The assessment of childhood maltreatment and its associations with affective symptoms in adulthood: Results of the German National Cohort (NAKO)

Abstract

Objectives

Childhood maltreatment affects 20–30% of the German population and is an important risk factor for physical and mental diseases in adult life. This study reports first results of the distribution of childhood maltreatment in the population-based mega cohort German National Cohort (NAKO) and estimates associations with affective symptoms in adulthood.

Methods

The Childhood Trauma Screener (CTS), a short version of the Childhood Trauma Questionnaire, was used in 83,995 adults (age: 20–72 years; 47.3% men) of NAKO. The five-item CTS assesses the severity of three types of childhood abuse and two types of childhood neglect.

Results

Overall, 21,131 participants (27.5%) reported at least one type of childhood maltreatment; 14,017 participants (18.3%) reported exactly one type and 250 participants (0.3%) reported all five types of childhood maltreatment. Small differences regarding age (mean absolute deviation around the mean (MAD)=0.47), sex (MAD = 0.07) and education (MAD = 0.82) were observed. The severity of childhood maltreatment was associated with more severe symptoms of depression (β = 0.23), anxiety (β = 0.21) and perceived stress (β = 0.23) in adulthood, validated particularly for emotional abuse and emotional neglect.

Conclusions

The distribution of childhood maltreatment in NAKO is similar to previous reports. Additionally, our results suggest differential associations with psychopathological symptoms for the five types of childhood maltreatment.

Keywords:

• German National Cohort
• Childhood Trauma Screener
• depression
• anxiety
• stress

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Acknowledgements

We thank all study participants, and staff at the NAKO study centres, the data management and integration centre, and the NAKO head office who enabled the conduction of the study and made the collection of all data possible.

Statement of interest

H. J. Grabe has received travel grants and speakers honoraria from Fresenius Medical Care, Neuraxpharm, Servier and Janssen Cilag J. Deckert is the co-recipient of a grant of the Bavarian State Government to BioVariance and an investigator in a European grant to P1Vital.

Additional information

Funding

The German National Cohort (NAKO) (www.nako.de) is funded by the Federal Ministry of Education and Research (project numbers: 01ER1301A/B/C and 01ER1511D), the federal states, and the Helmholtz Association, with additional financial support from the participating universities and the participating institutes of the Leibniz Association and the Helmholtz Association. The Helmholtz Society supports the German National Cohort witin its 'Program Oriented Funding (POF) III and IV. This work was supported by the German Federal Ministry of Education and Research (BMBF) through ERA-NET NEURON, ‘SynSchiz – Linking synaptic dysfunction to disease mechanisms in schizophrenia – a multilevel investigation’ [01EW1810] to MR, through ERA-NET NEURON ‘Impact of Early life MetaBolic and psychosocial strEss on susceptibility to mental Disorders; from converging epigenetic signatures to novel targets for therapeutic intervention’ [01EW1904] to MR.