The aims of the present study were to explore the occurrence of childhood trauma and importantly to determine the impacts of childhood trauma on psychosocial features in a Chinese sample of young adults.
A survey was carried out in a group of 555 university students by using Childhood Trauma Questionnaire (CTQ), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Dysfunctional Attitudes Questionnaire (DAS), Eysenck Personality Questionnaire (EPQ), and Social Support Rating Scale (SSRS). The moderate-severe cut-off scores for CTQ were used to calculate the prevalence of childhood trauma, and then psychosocial features were compared between individuals with and without childhood trauma.
A proportion of 18.6% of university students had self-reported childhood trauma exposures. Subjects with childhood trauma reported higher scores of SDS, SAS, DAS, and psychoticism and neuroticism dimensions of EPQ (t=4.311–5.551, p<0.001); while lower scores of SSRS and extraversion dimension of EPQ (t=-4.061– -3.039, p<0.01). Regression analyses further revealed that scores of SAS and DAS were positively (Adjusted B=0.211–0.230, p<0.05), while scores of SSRS were negatively (Adjusted B=-0.273– -0.240, p<0.05) associated with specific CTQ scores.
Childhood trauma is still a common social and psychological problem. Individuals with childhood trauma show much more depression, anxiety, distorted cognition, personality deficits, and lower levels of social support, which may represent the social and psychological vulnerability for developing psychiatric disorders after childhood trauma experiences.
Childhood trauma is the experience of a single or multiple events by a child that is emotionally painful or distressful, which often leads to seriously lifelong damages to physical and mental health [
Over the past decades, extensive studies suggested that childhood trauma contributed to an increased risk of diverse mental disorders that continued into adulthood [
Social support can be a protective factor in maintaining mental wellbeing. Nevertheless, exposures to traumatic events during childhood are generally associated with low levels of social support in adulthood [
As listed above, prior studies have proved that childhood trauma may result in a series of deleterious outcomes of social and psychological characteristics which could be served as mediators between childhood trauma and later psychopathology. However, the majority of these studies were conducted in psychiatric patients, which raised questions concerning potential sample and selection bias. In addition, most studies were proceeded in western countries, relatively few studies have been developed to examine the association between childhood trauma and adulthood psychosocial features in Asian countries [
Hence, the aims of the present study were to explore the occurrence of childhood trauma and importantly to determine the impacts of childhood trauma on psychosocial features, including levels of anxiety and depression, personality traits, dysfunctional attitudes and social support, in a Chinese sample of young adults.
In this study, a total of 555 students (male/female, 101/454), from a local university were recruited via advertisements posted in the campus. This university is a four-year undergraduate-level normal university located in Changsha city, which has over 16,000 undergraduates. Changsha, the capital city of Hunan province, is a new first-tier city in the middle of China. Data were collected during October to November, 2011. All the participants were freshmen from different departments of the university and they responded with no direct reference to childhood trauma as a key variable. The average age of the male and female subjects were 19.2±1.75 and 19.0±2.00 years, respectively. The principal investigator obtained an approval to conduct this study. This study was approved by the ethic committee of the Second Xiangya Hospital of Central South University (2011-S049).
The investigators received the volunteers and provided them with a detailed description of the purpose and content of the present study. Students were informed that they needed to finish seven questionnaires in 45 minutes in the classroom of the university and that they were free to quit at any time. Issues of anonymity and confidentiality were discussed and consent to participate was implied by the return of a written informed consent. All participants were asked to answer the questionnaires independently and to not discuss with others. The completed questionnaires were handed in to the investigators directly.
A battery of questionnaires were administered for the needs of this study, including general information, Childhood Trauma Questionnaire (CTQ), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Dysfunctional Attitudes Scale (DAS), Eysenck Personality Questionnaire (EPQ), and Social Support Rating Scale (SSRS).
The CTQ is a 28-item retrospective self-report questionnaire designed to evaluate five types of adverse childhood experiences by five subscales: emotional neglect, emotional abuse, sexual abuse, physical neglect, and physical abuse, respectively. Individuals who score higher than the moderatesevere threshold of a subscale are treated as existence of corresponding childhood trauma experience. The cutoffs of each subscale are 1) emotional abuse ≥13, 2) emotional neglect ≥15, 3) sexual abuse ≥8, 4) physical abuse ≥10, and 5) physical neglect ≥10, which have provided good sensitivity and specificity for confirmed abuse or neglect [
Both SDS [
The DAS [
The EPQ is designed to measure personality dimensions [
The SSRS [
All statistical analyses were conducted using Statistical Package for the Social Sciences (SPSS) version 16.0 (SPSS Inc., Chicago, IL, USA). Independent two-sample t tests and chi-square tests (χ2) were respectively used to tests for the continuous variables and categorical variables between two groups. Values are given as mean±standard deviation. The level of twotailed statistical significance was set at p<0.05 for all tests. Several stepwise multiple linear regression models were used to identify and quantify the relationships of psychosocial features with CTQ scores. The stepping criteria employed for entry and removal were based on the significance level of the F-value and set at 0.05 and 0.10, respectively.
A total of 103 out of 555 university students had self-reported childhood trauma exposures, the prevalence rate was 18.6%, a proportion of 42.7% (n=44) of maltreated individuals experienced at least two forms of childhood trauma. Physical neglect (n=66, 11.9%) was the most common aspect of childhood trauma followed by emotional neglect, sexual abuse, emotional abuse, and physical abuse (
As compared with subjects without childhood trauma, individuals with adverse childhood experiences reported higher scores of SDS, SAS, DAS, and P and N dimensions of EPQ, while lower scores of E dimension of EPQ, and SSRS, including scores of objective support and utilization of social services, all p<0.05, for more details, please refer to
As listed in
The current study investigated the prevalence of childhood trauma and the impacts of childhood trauma on psychosocial features in a general population of university students. Our results indicated a high prevalence of childhood trauma in such a sample, and furthermore, we demonstrated a negative effect of childhood trauma on social and psychological development. Our findings may have potential significance for contributing to understanding the social and psychological mechanisms of early life stress.
In this study, the prevalence rate of childhood trauma was 18.6%, with five types of trauma ranged from 3.06% to 11.9%, which may suggest that childhood trauma is a common problem. However, the prevalence of five types of childhood trauma were much higher in a previous comparable Chinese study [
A second noteworthy finding of the current study was elevated levels of depression and anxiety in subjects with childhood trauma. In nonclinical community volunteers, exposure to a greater number of early life stressor events has been shown to account for significantly higher levels of self-reported depressive and anxiety symptoms [
In the present study, individuals with childhood trauma showed increased scores of DAS which suggested more dysfunctional attitudes. Cognitive theories have identified different cognitive vulnerabilities and processes hypothesized to predict the onset and/or maintenance of depression, while Beck’s theory focuses on negative schema and dysfunctional attitudes [
Moreover, this study confirmed an adverse effect of childhood trauma on personality development. Individuals subjected to childhood trauma had significantly higher EPQ-P and EPQ-N scores, but lower scores of EPQ-E. This is partially consistent with a Chinese study that showed abused adolescents had higher EPQ-P and EPQ-N scores than the control group [
Finally, the present study indicated that experiences of childhood trauma were related to decreased levels of social support, including objective support and utilization of social services. This indication is supported by a number of prior studies [
Several limitations of the present study need to be acknowledged. Firstly, although the participants were recruited from different departments of a university, our current sample might be not sufficiently representative. The limited sample size might increase the chance of sampling bias. Also, the gender imbalance in our sample might generate bias for the prevalence of childhood trauma. Secondly, demographic data, such as growth environment and family status were not collected in this study, which restricted us to explore the risk factors of developing childhood trauma. Thirdly, since the proportion of multiple trauma exposures in our sample were high, we did not investigate the effects of different types of childhood trauma on social and psychological alterations. Fourthly, this study was a cross-sectional design, which precluded causal inferences. Meanwhile, data on childhood trauma were obtained by a retrospective questionnaire, which might lead to information bias. Finally, all the questionnaires used in this study were self-rating scales, instead of structured or semistructured interviews, the outcomes might be influenced by subjectivity of participants. In this context, the present findings need to be replicated in a larger and better designed study.
In conclusion, the current study suggests that childhood trauma is still a common social and psychological problem. Individuals with childhood trauma show much more depression, anxiety, distorted cognition, personality deficits, and lower levels of social support, which may represent the social and psychological vulnerability for developing psychiatric disorders after childhood trauma experiences.
We sincerely thank the support of funds from the National Natural Science Foundation of China (81601182 to Shaojia Lu), and Key Research Project of Zhejiang Province (2015C03040 to Yi Xu).
The prevalence of childhood trauma in the present sample. The prevalence of childhood trauma in our sample was 18.6%. The prevalence of five types of childhood trauma ranked as follows, physical neglect (11.9%), emotional neglect (8.47%), sexual abuse (4.68%), emotional abuse (3.24%), and physical abuse (3.06%).
The prevalence of five types of childhood trauma in male and female students
Gender |
χ2 | p-value | ||
---|---|---|---|---|
Male | Female | |||
Total trauma, N (%) | 20 (19.8) | 83 (18.3) | 0.126 | 0.722 |
Emotional abuse | 5 (4.95) | 13 (2.86) | 1.150 | 0.284 |
Physical abuse | 3 (2.97) | 14 (3.08) | 0.004 | 0.952 |
Sexual abuse | 5 (4.95) | 21 (4.63) | 0.020 | 0.889 |
Emotional neglect | 10 (9.90) | 37 (8.15) | 0.327 | 0.568 |
Physical neglect | 13 (12.9) | 53 (11.7) | 0.113 | 0.737 |
The comparisons of social and psychological characteristics between individuals with and without childhood trauma
Childhood trauma group, N=103, mean (SD) | Non-childhood trauma group, N=452, mean (SD) | t | p-value | |
---|---|---|---|---|
SDS | 35.3 (7.68) | 31.6 (6.28) | 5.183 | 0.000 |
SAS | 32.2 (5.83) | 29.4 (5.25) | 4.650 | 0.000 |
DAS | 125.7 (25.0) | 113.3 (19.2) | 5.551 | 0.000 |
EPQ-P | 2.91 (2.10) | 2.18 (1.41) | 4.311 | 0.000 |
EPQ-E | 7.74 (3.35) | 8.71 (2.92) | -2.949 | 0.003 |
EPQ-N | 5.40 (3.45) | 3.77 (3.13) | 4.677 | 0.000 |
EPQ-L | 4.54 (2.65) | 5.48 (2.56) | -3.340 | 0.001 |
SSRS | 39.7 (9.02) | 42.7 (9.00) | -3.039 | 0.002 |
OS | 7.05 (2.01) | 7.92 (1.95) | -4.061 | 0.000 |
SS | 24.8 (8.45) | 26.2 (8.47) | -1.480 | 0.139 |
UOS | 7.83 (1.93) | 8.59 (1.73) | -3.982 | 0.000 |
DAS: dysfunctional attitudes scale, E: extraversion, EPQ: eysenck personality questionnaire, L: lie, N: neuroticism, OS: objective support, P: psychoticism, SAS: self-rating anxiety scale, SD: standard deviation, SDS: self-rating depression scale, SS: subjective support, SSRS: social support rating scale, UOS: utilization of social services
Stepwise multiple linear regressions analyses: associations of social and psychological characteristics with childhood trauma
Adjusted B | SE | t | p-value | |
---|---|---|---|---|
SAS | 0.153 | 2.370 | 0.020 | |
Physical neglect | 0.230 | |||
Adjusted R2 | 0.043 | |||
F-change | 5.617 | |||
p-value (F-change) | 0.020 | |||
DAS | 1.072 | 2.167 | 0.033 | |
Sexual abuse | 0.211 | |||
Adjusted R2 | 0.035 | |||
F-change | 4.694 | |||
p-value (F-change) | 0.033 | |||
SSRS | 0.224 | -2.853 | 0.005 | |
Emotional abuse | -0.273 | |||
Adjusted R2 | 0.065 | |||
F-change | 8.137 | |||
p-value (F-change) | 0.005 | |||
SSRS-OS | 0.051 | -2.489 | 0.014 | |
Physical neglect | -0.240 | |||
Adjusted R2 | 0.048 | |||
F-change | 6.193 | |||
p-value (F-change) | 0.014 |
DAS: dysfunctional attitudes scale, OS: objective support, SAS: Selfrating anxiety scale, SE: standard error, SSRS: social support rating scale