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The Effect of Childhood Adversities and Protective Factors on the Development of Child-Psychiatric Disorders and
Egon Bachler1, Alexander Frühmann2, Herbert Bachler3
1Institute for Synergetics and Psychotherapy Research, Paracelsus Medizinische Privatuniversität, Salzburg, Austria.
Insights
Childhood adversities (CAs) are linked to mental health issues in children. Psychotherapy effectively reduces psychopathological symptoms in children with high risk factors, showing that early life stressors do not determine irreversible outcomes.
Area of Science:
- Child and Adolescent Psychiatry
- Developmental Psychology
- Public Health Policy
Background:
- Childhood adversities (CAs) significantly impact families, particularly those with multiple problems (MPF), raising public health concerns.
- Understanding the interplay of risk and protective factors is crucial for addressing mental health disorders in children from MPF.
- Previous research indicates a correlation between CAs and psychopathology, but the specific impact on treatment outcomes requires further investigation.
Purpose of the Study:
- To investigate the relationship between risk factors, protective factors, and the severity of mental disorders in children.
- To examine the treatment outcomes of psychotherapy for children experiencing multiple childhood adversities.
- To compare clinical and non-clinical samples regarding psychopathological symptoms and the influence of risk and protective factors.
Main Methods:
- A comparative study design involving a clinical sample (N=1031) of children aged 4-17 undergoing family-therapeutic home-based treatment and a non-clinical sample (N=148).
- Assessment of psychopathological symptoms, childhood adversities (CAs), and protective factors in both clinical and non-clinical groups.
- Statistical analysis to determine the predictive value of risk and protective factors on psychopathological diagnoses and treatment outcomes.
Main Results:
- The clinical sample exhibited significantly higher rates of psychopathological diagnoses (95.7%) and CAs, with fewer protective factors compared to the non-clinical sample (21.6%).
- Children in the clinical group showed significant reductions in psychopathological symptoms, indicating effective treatment outcomes.
- Risk factors predicted the likelihood of psychopathological diagnosis in the non-clinical sample, while protective factors predicted its absence.
Conclusions:
- High levels of childhood adversities are strongly associated with child psychiatric symptoms, including various ICD diagnoses.
- Psychotherapy demonstrates significant effectiveness in reducing psychopathological symptoms in children with high risk factors, challenging the notion of irreversible outcomes from early life stressors.
- The findings underscore the importance of identifying risk and protective factors for targeted interventions and highlight the positive impact of psychotherapy on children's mental health outcomes.
Abstract:
Context: Families with high rates of childhood adversities (CAs) (multi problem families, MPF) have an increasing importance in public health-policy. Objective: The present study addresses the relationship between risk- and protective factors and the severity and treatment-outcome of mental disorders. Setting: Family-therapeutic home-based treatment for MPF. We examined a clinical sample (N = 1031) of children between the age of 4 to 17, and a non-clinical sample of 148 children. We hypothesized that of all children of the clinical group have a predominance of risk factors and a higher number of psychopathological symptoms. Furthermore, we hypothesized that children with a predominance of protective factors benefit stronger from psychotherapy. Main Results: In the clinical sample, most children met the criteria of a psychopathological diagnosis (95.7%, as compared to 21.6% in the non-clinical sample) and showed significant higher rates of CAs and significant less protective factors as compared to the non-clinical sample. The clinical group showed a significant reduction of psychopathological symptoms and benefited equally well from treatment. The number of risk factors was a significant predictor for a child from the non-clinical sample to meet the criteria of a psychopathological diagnosis, while the number of protective factors significantly predicted the absence thereof. Conclusion: Children and adolescents with high scores of CAs show significant associations with child psychiatric symptoms (d = 0.35; including all ICD-diagnosis such as, e.g., Asperger Syndrome, ADHD etc. with a higher rate of genetic etiology). Early life stressors, however, do not trigger an irreversible fate, as psychotherapy with young people with high numbers of risk factors does help to reduce psychopathological symptoms significantly (range of five outcome parameters: d = 0.31-0.72).
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