Negative events in childhood are significant risk for developing most mental health problems, including psychosis.(1,2)
As we moved from the theorem of the psychoanalysts to that of the neuroscientists neither extreme has always treated the impact of negative childhood events with the seriousness they deserve. Freud misinterpreted those subjects who reported sexual abuse as describing fantasies and abuse and child neglect was championed by the women’s movement not psychologists or psychiatrists (1).
Recent evidence(1) has identified that a wide range of psychological traumatic experiences which can predict future mental health problems; not just the now well-known psychological trauma of PTSD (2). The adversities that the child can experience can include: abuse, being ‘an unwanted pregnancy’, stress of the mother during pregnancy physical illness, parental violence, loss of parents, dysfunctional parenting, neglect, bullying – to name a few. Childhood abuse, physical or sexual, is associated with higher rates of admission to psychiatric hospital with more significant mental health challenges. Maladaptive family functioning with childhood abuse was very strongly predictive of all classes of mental health disorders.
An important factor that could predict mental health is that of wealth within a country. But which is the best predictive approach? Could it be the poorest countries in the world? Would this be the best predictive approach to those with the worst mental health? This is not the case. The better predictor lies with those countries with the greatest variation in wealth within a country. Put in another way, those Countries with the greatest differences of wealth distribution between the poorest and wealthiest, within their populations is the stronger predictor of poor mental health, than the poverty overall for that country (3).
Read and Bentall conclude, “The implications of our having finally taken seriously the causal role of childhood adversity are profound. Clinically, the first step is to ask about childhood events in order to facilitate meaningful formulations and comprehensive treatment plans. This is still not happening routinely in many services.
The most important implication is in the domain of primary prevention. George Albee put it succinctly: ‘Primary prevention research inevitably will make clear the relationship between social pathology and psychopathology and then will work to change social and political structures in the interests of social justice. It is as simple and as difficult as that!’” (1)
This information indicates that negative childhood events are not merely important but can permeate through someone’s adult life to a marked extent. In my clinical practise I have seen a number of adults, who have presented in their adulthood of varying ages with a range of mental illnesses. They have been markedly affected, with a wide variety of self awareness. As such they have been unable to cope with the consequences of their childhood adverse experiences.
1.Read J, Bentall RP. Negative childhood experiences and mental health: theoretical, clinical and primary prevention implications. The British Journal of Psychiatry. 2012; 200: 89-91.
2.Varesse F et al Childhood Adversities increase the risk of psychosis: a meta-analysis of Patient Control, Prospective- Cross-sectional Cohort Case Studies. Schizophrenia Bulletin vol.38 no 4 pp661-671,2012
3. Wilkinson and Pickett ‘The Spirit Level’. 2009