Childhood physical maltreatment, perceived social isolation, and internalizing symptoms: a longitudinal, three-wave, population-based study
A number of cross-sectional studies have consistently shown a correlation between childhood physical maltreatment, perceived social isolation and internalizing symptoms. Using a longitudinal, three-wave design, this study sought to assess the mediating role of perceived social isolation in adulthood in the association between childhood physical maltreatment and internalizing symptoms in adulthood. The study has a three-wave design. We used data collected from 1994 to 2008 within the framework of the Tromsø Study (N = 4530), a representative prospective cohort study of men and women. Perceived social isolation was measured at a mean age of 54.7 years, and internalizing symptoms were measured at a mean age of 61.7 years. The difference-in-coefficients method was used to assess the indirect effects and the proportion (%) of mediated effects. Childhood physical maltreatment was associated with an up to 68% [relative risk (RR) = 1.68, 95% confidence interval (CI): 1.33–2.13] higher risk of perceived social isolation in adulthood. Childhood physical maltreatment and perceived social isolation in adulthood were associated with greater levels of internalizing symptoms in adulthood (p < 0.01). A dose-response association was observed between childhood physical maltreatment and internalizing symptoms in adulthood (p < 0.001). Perceived social isolation in adulthood mediated up to 14.89% (p < 0.05) of the association between childhood physical maltreatment and internalizing symptoms in adulthood. The results of this study indicate the need to take perceived social isolation into account when considering the impact of childhood physical maltreatment on internalizing symptoms.
KeywordsPsychological well-being Psychological distress Social support Anxiety Depression Childhood abuse Emotional distress Loneliness
I am thankful to Jan Abel Olsen and Birgit Abelsen for their collaboration throughout the project that resulted in this manuscript.
Compliance with ethical standards
Conflict of interest
The author declared no conflicts of interest with respect to the authorship or the publication of this article.
This research was funded by the University of Tromsø.
This investigation was carried out in accordance with the latest version of the Declaration of Helsinki. The Tromsø study has been approved by the Regional Committee for Medical and Health Research Ethics, the Data Inspectorate, and the Norwegian Directorate of Health. Written informed consent was obtained from all individual participants included in the study.
- 4.Sheikh MA (2018) The potential protective effect of friendship on the association between childhood adversity and psychological distress in adulthood: a retrospective, preliminary, three-wave population-based study. J Affect Disord 226:21–27. https://doi.org/10.1016/j.jad.2017.09.015 CrossRefPubMedGoogle Scholar
- 14.Herrenkohl TI, Klika JB, Herrenkohl RC, Russo MJ, Dee T (2012) A prospective investigation of the relationship between child maltreatment and indicators of adult psychological well-being. Violence Vict 27(5):764–776. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501987/ CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Wright MOD, Folger SF (2017) Creating a safe haven following child maltreatment: the benefits and limits of social support. In: Teti DM (ed) Parenting and family processes in child maltreatment and intervention. Springer International Publishing, Cham, pp 23–34. https://doi.org/10.1007/978-3-319-40920-7_2 CrossRefGoogle Scholar
- 26.Goodwin-Smith I, Hill K, Due C, Waterford M, Corrales T, Wood L, Yourell T, Ho C (2017) ‘I’m not a barcode or case file number’: understandings of perceived social support and belonging within disadvantaged adolescents and young adults. J Fam Stud. https://doi.org/10.1080/13229400.2016.1268191 Google Scholar
- 39.Perlman D, Peplau LA (1981) Toward a social psychology of loneliness. In: Duck S, Gilmour R (eds) Personal relationships: personal relationships in disorder, vol 3. Academic Press, London, pp 31–56Google Scholar
- 40.Oetzel J, Duran B, Jiang Y, Lucero J (2007) Social support and social undermining as correlates for alcohol, drug, and mental disorders in American Indian Women Presenting for Primary Care at an Indian Health Service Hospital. J Health Commun 12(2):187–206. https://doi.org/10.1080/10810730601152771 CrossRefPubMedGoogle Scholar
- 41.Landstedt E, Gustafsson PE, Johansson K, Hammarström A (2016) Longitudinal associations between social relationships at age 30 and internalising symptoms at age 42: findings from the Northern Swedish Cohort. Inte J Public Health 61(1):75–81. https://doi.org/10.1007/s00038-015-0691-x CrossRefGoogle Scholar
- 57.Weber LJ, Cummings AL (2003) Research and theory: relationships among spirituality, social support and childhood maltreatment in university students. Couns Values 47(2):82–95. https://doi.org/10.1002/j.2161-007X.2003.tb00226.x CrossRefGoogle Scholar
- 63.Briggs-Gowan MJ, Carter AS, Clark R, Augustyn M, McCarthy KJ, Ford JD (2010) Exposure to potentially traumatic events in early childhood: differential links to emergent psychopathology. J Child Psychol Psychiatry 51(10):1132–1140. https://doi.org/10.1111/j.1469-7610.2010.02256.x CrossRefPubMedPubMedCentralGoogle Scholar
- 65.Sheikh MA, Abelsen B, Olsen JA (2014) Role of respondents’ education as a mediator and moderator in the association between childhood socio-economic status and later health and wellbeing. BMC Public Health 14(1):1172. https://doi.org/10.1186/1471-2458-14-1172 CrossRefPubMedPubMedCentralGoogle Scholar
- 75.Reuben A, Moffitt TE, Caspi A, Belsky DW, Harrington H, Schroeder F, Hogan S, Ramrakha S, Poulton R, Danese A (2016) Lest we forget: comparing retrospective and prospective assessments of adverse childhood experiences in the prediction of adult health. J Child Psychol Psychiatr 57(10):1103–1112. https://doi.org/10.1111/jcpp.12621 CrossRefGoogle Scholar
- 77.Fisher HL, Craig TK, Fearon P, Morgan K, Dazzan P, Lappin J, Hutchinson G, Doody GA, Jones PB, McGuffin P, Murray RM, Leff J, Morgan C (2009) Reliability and comparability of psychosis patients’ retrospective reports of childhood abuse. Schizophr Bull 37(3):546–553. https://doi.org/10.1093/schbul/sbp103 CrossRefPubMedPubMedCentralGoogle Scholar
- 79.Robins LN, Schoenberg SP, Holmes SJ, Ratcliff KS, Benham A, Works J (1985) Early home environment and retrospective recall: a test for concordance between siblings with and without psychiatric disorders. Am J Orthopsychiatr 55(1):27–41. https://doi.org/10.1111/j.1939-0025.1985.tb03419.x CrossRefGoogle Scholar
- 81.Brown GW, Craig TKJ, Harris TO, Handley RV, Harvey AL (2007) Validity of retrospective measures of early maltreatment and depressive episodes using the Childhood Experience of Care and Abuse (CECA) instrument—a life-course study of adult chronic depression—2. J Affect Disord 103(1–3):217–224. https://doi.org/10.1016/j.jad.2007.06.003 CrossRefPubMedGoogle Scholar
- 85.Patten SB, Wilkes TCR, Williams JVA, Lavorato DH, el-Guebaly N, Schopflocher D, Wild C, Colman I, Bulloch AGM (2015) Retrospective and prospectively assessed childhood adversity in association with major depression, alcohol consumption and painful conditions. Epidemiol Psychiatric Sci 24(2):158–165. https://doi.org/10.1017/S2045796014000018 CrossRefGoogle Scholar
- 87.Björkenstam E, Burström B, Brännström L, Vinnerljung B, Björkenstam C, Pebley AR (2015) Cumulative exposure to childhood stressors and subsequent psychological distress. An analysis of US panel data. Soc Sci Med 142:109–117. https://doi.org/10.1016/j.socscimed.2015.08.006 CrossRefPubMedGoogle Scholar
- 88.Davies SJC, Pearson RM, Stapinski L, Bould H, Christmas DM, Button KS, Skapinakis P, Lewis G, Evans J (2015) Symptoms of generalized anxiety disorder but not panic disorder at age 15 years increase the risk of depression at 18 years in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort study. Psychol Med 46(1):73–85. https://doi.org/10.1017/S003329171500149X CrossRefPubMedPubMedCentralGoogle Scholar
- 92.McGuffin P, Katz R, Watkins S, Rutherford J (1996) A hospital-based twin registry study of the heritability of DSM–IV unipolar depression. Arch Gen Psychiatr 53(2):129–136. https://doi.org/10.1001/archpsyc.1996.01830020047006 CrossRefPubMedGoogle Scholar
- 93.Johnson JG, Cohen P, Dohrenwend BP, Link BG, Brook JS (1999) A longitudinal investigation of social causation and social selection processes involved in the association between socioeconomic status and psychiatric disorders. J Abnorm Psychol 108(3):490–499. https://doi.org/10.1037/0021-843X.108.3.490 CrossRefPubMedGoogle Scholar