title: Patterns of childhood abuse and neglect as predictors of treatment outcome in inpatient psychotherapy: a typological approach.
abstract: BACKGROUND
  Childhood maltreatment is associated with the development and maintenance of mental disorders. The purpose of this naturalistic study was (a) to identify different patterns of childhood maltreatment, (b) to examine how these patterns are linked to the severity of mental disorders and (c) whether they are predictive of treatment outcome.
  
  
  METHODS
  742 adult patients of a university hospital for psychotherapy and psychosomatics were assessed at intake and discharge by standardized questionnaires assessing depression (Beck Depression Inventory, BDI) and general mental distress (Symptom Check List-90-R, SCL-90-R). Traumatic childhood experience (using the Childhood Trauma Questionnaire, CTQ) and ICD-10 diagnoses were assessed at intake.
  
  
  RESULTS
  The patients could be allocated to three different patterns of early childhood trauma experience: mild traumatization, multiple traumatization without sexual abuse and multiple traumatization with sexual abuse. The three patterns showed highly significant differences in BDI, General Severity Index (GSI) and in the number of comorbidity at intake. For both BDI and GSI a general decrease in depression and general mental distress from intake to discharge could be shown. The three patterns differed in BDI and GSI at intake and discharge, indicating lowest values for mild traumatization and highest values for multiple traumatization with sexual abuse. Patients with multiple traumatization with sexual abuse showed the least favourable outcome.
  
  
  CONCLUSIONS
  The results provide evidence that the severity of childhood traumatization is linked to the severity of mental disorders and also to the treatment outcome in inpatient psychotherapy. In the study, three different patterns of childhood traumatization (mild traumatization, multiple traumatization without sexual abuse, multiple traumatization with sexual abuse) showed differences in the severity of mental disorder and in the course of treatment within the same therapy setting.
authors.affiliation: Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Dresden, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schilling
authors.forename: Kerstin
authors.initials: K
authors.lastname: Weidner
authors.forename: Julia
authors.initials: J
authors.lastname: Schellong
authors.forename: Peter
authors.initials: P
authors.lastname: Joraschky
authors.forename: Karin
authors.initials: K
authors.lastname: Pöhlmann
mesh_terms: D000328:Adult; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D016000:Cluster Analysis; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000453:epidemiology / Q000628:therapy; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D038801:International Classification of Diseases; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D010343:Patient Admission; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome