Relationship of psychopathological symptoms in adulthood with childhood trauma: A network analysis

WHO (1999) defines child abuse as any action or inaction that violates the rights of the child, endangers his or her optimum health, survival or development. According to a more detailed definition based on social rules and professional people's opinions, child abuse and neglect is considered as all of the actions and inactions directed to the child by an adult such as a parent or caregiver, which are considered as inappropriate or damaging and also these actions and inactions prevent or restrict the child's development (Taner & Gökler, 2004). Such kind of violence, abuse and neglect that experienced in childhood may have serious and stable effects on mental health (UNICEF, 2010). Network analysis focuses on the symptoms that constitute psychological disorders, based on the view that psychological disorders are different from medical illnesses. For this reason, it defends the view that the most important symptom(s) that make up the psychopathology network should be identified and intervened directly. In this study, only child abuse and neglect was considered within the scope of childhood traumas and the relationship between childhood traumas and psychological symptoms in adulthood was examined using the psychological network analysis method. In this study participants were the patients with childhood trauma history applied to psychiatry policlinics of Aydın Public Hospital and Traning & Research Hospital of Aydın Adnan Menderes University Faculty of Medicine for examination and treatment. 184 participants (Mean Age: 27.80 ∓ 10.50, 79% female) agreed to fullfill a demographic form that contain general information about patients and their parents, Childhood Trauma Questionaire that evaluate five kinds of childhood trauma (Physical, emotional, sexual abuse; physical and emotional neglect), and Symptom Check List include 10 psychological symptom clusters (depression, anxiety, phobic anxiety, somatization, obsessive-compulsive symptoms, anger-hostility, interpersonal sensitivity, paranoid ideation, psychoticism, eating-sleeping disorders). Collected data was recorded by using SPSS. Network analysis was conducted by using R statistics and R packages. The gathered data were analysed in three stages. In the first stage, a general network was formed that included 10 sets of psychological symptoms and 5 types of childhood trauma. In the second stage, the shortest paths between the types of childhood traumas and psychological symptoms in the formed network were examined and the order of the trauma types in interaction with the symptoms was examined. In the third stage, networks containing individual items in symptom sets were formed for symptom clusters. Considering the types of traumas, it was found that emotional abuse and sexual abuse were directly related to psychological symptoms. Physical abuse, emotional neglect and physical neglect, which are types of traumas, were found to be associated with psychological symptoms by the way of emotional abuse. In addition to the network analysis, canonical correlation analysis confirms a meaningful relationship between childhood trauma and adulthood psychopatology. Canonical correlation analysis also revealed that emotional and sexual abuse are the most effective traumas among childhood traumas. When the concentration network, which includes all symptom clusters, was examined, it was understood that depression, anxiety and psychoticism were central symptoms in those who experienced childhood trauma. A concentration and a Bayesian network was formed to understand the importance of depression symptoms. In the network of depression symptoms, pessimism was found to be the most central symptom. When the Bayesian network created for the depression symptom cluster was examined, it was found that pessimistic thoughts was driving force on the network. Furthermore, somatization symptoms were found to be an important symptom that connects childhood trauma to psychological symptoms. So, it is thought that treating these symptoms may reduce the symptom interaction in the network and diminish severity of psychopathology. This study may lead to the widespread use of psychological network analysis as a new statistical research method in the future by making it known in our country as well. KEY WORDS: Childhood Trauma, Child Abuse, Child Neglect, Trauma, Network Analysis.