Seeing the past in a new light: change in reports of childhood abuse and neglect before and after inpatient psychotherapy and its relevance for change in depression symptoms

ABSTRACT

Objective

As changes in mental representations have been discussed as mechanisms of change in psychotherapy, the question arises whether recollections of childhood abuse and neglect are altered as well and how they relate to symptom changes.

Method

Individuals in psychosomatic inpatient treatment (N = 488, 60.5% women) filled out the Childhood Trauma Questionnaire (CTQ) and Patient Health Questionnaire (PHQ-9). Changes in both were investigated with correlations and t-tests. Linear regression analysis was used to test whether CTQ changes predicted symptom changes. Network analysis was performed to ascertain structural connections between somatic and emotional-cognitive depression symptoms and CTQ subscales before and after treatment.

Results

After treatment (duration in days: M = 52.83, SD = 20.94), patients reported fewer depression symptoms (d = 0.84), while CTQ scores increased slightly (d = 0.11). Changes in the CTQ predicted recovery from depression symptoms in a statistically significant way (β = .133, p = .001). We did not observe changes in the overall network structure between baseline assessment and discharge.

Conclusion

The findings suggest that the evaluation of past experiences can change over multiple weeks of psychotherapy. Further, these updated mental representations, indicating a greater recognition of past adversity, may contribute to symptom relief.

Keywords:

• childhood trauma
• depression
• memory
• mental representations
• psychotherapy

Conflict of Interest Statement

The authors have no conflicts of interest to declare.

Author Contributions.

As clinic director, MEB oversaw routine data collection. The data collection and management team was led by RZ. ME and MEB developed the concept. ME (descriptive statistics, regression analysis) and LK (network analyses) conducted the statistical analyses. ME wrote the first draft of the article. LK, RZ and MEB revised it for important intellectual content. All authors have reviewed the final version of the manuscript, agree with its submission and are responsible for all aspects of the work.

Disclosure Statement

No potential conflict of interest was reported by the author(s).