“Silent” Forms of Child Abuse Strongly Tied to Depression

Justin Karter
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Psychological abuse and childhood neglect are strongly associated with depression in adulthood, according to a meta-analysis of childhood trauma and depression published in this month’s issue of the Journal of Affective Disorders. “The findings clearly highlight the potential impact of the more ‘silent’ types of childhood maltreatment (other than physical and sexual abuse) on the development of depression,” the researchers conclude.

Recent research suggests that emotional and psychological abuse in childhood is strongly linked with the development of depression
Recent research suggests that emotional and psychological abuse in childhood is strongly linked with the development of depression

While a great deal of research has established the connection between childhood physical and sexual abuse and the development of depression, fewer studies have examined the effects of emotional and psychological abuse. Experts have hypothesized, however, that particular types of abusive childhood experiences may increase an individual’s vulnerability to specific depression symptoms.

The authors of the latest meta-analysis, led by Dr. Maria Rita Infurna of the University of Heidelberg in Germany, propose that different types of abuse may influence the development of distinct forms of depression that could benefit from individually tailored therapies.

They investigated several distinct forms of neglect, including: antipathy, hostility and rejection toward the child; neglect, failure to provide child with basic needs; physical abuse, hitting and violence directed toward the child; sexual abuse, inappropriate sexual contact by older peer or adult; and, psychological abuse, controlling and domineering parenting characterized by humiliation and terrorization.

The researchers found that some types of abuse had a particularly strong association with the development of depression. For instance, psychological abuse, such as “verbal and nonverbal acts by a close other in a position of power,” was more strongly associated with depression than any of the other forms of maltreatment. Childhood neglect, where a caretaker fails to provide for the child’s basic emotional and material needs, was also strongly related to depression.

“We should highlight here that neglect and psychological abuse likely represent the two extreme polarities of maltreatment in a child. On the one hand, neglect is the most relevant form of maltreatment “by omission”, in which the child is deprived of basic responses to his or her needs of protection, care, and love from caregivers; on the other, psychological abuse is a perfect representative of maltreatment ‘by commission,’ in which caretakers voluntarily degrade, humiliate, and terrorize their young in order to have power and control over them.”

In both instances, they add, these experiences create feelings of shame and powerlessness in the child that may result in reduced self-esteem, leading to depression in later life.

“Overall, the results of this meta-analysis point to the importance of considering several types of maltreatment experiences as risk factors for an outcome of depression with a particular focus on the more ‘silent’ forms of maltreatment such as psychological abuse and neglect.”

Another study published this month in JAMA Psychiatry found that emotional and verbal abuse are just as harmful as physical and sexual abuse and are connected with a broad range of mental health problems.  To see MIA’s coverage of this study click here →

 

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Infurna, M. R., Reichl, C., Parzer, P., Schimmenti, A., Bifulco, A., & Kaess, M. (2016). Associations between depression and specific childhood experiences of abuse and neglect: A meta-analysis. Journal of affective disorders, 190, 47-55. (Abstract)

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18 COMMENTS

  2. Again, this all seems to obvious to me as to not even need investigation. It’s sad that these folks have to work to convince the mainstream that this is true.

    Depression is the physiological reaction to being in an untenable situation that you can’t fix. It’s essentially a response to being powerless, an effort for the organism to conserve energy until such time as an attack or escape becomes available. There is nothing abnormal or unhealthy about a kid being depressed when s/he is in a situation of powerlessness – it is the obvious and actually most rational approach to take.

    That this has long-term consequences should also surprise no one. The real question is how and why the professionals have allowed this obvious conclusion to be “news.” It continues to astound me that so-called professionals can minimize this obvious causal factor and waste so much time and money exploring biological explanations that obviously explain very, very little.

    —- Steve

    • Steve,
      Remember that this is one of the reasons we come to the MIA site: to be told obvious things that we already know 🙂

      I’m just kidding – well, sort of. I actually do find it entertaining to see obvious “news” repeated week after week on MIA as if it were groundbreaking. I know that if I come to MIA after a few days away, I will see some obvious headline like, “Trauma linked to depression” which makes me laugh until I stop myself because it’s really not a laughing matter.

      I have been doing some reading on other forums where many people who only have contact with the mainstream media, NAMI, or local mental health services post. I often experience their viewpoints as “stupid” (i.e. believing they “have” so and so mental illness that is causing them to act this way, and trying to figure out the correct pill to treat it, etc.). But then I try to stop myself because if I go on thinking that way it’s presumptuous of me and I am not understanding them. I have to remind myself that these people just literally don’t know any better. They are being shoveled this misinformation by the drug companies and their minions the psychiatrists, both of whom are also pressuring and in some cases directly financing the mainstream media. Therefore it is important for MIA to have articles like this one on there, so that the these poor people can stop jumping off the mental cliff into the black hole of biological deterministic psychiatry.

      • I absolutely agree, these articles are VERY helpful in providing education to the miseducated masses. It just pisses me off that those in power to do something about it are so married to the status quo that we have to “discover” these obvious things and encounter resistance to “reeducation” from people who have a hard time believing their doctors would wittingly or unwittingly deceive them.

        I also agree it requires great patience when dealing with folks who are steeped in the “conventional wisdom.” It makes me sad, as most are decent folks just looking for answers. It is those who know better, meaning the professionals in charge of mental health institutions and agencies, who are most at fault for allowing their charges to be mis-educated due to their own lackadaisical attitudes or venal greed.

        It’s hard to know who to go after, though, because a lot of doctors are consuming the same propaganda as their patients. Where does the buck really stop?

        —– Steve

        • Steve,
          Recently I finished reading Whitaker’s new book, Psychiatry Under the Influence. The last chapter, on how cognitive biases so powerfully affect people and render them unable to see where they may be mistaken, changed my thinking somewhat. I have long attacked psychiatrists for being willfully destructive charlatans who should know better. But I think this was wrong. In most cases they are simply ignorant, poorly educated, and/or in the bottom 50% of intelligence i.e. stupid (and yes I’m in the top 50%, of course! Did you know that 90% of people think they’re above average intelligence?).

          To understand psychiatric problems developmentally and relationally takes much time and training and many psychiatrists and mental health workers never get this opportunity. I think in many cases they simply don’t know what they are missing. And they want to see themselves as doing good and as informed, so they cling to the simplistic DSM descriptions and the myth of effective drug treatments. Otherwise they would be confronted with the horribly cognitively dissonant fact that they are daily doing much more harm than good and that they suck at their job. You can see that Ronald Paes is this way: he is an intelligent and well-meaning man, but at the same time, he is essentially delusional in that he does not realize or cannot consciously accept that diagnosing and drugging do much more harm than good. I really doubt that it is willful on his part.

          Many NAMI parents are this way as well: they are naïve, simple-minded, uneducated middle class or lower class people who simply swallow the lies about diagnoses being valid and drugs being effective whole. It also protects them since they then don’t have to acknowledge their own contribution to their family member’s “disorder”, nor do they have to make real efforts to understand the terror and rage that are usually their under the distressing “symptoms”. But they don’t know this; it’s not intentional. The medical model just fits their already existing needs for simplistic answers that seemingly absolve them of “blame” and make things understandable, albeit in a way that causes massive damage over the long term to their family member’s chance of real recovery.

          • Since it’s late and I can’t fall asleep (no doubt due to some mental illness), I thought I would come up with some new potential article titles for MIA In The News:

            – Being Shot Out of a Volcano, Gored by a Bull, and Attacked by Rabid Hounds Linked to Schizophrenia Diagnosis

            – Histopsychiatrists Want to Dig Up Ancient Rulers and Retroactively Diagnose them with Mental Illnesses

            – ISIS Militants Showing Signs of Mental Illness

            – Visiting Las Vegas Increases Your Chances of Being Diagnosed Bipolar

            – Antarctica, the Land Beyond Neuroleptics.

            – Paleopsychiatrists Investigating the Prevalence of Major Depressive Disorder In Tyrannosaurs and Pterodactyls

            – More Minecraft, More ADHD: The New Epidemic, Dum Dum Dum

            – The Strange Story of I Went To Bed Normal, and Woke Up With a Mental Illness!

            Trust me, these studies are just as valid as any other study linked to on MIA.

            Anyone have any others?

            Wow, it really is late. I better stop this lest the online thought police see my crazy postings and send the Assisted Outpatient Treatment team to pick me up and gently minister to my delusions. Then again, good thing I’m doing this through TOR so they can’t easily trace me.

          • Great post! I mostly do agree, but I think there is one point that is missing from your analysis: people who haven’t done their own work on their own trauma or childhood distress are often eager to see ways to work out their issues on others on whom they can project their problems. I think a lot of psychiatrists and other MH professionals fit into this category. The absolution from guilt you so correctly observe is a big part of the appeal of this labeling system. But I can’t absolve those who grasp onto this from all responsibility – because their decision IS intentional (albeit unconscious) and they are acting out of their own interests rather than their clients’. Your description is accurate and makes their behavior more understandable, but I don’t think it makes it more excusable.

            You are, of course, correct that it is hard for someone high in the IQ department to really understand what it’s like to be in the lower 50%. I try to be compassionate, but when a person has a power OVER another person, my compassion goes first to their victim, regardless of their own limitations.

            But like I said, it’s hard to know who to be mad at. Somewhere at the top of the food chain, there are people who know EXACTLY what is happening and are very conscious and intentional about their actions. But I can’t believe that all psychiatrists are just dumb and misled. I am sure that some have heard data and arguments that counter how they have been trained, and if they are real professionals intending to help their clients, they are responsible to explore and examine this data. Not to do so makes them guilty of severe neglect, at the very least, and I don’t think it’s correct to let them off the hook just because they’re mistrained. After all, the clients’ responses can tell them what is and isn’t helping if they bother to listen, but that would mean exhibiting a humility that all too many seem unwilling to embrace.

            Thanks as always for your great and stimulating post!

            —- Steve

    • I agree. This isn’t news that is in the least revealing.

      We have a system that, after throwing the topic around for decades, hasn’t made much of a dent in curbing the abuse of kids. Having been there and caught in the wake of those experiences, I found psychiatry overlooked that abuse and the substantial impact that it had/has on my life. I was actually further abused by the very system that was “helping” me with medications and institutionalization I became the scapegoat for the very people who were abusive. It’s very sad to see that so little has changed and that still, more than anything there is more lip service dedicated to the problem than actual help. I recoil when I think about the number of school aged kids who are medicated because their abuse isn’t addressed (because they don’t have the words or are too afraid to expose it knowing it will impact their lives tremendously).
      The professionals are just puppets for the profiteers. There is no other explanation for such an incredibly inhumane way of treating human beings they are “helping”.

      • I agree, the system repeats the abusive dynamics often found in families, with clients playing the same role, only to deepen the feelings of powerlessness.

        What’s unclear to me is whether they pretend to not recognize abuse as some of us might (which is abusive in and of itself), or if some of us really have different definitions of what is and is not abusive. To me, what is obviously abusive is often denied as abuse by others, whether I’m experiencing it or witnessing it. I’ve actually seen a split with this issue, where what some call abuse others call benign. That always leaves me a bit baffled. Seems like it would be important to the cohesiveness of a community to be in agreement about this.

        • I think it has to do with whether the professionals have dealt with their own abuse issues. A lot of abusive behavior is simply accepted as “normal” in our culture. Consider this: if a parent is taking his/her kid to preschool, and they’re crying every day or pretending to be sick or begging the parents not to make them go, almost any parent would investigate and if necessary pull their kid out of that daycare setting, as it’s obviously harming their child. But a kid in Kindergarten doing the same thing is told they have to go, that school is difficult but it’s part of growing up, that they have to adjust, etc, and if they can’t, they earn a trip to the psychologist or psychiatrist and are pathologized. Yet we all know that school environments can be abusive, and are often neglectful, especially in terms of setting unreasonable expectations of children based on their development. We accept this as “normal” because we all went through it and nobody believed our cries for help and it’s uncomfortable to think about trying to confront this behemoth, so instead, we do to our kids what was done to us and the cycle continues.

          How much harder to face that your PARENTS may have mistreated you, intentionally or not, or that your needs went unmet when you were very young! And if this is true, and you personally haven’t faced it, how much EASIER is it to diagnose and prescribe a pill than to sit and listen to the helplessness of another person that reminds you of your own unresolved feelings of helplessness?

          The inability of professionals to deal with their own pain leads to them acting out those issues on their clients. The DSM facilitates this process very effectively, as it’s simple to find a label for the distress in another and to make your objec tive to WIPE OUT THE DISTRESS that is making YOU uncomfortable, rather than facing the uncertainty of recognizing that the distress may have a very real and understandable cause that reflects your own distress that you’ve been trying so very hard to avoid experiencing.

          —- Steve

          • I agree with all you say, Steve. Systemic and social abuse is, indeed, the norm, and I find that totally unacceptable.

            I think it’s pretty clear that if a person doesn’t own and address their issues, then they are most likely to project them onto others in a very negative and judgmental way. That’s what comes from not owning one’s issues/shadow, and I think this is also the norm now–which is the blatant and chronic stigma that screws up progress, clarity, and communities because nothing is real, it’s all smoke and mirror illusion, and extremely divisive rather than unifying.

            So how does one reconcile differences of perspective regarding abuse and bullying in a community of adults? There would still need to be some kind of agreement here, otherwise, you’ve just got a community of bullies and victims. I believe this is what we’re trying to ascend, from a sick society to a balanced and just one.

            There can be no harmony whatsoever if there is a split in the issue of what constitutes abuse and bullying and what is the result of someone projecting because not dealing with their issues. That’s still extremely ambiguous, and I caution anyone that judges another as projecting when calling out abuse. That is very edgy territory, and yes indeed, the norm in psychology. I call that, both, ‘victim blaming’ and gaslighting, and can really come back to haunt, in a humbling sort of way.

          • Exactly. The only legitimate measure is the impact on the client, and if it’s negative and the treatment persists, it’s abusive. I don’t really care why the perpetrator acted that way – s/he had the power and abused it to harm his/her charge. There really is no legitimate excuse.

            — Steve

          • And the real kick in the butt of it all, at least from my own experiences, is that you have to go through it to get beyond it. The distress becomes the issue instead of the signal that something is/was wrong. What has occurred is forced to remain locked inside to fester with the help of numerous medications and diagnosis that miss the mark and foster anything but recovery.
            But the system doesn’t believe in recovery so that’s a separate issue all together.
            Your comments are great and point to a need for true social and ideological change in the way we respond to and define abuse. Recognition and a calling to account the systems that perpetuate it also is long overdue.

          • Yes, my experience, too, going through it to get past it. It gets beyond tiresome.

            A new ideology or paradigm would ascend us from the perpetual systemic abuse/victim cycle because it would not be based on this dualistic power differential, but instead would inherently acknowledge the natural connection between all human beings on a continuum as opposed to ‘us vs. them.’

            I think this achievement would inherently kill the system, because it could not survive outside duality, as it is entirely based on it.

  3. It’s not news, but to be fair this was a meta analysis. The goal of that kind of paper is to come up with a pooled estimate of the association between abuse and depression from existing studies, not do something ground breaking. I see coverage of these articles as good, as I think the message really does need to be hammered home given resistance from others to accept the truth. That said, we really are at the point where we need to spend a lot of research efforts on prevention of abuse and strategies to stop intergenerational transmission.