still presented depressive and anxiety disorders. Remission of depressive and anxiety disorders was defined as the absence of both depressive and/or anxiety symptoms during 3 consecutive months, based on the LCI. Participants were asked to score the frequency of their childhood maltreatment on a 5-point scale (i.e., once, sometimes, regularly, often, and very often). These frequencies were divided into three groups (i.e., no childhood maltreatment, mild childhood maltreatment, and severe childhood maltreatment). Using the sum scores of the 5-point scale and the three frequency groups, a cumulative childhood maltreatment score was created ranging from 0 to 8.

The authors studied the relationship between maltreatment and: demographic characteristics (e.g., age, gender, education level, household income, and unemployment); psychosocial characteristics (e.g., social network size, partner present, friends(s) present, loneliness, and number of adverse events); personality characteristics (e.g., neuroticism, extraversion, openness, agreeableness, conscientiousness, depression, hopelessness/suicidality, and external locus of control). The authors found that:

• All socioeconomic and psychosocial characteristics (except the presence of friends), were significantly associated with the severity of childhood maltreatment status and all personality characteristics were strongly associated with severity of childhood maltreatment status
• Emotional neglect and psychological abuse were significantly associated with all socioeconomic and psychosocial characteristics, except for unemployment
• Emotional neglect was the only significant predictor of poor 4-year remission for depressive and/or anxiety disorder
• A higher cumulative childhood maltreatment score was predictive of a lower likelihood of the 4-year remission for depressive and/or anxiety disorders.
• Higher levels of the personality characteristics of neuroticism, hopelessness, and external locus of control and lower levels of the personality characteristic of extraversion strongly mediated the unfavourable 4-year course of depressive and anxiety disorders, in patients with a history of childhood maltreatment. The authors noted that these results are suggestive of the strong mediating effects of personality characteristics on the association between childhood maltreatment and remission rates.

Methodological notes: 

Retrospective assessment of childhood maltreatment at baseline was gathered. However, the recall of childhood maltreatment did not seem critically affected by current mood state. Since data was gathered only from the participant’s evaluations, their assessment may be affected by their own bias and further affected by their ability to accurately remember past events. The participants were having current depressive and anxiety disorders; this may have caused some personality measurements to become contaminated due to the participants’ current state. As well, measures of personality were based on limited self-reports. The Leiden Index of Depression Sensitivity Revised (LEIDS-R) was used to evaluate hopelessness and rumination. It is a 34-item self-report questionnaire that measures cognitive reactivity in response to low mood. It has been shown to reliably distinguish between depression-vulnerable and healthy populations.