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Childhood Adversities and Complex Adult Psychopathology: Findings from the National Comorbidity Survey Replication (NCS-R) Study

Putnam, Karen T.
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1312482924

Abstract Details

2011, PhD, University of Cincinnati, Medicine: Epidemiology (Environmental Health).
Mental disorders affect over 26% of Americans aged 18 and older. For individuals having lifetime psychiatric diagnoses, comorbidity with one or more psychiatric disorders is common and occurs in 35-50% of adults with a mental illness. Retrospective epidemiological studies have reported significant associations between childhood adversities and adult mental disorders. Using the National Comorbidity Survey Replication (NCS-R) data, the central study objective examined how patterns of childhood adversities contribute to complex clusters of lifetime psychiatric disorders in adults, defined by the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-IV). Childhood adversities of 1) sexual abuse, 2) physical abuse, 3) parental depression or anxiety, 4) parental alcohol or drug abuse, 5) living with one or no biological parent, 6) domestic violence, 7) being a crime victim, and 8) economic hardship were examined. The study examined two related hypotheses. The aims for the first hypothesis included: to import, review and subset NCS-R data, and next characterize descriptive epidemiology for DSM-IV mental disorder groupings and complex adult psychopathology with associations to childhood adversities by gender and age cohorts. Complex adult psychopathology is defined as clustering of two or more lifetime DSM-IV diagnoses spanning more than one clinical disorder group (mood, anxiety, impulse, substance abuse). It was hypothesized that childhood adversities patterns and the associations to subsequent complex adult psychopathology profiles would differ by gender and age cohorts. Gender-related differences in disorder rates were present in all four mental disorder groups but not in complex adult psychopathology. Males had higher prevalence rates of impulse and substance abuse, while females had higher rates of anxiety and mood disorders. Childhood sexual abuse occurred almost four times more often in females, who subsequently had significantly higher rates of anxiety and mood disorders compared with males. Age-related differences were present in impulse disorders for both genders. Being a childhood crime victim was reported more in males, who had higher proportions of adult impulse disorders. Being exposed to no childhood adversities showed a protective trend against subsequent development of complex adult psychopathology. Exposure to a single adversity did not increase the risk of complex adult psychopathology. Second, it was hypothesized that males and females would have different pairwise interactions among childhood adversities associated with subsequent outcomes of complex DSM-IV internalizing and externalizing profiles. The two aims for the second hypothesis included determining the best two-factor common structure for 19 DSM-IV disorders, and assessment of additive and multiplicative interactions among childhood adversity patterns and complex adult psychopathology outcomes. Economic hardship and sexual abuse worked synergistically with other childhood adversities for the subsequent development of the complex profile of co-occurring internalizing and externalizing disorders. Parental depression and anxiety disorders were also synergistic in both males and females with other adversities. This study provides novel descriptive epidemiology in table format, examining age and gender related differences, combinations and trends for childhood adversities, common mental illnesses and complex adult psychopathology. The research supports the hypothesis that environmental risk factors of childhood maltreatment are associated with co-occurring psychiatric disorder profiles.
Kim Dietrich, PhD (Committee Chair)
Chad Shenk, PhD (Committee Member)
Erin Nicole Haynes, PhD (Committee Member)
Paul Succop, PhD (Committee Member)
112 p.
Mental Health
Mental Disorders; Complex Adult Psychopathology; Childhood adversities; prevalence; epidemiology; NCS-R

Recommended Citations

Citations

  • Putnam, K. T. (2011). Childhood Adversities and Complex Adult Psychopathology: Findings from the National Comorbidity Survey Replication (NCS-R) Study [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1312482924

    APA Style (7th edition)

  • Putnam, Karen. Childhood Adversities and Complex Adult Psychopathology: Findings from the National Comorbidity Survey Replication (NCS-R) Study. 2011. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1312482924.

    MLA Style (8th edition)

  • Putnam, Karen. "Childhood Adversities and Complex Adult Psychopathology: Findings from the National Comorbidity Survey Replication (NCS-R) Study." Doctoral dissertation, University of Cincinnati, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1312482924

    Chicago Manual of Style (17th edition)

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© 2011, all rights reserved.
This open access ETD is published by University of Cincinnati and OhioLINK.