The relationship of childhood physical and sexual abuse with depression in young adulthood

1. The relationship of childhood physical and sexual abuse with depression in young adulthood Ellen Jamieson, Harriet MacMillan, Yvonne Racine, Michael Boyle

2. Background • Childhood abuse is associated with emotional-behavioral, social and physical impairments • OCHS provides new community data on association of abuse with depression • Control for childhood disorder measured prior to depression data • Parental disorder self-reported 1983 • Shorter retrospective interval for abuse

3. Community-based studies • ECA: sexual abuse increased risk for lifetime MD (OR 2.4) • NCS: being “physically attacked” was associated with lifetime MD (OR 2.50) • OHSUP: association (OR) w lifetime MD • Physical abuse: women 3.2 men 1.5* • Sexual abuse: women 3.9 men 1.9 • Any abuse: women 3.3 men 1.5*

4. Model Parental psychiatric disorder Childhood psychiatric disorder Physical abuse Depression (12 month) SES 1983 SES 2000 Current age Gender Sexual abuse and any abuse models same as above

5. Definitions

6. Depression • Collected OCHS 2001 • Composite International Diagnostic Interview, Short Form (UM-CIDI SF) • DSM-IV criteria • 12 month prevalence

7. Physical abuse • How many times before age 16 did an adult slap you on the face, head or ears or hit or spank you with something like a belt, wooden spoon or something hard? (3-5 times +) • Before age 16 did an adult push, grab, shove or throw something at you to hurt you? (3-5 times +) • Before age 16 how many times did an adult kick, bite, punch, choke, burn you, or physically attack you in some way? (1-2 times +)

8. Sexual abuse • Before age 16 when you were growing up, did anyone ever do any of the following things when you didn't want them to: touch the private parts of your body or make you touch their private parts, threaten or try to have sex with you or sexually force themselves on you? (1-2 times +)

9. Other constructs • Parent psychiatric disorder: PMK or spouse ever treated for nerves, 1983 • Child psychiatric disorder: internalizing disorder score, parent report, 1983 • SES 1983: derived from parental education, parental occupation (Blishen) and household income • SES 2001: derived from respondent’s and spouse’s education, occupation (Pineo) and household income

10. Results

11. Lifetime prevalence of abuse* * In this sample of 1845/1928 (96%)

12. 12 month prevalence of MDD* * In this sample of 1845/1928 (96%)

13. 12 month prevalence of depression with and without child physical abuse OR 2.3 (1.6 – 3.2)† OR 2.1 (1.6 – 2.8)† OR 2.0 (1.3 – 3.1)† †Adjusted OR

14. 12 month prevalence of depression with and without child sexual abuse OR 2.4 (1.6 – 3.4)† OR 2.6 (1.9 – 3.5)† * *Cell <30 unreportable †Adjusted OR

15. 12 month prevalence of depression with and without any child abuse OR 2.4 (1.7 – 3.3)† OR 2.3 (1.8 – 3.0)† OR 2.2 (1.4 – 3.5)† †Adjusted OR

16. Other significant relationships Controlling for all other factors, and in each model (physical, sexual, any abuse), • Female gender • Parental disorder • SES in childhood • Childhood internalizing disorder significant in bivariate, marginal (p<.10) in full models; highly related to parent disorder, both types of abuse and gender

17. Conclusions • Physical abuse and sexual abuse at least double the risk for depression in young adulthood • Physical abuse is as important a factor as sexual abuse