TY - JOUR
T1 - Immediate impact of child maltreatment on mental, developmental, and physical health trajectories
AU - Winter, Sibylle M.
AU - Dittrich, Katja
AU - Dörr, Peggy
AU - Overfeld, Judith
AU - Moebus, Imke
AU - Murray, Elena
AU - Karaboycheva, Gergana
AU - Zimmermann, Christian
AU - Knop, Andrea
AU - Voelkle, Manuel
AU - Entringer, Sonja
AU - Buss, Claudia
AU - Haynes, John Dylan
AU - Binder, Elisabeth B.
AU - Heim, Christine
N1 - Funding Information:
This report is part of the Berlin Longitudinal Children Study that investigates the immediate biological embedding of maltreatment in children, funded by the Federal Ministry of Education and Research (01KR1301) and conducted at Charité − Universitätsmedizin Berlin, Germany. The aim of the larger study was to identify biological processes at multiple levels of regulation in the immediate aftermath of exposure and over time (every 6 months for up to 2 years) and to associate these processes with clinical and developmental trajectories over time. The present report presents clinical and developmental data obtained in this study.
Funding Information:
This study was funded by the Federal Ministry of Education & Research 01KR1301‐A to C.H. and 01KR1301‐B to E.B.B.
Funding Information:
The authors thank LO White and colleagues, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Leipzig, Germany, for providing German versions of the Maternal Maltreatment Classification Interview and the Preschool Age Psychiatric Assessment. This study was funded by the Federal Ministry of Education & Research 01KR1301-A to C.H. and 01KR1301-B to E.B.B. C.H., S.M.W., and K.D. wrote the manuscript. C.H., S.M.W., J-D.H., and E.B.B. conceived of the study and acquired the funding. S.M.W., C.H., K.D., P.D., and J.O. implemented the study procedures. S.M.W. supervised the clinical study procedures. K.D., P.D., J.O., I.M., E.M., G.K., C.Z., A.K. collected the data. K.D. and M.V. ran the statistical analyses. G.K. assisted in manuscript development. C.B., S.E., and M.V. edited the manuscript. C.H., S.M.W., K.D., P.D., J.O., E.M., G.K., C.Z., A.K. report no competing interests. E.B.B is co-inventor on “FKBP5: a novel target for antidepressant therapy, European Patent# EP 16 1687443 B1” and receives a research grant from Böhringer-Ingelheim for a collaboration on 17 functional investigations of FKBP5, which is relevant to the larger Berlin Longitudinal Children Study. The remaining authors have declared that they have no competing or potential conflicts of interest. Open access funding enabled and organized by ProjektDEAL.Key points Child maltreatment is a risk factor for mental and physical disorders across the lifespan. We here report stable trajectories of marked mental and physical–medical symptoms as well as developmental impairments in the immediate aftermath of exposure to maltreatment and over 2 years in very young children. Marked symptoms and impairments can be observed even after mild forms of maltreatment at all time points. Clinical trajectories are best predicted by onset age and lifetime severity. This observation supports an early biological embedding model that may provide direct mechanism-driven targets for intervention. Child maltreatment is a risk factor for mental and physical disorders across the lifespan. We here report stable trajectories of marked mental and physical–medical symptoms as well as developmental impairments in the immediate aftermath of exposure to maltreatment and over 2 years in very young children. Marked symptoms and impairments can be observed even after mild forms of maltreatment at all time points. Clinical trajectories are best predicted by onset age and lifetime severity. This observation supports an early biological embedding model that may provide direct mechanism-driven targets for intervention.
Publisher Copyright:
© 2022 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.
PY - 2022/9
Y1 - 2022/9
N2 - Objective: The immediate impact of child maltreatment on health and developmental trajectories over time is unknown. Longitudinal studies starting in the direct aftermath of exposure with repeated follow-up are needed. Method: We assessed health and developmental outcomes in 6-month intervals over 2 years in 173 children, aged 3–5 years at study entry, including 86 children with exposure to emotional and physical abuse or neglect within 6 months and 87 nonmaltreated children. Assessments included clinician-administered, self- and parent-report measures of psychiatric and behavioral symptoms, development, and physical health. Linear mixed models and latent growth curve analyses were used to contrast trajectories between groups and to investigate the impact of maltreatment features on trajectories. Results: Maltreated children exhibited greater numbers of psychiatric diagnoses (b = 1.998, p <.001), externalizing (b = 13.29, p <.001) and internalizing (b = 11.70, p <.001) symptoms, impairments in cognitive (b = −11.586, p <.001), verbal (b = −10.687, p <.001), and motor development (b = −7.904, p =.006), and greater numbers of medical symptoms (b = 1.021, p <.001) compared to nonmaltreated children across all time-points. Lifetime maltreatment severity and/or age at earliest maltreatment exposure predicted adverse outcomes over time. Conclusion: The profound, immediate, and stable impact of maltreatment on health and developmental trajectories supports a biological embedding model and provides foundation to scrutinize the precise underlying mechanisms. Such knowledge will enable the development of early risk markers and mechanism-driven interventions that mitigate adverse trajectories in maltreated children.
AB - Objective: The immediate impact of child maltreatment on health and developmental trajectories over time is unknown. Longitudinal studies starting in the direct aftermath of exposure with repeated follow-up are needed. Method: We assessed health and developmental outcomes in 6-month intervals over 2 years in 173 children, aged 3–5 years at study entry, including 86 children with exposure to emotional and physical abuse or neglect within 6 months and 87 nonmaltreated children. Assessments included clinician-administered, self- and parent-report measures of psychiatric and behavioral symptoms, development, and physical health. Linear mixed models and latent growth curve analyses were used to contrast trajectories between groups and to investigate the impact of maltreatment features on trajectories. Results: Maltreated children exhibited greater numbers of psychiatric diagnoses (b = 1.998, p <.001), externalizing (b = 13.29, p <.001) and internalizing (b = 11.70, p <.001) symptoms, impairments in cognitive (b = −11.586, p <.001), verbal (b = −10.687, p <.001), and motor development (b = −7.904, p =.006), and greater numbers of medical symptoms (b = 1.021, p <.001) compared to nonmaltreated children across all time-points. Lifetime maltreatment severity and/or age at earliest maltreatment exposure predicted adverse outcomes over time. Conclusion: The profound, immediate, and stable impact of maltreatment on health and developmental trajectories supports a biological embedding model and provides foundation to scrutinize the precise underlying mechanisms. Such knowledge will enable the development of early risk markers and mechanism-driven interventions that mitigate adverse trajectories in maltreated children.
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U2 - 10.1111/jcpp.13550
DO - 10.1111/jcpp.13550
M3 - Article
C2 - 35266137
AN - SCOPUS:85126005066
SN - 0021-9630
VL - 63
SP - 1027
EP - 1045
JO - Journal of Child Psychology and Psychiatry and Allied Disciplines
JF - Journal of Child Psychology and Psychiatry and Allied Disciplines
IS - 9
ER -