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The prevalence of family childhood adversities and their association with first onset of DSM-IV disorders in metropolitan China

Published online by Cambridge University Press:  06 April 2010

S. Lee ,
W. J. Guo ,
A. Tsang ,
Y. L. He ,
Y. Q. Huang ,
M. Y. Zhang ,
Z. R. Liu ,
Y. C. Shen  and
R. C. Kessler
S. Lee
Affiliation:
Department of Psychiatry, The Chinese University of Hong Kong, HKSAR, P. R. China Hong Kong Mood Disorders Center, The Chinese University of Hong Kong, HKSAR, P. R. China
W. J. Guo*
Affiliation:
Hong Kong Mood Disorders Center, The Chinese University of Hong Kong, HKSAR, P. R. China
A. Tsang
Affiliation:
Hong Kong Mood Disorders Center, The Chinese University of Hong Kong, HKSAR, P. R. China
Y. L. He
Affiliation:
Shanghai Mental Health Center, P. R. China
Y. Q. Huang
Affiliation:
Institute of Mental Health, Peking University, P. R. China
M. Y. Zhang
Affiliation:
Shanghai Mental Health Center, P. R. China
Z. R. Liu
Affiliation:
Institute of Mental Health, Peking University, P. R. China
Y. C. Shen
Affiliation:
Institute of Mental Health, Peking University, P. R. China
R. C. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School, MA, USA
*
*Address for correspondence: Dr W. J. Guo, Hong Kong Mood Disorders Center, 7A, Block E, Staff Quarters, Prince of Wales Hospital, Shatin, N.T., Hong Kong, P. R. China. (Email: [email protected])
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Abstract

Background

The prevalence of family childhood adversities (FCAs) and their joint effects on the first onset of subsequent mental disorders throughout the life course are rarely examined, especially in Asian communities.

Method

Face-to-face household interviews of 5201 people aged 18–70 years in Beijing and Shanghai were conducted by a multi-stage household probability sampling method. The first onsets of four broad groups of mental disorders and six categories of FCAs were assessed using The World Mental Health Composite International Diagnostic Interview (WMH-CIDI). Joint effects of FCAs were analyzed by the best fitting of several competitive multivariate models.

Results

FCAs were highly prevalent and inter-correlated. Half of them were in a family-dysfunction cluster. The best-fitting model included each of six types of FCA (with family-dysfunction FCAs being the strongest predictors), number of family-dysfunction FCAs, and number of other FCAs. Family-dysfunction FCAs had a significant subadditive association with subsequent disorders. Little specificity was found for the effects of particular FCAs with particular disorders. Predictive effects of FCAs reached the highest in ages 13–24 compared to ages 4–12 and ⩾25. Estimates of population-attributable risk proportions indicated that all FCAs together explained 38.5% of all first-onset disorders.

Conclusions

Chinese children were exposed to a broad spectrum of inter-related FCAs, as found in Western countries. FCAs related to family dysfunction were especially associated with subsequent mental disorders. Biological and/or environmental factors that mediate these long-term effects should be studied in prospective research on broad groups of FCAs.

Keywords

Childhood adversity (CA)Chinafamilyfirst onsetmental disorders
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 1 , January 2011 , pp. 85 - 96
Copyright
Copyright © Cambridge University Press 2010

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References

Amato, PR (1993). Children's adjustment to divorce: theories, hypotheses, and empirical support. Journal of Marriage and Family 55, 23–38.CrossRefGoogle Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Arata, CM, Langhinrichsen-Rohling, J, Bowers, D, O'Brien, N (2007). Differential correlates of multi-type maltreatment among urban youth. Child Abuse and Neglect 31, 393–415.CrossRefGoogle ScholarPubMed
Brown, GW, Bifulco, A, Harris, TO (1987). Life events, vulnerability and onset of depression: some refinements. British Journal of Psychiatry 150, 30–42.CrossRefGoogle ScholarPubMed
Burnham, KP, Anderson, DR (2002). Model Selection and Multimodel Inference: A Practical Information-Theoretic Approach, 2nd edn. Springer-Verlag: New York.Google Scholar
Cao, WS, Yu, HH, Xu, CG, Jiao, ZA (2007). Childhood maltreatment experiences of patients with both obsessive-compulsive disorder and personality disorders [in Chinese]. Chinese Mental Health Journal 21, 481–483, 487.Google Scholar
Caspi, A, Sugden, K, Moffitt, TE, Taylor, A, Craig, IW, Harrington, H, McClay, J, Mill, J, Martin, J, Braithwaite, A, Poulton, R (2003). Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science 301, 386–389.CrossRefGoogle ScholarPubMed
Chang, XL, Wang, HY (2008). Effect of psychological abused and neglect in childhood on adult mental health [in Chinese]. China Journal of Health Psychology 16, 1239–1241.Google Scholar
Chen, CN, Wong, J, Lee, N, Chan-Ho, MW, Lau, TF, Fung, M (1993). The Shatin Community Mental Health Survey in Hong Kong II. Major findings. Archives of General Psychiatry 50, 125–133.CrossRefGoogle Scholar
Chen, J (2005). Childhood physical and emotional maltreatment and its psychological effects in 391 university students in China [in Chinese]. Chinese Journal of School Doctor 19, 341–344.Google Scholar
Chen, J, Dunne, MP, Han, P (2004). Child sexual abuse in China: a study of adolescents in four provinces. Child Abuse and Neglect 28, 1171–1186.CrossRefGoogle Scholar
Chen, J, Zhang, J, Zhang, W, Feng, J (2008). The relationship between childhood abuse and clinical features of depressive patients [in Chinese]. Journal of Psychiatry 21, 258–260.Google Scholar
Clemmons, JC, Walsh, K, DiLillo, D, Messman-Moore, TL (2007). Unique and combined contributions of multiple child abuse types and abuse severity to adult trauma symptomatology. Child Maltreatment 12, 172–181.CrossRefGoogle ScholarPubMed
Collishaw, S, Pickles, A, Messer, J, Rutter, M, Shearer, C, Maughan, B (2007). Resilience to adult psychopathology following childhood maltreatment: evidence from a community sample. Child Abuse and Neglect 31, 211–229.CrossRefGoogle ScholarPubMed
Comijs, HC, Beekman, AT, Smit, F, Bremmer, M, van Tilburg, T, Deeg, DJ (2007). Childhood adversity, recent life events and depression in late life. Journal of Affective Disorders 103, 243–246.CrossRefGoogle ScholarPubMed
Courtney, ME, Piliavin, I, Grogan-Kaylor, A, Nesmith, A (1998). Foster Youth Transitions to Adulthood: A Longitudinal View of Youth Leaving Care. Institute for Research on Poverty: Madison, WI.Google Scholar
Dong, M, Anda, RF, Felitti, VJ, Dube, SR, Williamson, DF, Thompson, TJ, Loo, CM, Giles, WH (2004). The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse and Neglect 28, 771–784.CrossRefGoogle ScholarPubMed
Dong, M, Anda, RF, Felitti, VJ, Williamson, DF, Dube, SR, Brown, DW, Giles, WH (2005). Childhood residential mobility and multiple health risks during adolescence and adulthood: the hidden role of adverse childhood experiences. Archives of Pediatrics and Adolescent Medicine 159, 1104–1110.CrossRefGoogle ScholarPubMed
Dube, SR, Anda, RF, Felitti, VJ, Chapman, DP, Williamson, DF, Giles, WH (2001). Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study. Journal of the American Medical Association 286, 3089–3096.CrossRefGoogle ScholarPubMed
Dube, SR, Miller, JW, Brown, DW, Giles, WH, Felitti, VJ, Dong, M, Anda, RF (2006). Adverse childhood experiences and the association with ever using alcohol and initiating alcohol use during adolescence. Journal of Adolescent Health 38, 444.e1–444.e10.CrossRefGoogle ScholarPubMed
Edwards, VJ, Holden, GW, Felitti, VJ, Anda, RF (2003). Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: results from the Adverse Childhood Experiences Study. American Journal of Psychiatry 160, 1453–1460.Google Scholar
Endicott, J, Andreasen, N, Spitzer, RL (1978). Family History Research Diagnostic Criteria. Biometrics Research, New York State Psychiatric Institute: New York.Google Scholar
Fergusson, DM, Horwood, LJ, Lynskey, MT (1996). Childhood sexual abuse and psychiatric disorder in young adulthood: II. Psychiatric outcomes of childhood sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry 35, 1365–1374.Google Scholar
Finkelhor, D, Ormrod, RK, Turner, HA (2007). Poly-victimization: a neglected component in child victimization. Child Abuse and Neglect 31, 7–26.CrossRefGoogle ScholarPubMed
Fristad, MA, Jedel, R, Weller, RA, Weller, EB (1993). Psychosocial functioning in children after the death of a parent. American Journal of Psychiatry 150, 511–513.Google Scholar
Green, JG, McLaughlin, KA, Berglund, PA, Gruber, MJ, Sampson, NA, Zaslavsky, AM, Kessler, RC (2010). Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. Archives of General Psychiatry 67, 113–123.CrossRefGoogle ScholarPubMed
Hardt, J, Rutter, M (2004). Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. Journal of Child Psychology and Psychiatry 45, 260–273.CrossRefGoogle ScholarPubMed
Heeringa, SG, Wells, JE, Hubbard, F, Mneimneh, ZN, Chiu, WT, Sampson, NA, Berglund, PA (2008). Sample designs and sampling procedures. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 14–32. Cambridge University Press: New York.Google Scholar
Hesketh, T, Hong, ZS, Lynch, MA (2000). Child abuse in China: the views and experiences of child health professionals. Child Abuse and Neglect 24, 867–872.CrossRefGoogle Scholar
Hetherington, EM, Stanley-Hagan, M (1999). The adjustment of children with divorced parents: a risk and resiliency perspective. Journal of Child Psychology and Psychiatry 40, 129–140.Google Scholar
Horwitz, AV, Widom, CS, McLaughlin, J, White, HR (2001). The impact of childhood abuse and neglect on adult mental health: a prospective study. Journal of Health and Social Behavior 42, 184–201.Google Scholar
Huang, YQ, Liu, ZR, Zhang, MY, Shen, YC, Tsang, A, He, YL, Lee, S (2008). Mental disorders and service use in China. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 447–473. Cambridge University Press: New York.Google Scholar
Kendler, KS, Kuhn, JW, Vittum, J, Prescott, CA, Riley, B (2005). The interaction of stressful life events and a serotonin transporter polymorphism in the prediction of episodes of major depression. Archives of General Psychiatry 62, 529–535.CrossRefGoogle Scholar
Kendler, KS, Silberg, JL, Neale, MC, Kessler, RC, Heath, AC, Eaves, LJ (1991). The family history method: whose psychiatric history is measured? American Journal of Psychiatry 148, 1501–1504.Google Scholar
Kessler, RC, Berglund, P, Chiu, WT, Demler, O, Heeringa, S, Hiripi, E, Jin, R, Pennell, BE, Walters, EE, Zaslavsky, A, Zheng, H (2004). The US National Comorbidity Survey Replication (NCS-R): design and field procedures. International Journal of Methods in Psychiatric Research 13, 69–92.CrossRefGoogle ScholarPubMed
Kessler, RC, Davis, CG, Kendler, KS (1997). Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychological Medicine 27, 1101–1119.CrossRefGoogle ScholarPubMed
Kessler, RC, McGonagle, KA, Zhao, S, Nelson, CB, Hughes, M, Eshleman, S, Wittchen, HU, Kendler, KS (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry 51, 8–19.CrossRefGoogle ScholarPubMed
Kessler, RC, Üstün, TB (2004). The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93–121.Google Scholar
Kim, DH, Kim, KI, Park, YC, Zhang, LD, Lu, MK, Li, D (2000). Children's experience of violence in China and Korea: a transcultural study. Child Abuse and Neglect 24, 1163–1173.CrossRefGoogle Scholar
Knauper, B, Cannell, CF, Schwarz, N, Bruce, ML, Kessler, RC (1999). Improving the accuracy of major depression age of onset reports in the US National Comorbidity Survey. International Journal of Methods in Psychiatric Research 8, 39–48.Google Scholar
Lee, S, Tsang, A, Zhang, MY, Huang, YQ, He, YL, Liu, ZR, Shen, YC, Kessler, RC (2007). Lifetime prevalence and inter-cohort variation in DSM-IV disorders in metropolitan China. Psychological Medicine 37, 61–71.CrossRefGoogle ScholarPubMed
Luo, Y, Parish, WL, Laumann, EO (2008). A population-based study of childhood sexual contact in China: prevalence and long-term consequences. Child Abuse and Neglect 32, 721–731.Google Scholar
McLaughlin, KA, Green, JG, Gruber, MJ, Sampson, NA, Zaslavsky, AM, Kessler, RC (2009). Childhood adversities and adult psychopathology in the National Comorbidity Survey Replication (NCS-R) III: Associations with functional impairment related to DSM-IV disorders. Psychological Medicine. Published online: 7 September 2009. doi:10.1017/S0033291709991115.Google ScholarPubMed
McMahon, SD, Grant, KE, Compas, BE, Thurm, AE, Ey, S (2003). Stress and psychopathology in children and adolescents: is there evidence of specificity? Journal of Child Psychology and Psychiatry 44, 107–133.Google Scholar
Molnar, BE, Buka, SL, Kessler, RC (2001). Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey. American Journal of Public Health 91, 753–760.Google Scholar
Mullen, PE, Martin, JL, Anderson, JC, Romasn, SE, Herbison, GP (1996). The long-term impact of the physical, emotional, and sexual abuse of children: a community study. Child Abuse and Neglect 20, 7–21.CrossRefGoogle ScholarPubMed
Ney, P, Fung, T, Wickett, A (1994). The worst combinations of child abuse and neglect. Child Abuse and Neglect 18, 705–715.Google Scholar
Northridge, ME (1995). Public health methods – attributable risk as a link between causality and public health action. American Journal of Public Health 85, 1202–1204.Google Scholar
Pennell, BE, Mneimneh, ZN, Bowers, A, Chardoul, S, Wells, JE, Viana, MC, Dinkelmann, K, Gebler, N, Florescu, S, He, Y, Huang, Y, Tomov, T, Vilagut, G (2008). Implementation of the World Mental Health Surveys. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 33–57. Cambridge University Press: New York.Google Scholar
Qiao, PD, Chan, YC (2005). Child abuse in China: a yet-to-be-acknowledged ‘social problem’ in the Chinese mainland. Child and Family Social Work 10, 21–27.Google Scholar
Schilling, EA, Aseltine, RH, Gore, S (2008). The impact of cumulative childhood adversity on young adult mental health: measures, models, and interpretations. Social Science and Medicine 66, 1140–1151.Google Scholar
Shanahan, L, Copeland, W, Costello, EJ, Angold, A (2008). Specificity of putative psychosocial risk factors for psychiatric disorders in children and adolescents. Journal of Child Psychology and Psychiatry 49, 34–42.CrossRefGoogle ScholarPubMed
Shen, YC, Zhang, MY, Huang, YQ, He, YL, Liu, ZR, Cheng, H, Tsang, A, Lee, S, Kessler, RC (2006). Twelve-month prevalence, severity, and unmet need for treatment of mental disorders in metropolitan China. Psychological Medicine 36, 257–267.Google Scholar
Simon, GE, VonKorff, M (1995). Recall of psychiatric history in cross-sectional surveys: implications for epidemiologic research. Epidemiologic Reviews 17, 221–227.CrossRefGoogle ScholarPubMed
Straus, MA (1979). Measuring intrafamily conflict and violence: the Conflict Tactics (CT) scales. Journal of Marriage and Family 41, 75–88.Google Scholar
SUDAAN (2002). SUDAAN: Professional Software for Survey Data Analysis [Computer Program]. Version 8.0.1. Research Triangle Institute: Research Triangle Park, NC.Google Scholar
Sun, YP, Duan, YP, Sun, DF, Yi, MJ, Gao, FG, Wang, J (2005). Study on the risk factors and characteristics on childhood sexual abuse among female students in a college [in Chinese]. Chinese Journal of Epidemiology 26, 947–950.Google Scholar
Tennant, C, Bebbington, P, Hurry, J (1980). Parental death in childhood and risk of adult depressive disorders: a review. Psychological Medicine 10, 289–299.CrossRefGoogle ScholarPubMed
Wark, MJ, Kruczek, T, Boley, A (2003). Emotional neglect and family structure: impact on student functioning. Child Abuse and Neglect 27, 1033–1043.Google Scholar
Willett, JB, Singer, JD (1993). Investigating onset, cessation, relapse, and recovery: why you should, and how you can, use discrete-time survival analysis to examine event occurrence. Journal of Consulting and Clinical Psychology 61, 952–965.CrossRefGoogle ScholarPubMed
Wolter, KM (1985). Introduction to Variance Estimation. Springer-Verlag: New York.Google Scholar
Wong, WC, Leung, PW, Tang, CS, Chen, WQ, Lee, A, Ling, DC (2009). To unfold a hidden epidemic: prevalence of child maltreatment and its health implications among high school students in Guangzhou, China. Child Abuse and Neglect 33, 441–450.CrossRefGoogle ScholarPubMed
Xie, ZJ, Tang, QP, Chang, XL, Deng, YL (2008). 457 college students' experience of psychological abuse and neglect in childhood and mental health [in Chinese]. Chinese Journal of Clinical Psychology 16, 63–65.Google Scholar
Xu, CG, Jiao, ZA, Cao, WS, Yu, HH (2007). Relationship of depressive disorder and childhood maltreated experiences [in Chinese]. Journal of Psychiatry 20, 147–149.Google Scholar
Zeng, Y, Wu, D (1997). Changes in the divorce rate and age distribution in China since the 1980s. Social Sciences in China 18, 106–112.Google Scholar
Zhu, XH, Li, J, Liang, GL, Wei, XY (2006 a). Mental health and alexithymia of technical school student abused in childhood [in Chinese]. Chinese Mental Health Journal 20, 643–645.Google Scholar
Zhu, XH, Liang, GL, Li, J, Wei, XY, Tian, YX (2006 b). Effect of childhood abuse on attitude of committing suicide and suicide ideation [in Chinese]. Chinese Mental Health Journal 20, 462–464.Google Scholar