Conscious memories of childhood maltreatment strongly associated with psychopathology

New analysis from the Institute of Psychiatry, Psychology & Neuroscience at King's College London has found that an individual's conscious recollection of child maltreatment is strongly associated with psychopathology.

The research, published in JAMA Psychiatry, analyzed studies of both "retrospective" and "prospective" measures of childhood maltreatment, and their association with psychopathology—a collection of symptoms ranging from internalizing problems like depression and anxiety to externalizing problems such as antisocial behavior and substance abuse.

Retrospective measures refer to first-person, subjective recollections of childhood events, while prospective measures typically refer to third-person accounts of childhood events, such as from parental testimony or official records.

In a meta-analytic review of 24 studies covering 15,485 individuals, psychopathology was more strongly associated with retrospective measures of childhood maltreatment than prospective measures, suggesting that it is the personal memories of abuse or neglect at a young age and the meanings we attached to them that may contribute to psychopathology later in life.

"Psychoanalytic and physical theories of mental ill-health generally focus on unconscious memories that cannot be accessed by a person's voluntary recollection. In contrast, our findings support theories that one's individual interpretation of events, conscious remembering, and the associated thought patterns are more strongly linked with psychopathology than the mere events themselves," says Dr. Jessie Baldwin, Ph.D., Visiting Researcher, IoPPN and Senior Research Fellow, UCL. Dr. Baldwin is the first author of the study.

Child maltreatment encompassed a range of traumatic experiences between birth and the age of 18, including physical, sexual and emotional abuse; or physical or emotional neglect.

Researchers found that the associations between retrospective measures of child maltreatment and psychopathology were particularly strong when the assessment of psychopathology was based on self-reports and focused on emotional disorders such as depression or anxiety.

Furthermore, retrospective reports of emotional abuse showed stronger associations with psychopathology compared to retrospective reports of other types of maltreatment.

Researchers suggest that the findings could have important implications for the treatment of mental health issues that stem from childhood maltreatment. In particular, it highlights the potential role of autobiographical memories of childhood maltreatment, which has not been explored in dominant theories on the outcomes of maltreatment.

"Our results indicate that evidence-based treatment for trauma-related psychopathology, such as trauma-focused cognitive behavioral therapy, and novel memory therapeutics may hold the key to softening the impact of childhood maltreatment on mental health," says researcher Oonagh Coleman, Ph.D. student, IoPP.

Professor Andrea Danese, MD, Ph.D., Professor of Child & Adolescent Psychiatry at the IoPPN, adds, "The role of autobiographical memory in psychopathology has been largely underappreciated outside the work on Post-Traumatic Stress Disorder (PTSD). Advancements in this area can provide novel insights into prevention and treatment for the broad range of psychological disorders emerging after traumatic experiences in childhood."

The study's authors note that the associations between retrospective measures of child maltreatment and psychopathology might be inflated, particularly for emotional disorders, due to recall bias. For example, evidence suggests that increases in depressive symptoms over time may lead to small increases in retrospective reports of maltreatment. However, other recent research from the team suggests that recall bias is unlikely to explain the findings, suggesting that individuals' memories of maltreatment may contribute to the development of psychopathology.